Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 103: Hiking After Knee Replacement (How to Prepare for Hills, Uneven Ground, and Longer Distances)

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Episode 103: Hiking After Knee Replacement (How to Prepare for Hills, Uneven Ground, and Longer Distances) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

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  It climbed steadily for the first mile, crossed
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  loose gravel, included exposed roots, and came
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  back down everything it climbed. The trailhead
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  was also a long walk from the parking area. Two
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  and a half miles on that trail had very little
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  in common with the two miles that she'd been
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  doing on familiar pavement. Are you ready to
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  get back to what you love after knee replacement?
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  The Total Knee Success Podcast is your trusted
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  guide with practical tips, evidence -based strategies,
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  and no fluff. It's not personal medical advice,
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  just solid education to help you manage pain,
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  regain mobility, and get back to living the life
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  you love. Let's dive in. Welcome back to the
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  Total Knee Success Podcast. I'm Michelle. If
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  hiking is one of those activities you want to
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  return to after a knee replacement, there's good
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  reason to be optimistic. A trail can take you
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  through the woods beside a lake. Into the mountains
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  are simply somewhere more interesting than another
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  lap around the neighborhood. The key is choosing
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  a trail whose demands fit what you can do now,
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  then building toward the trails that you want
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  to do later. Carol had been walking about two
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  miles around her neighborhood several times a
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  week. when a friend invited her on a two and
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  a half mile hike. That sounded close enough.
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  Then Carol looked up the route. It climbed steadily
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  for the first mile, crossed loose gravel, included
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  exposed roots, and came back down everything
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  it climbed. The trailhead was also a long walk
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  from the parking area. Two and a half miles on
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  that trail had very little in common with the
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  two miles that she'd been doing on familiar pavement.
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  Carol is fictional, and based on situations many
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  people experience after knee replacement. This
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  is the third episode in our four -part travel
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  and outdoor activity series. We began with road
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  trips in episode 101 and flying in episode 102.
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  Episode 104 will close the series with indoor
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  and outdoor cycling after knee replacement. By
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  the end of this episode, you'll have several
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  ways to learn what a trail is like, compare it
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  with the walking you've been doing, and decide
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  what preparation might help before your first
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  outing. Hiking after knee replacement is a realistic
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  goal for many people. A 2017 randomized trial
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  in Austria followed 48 people after total knee
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  replacement. 25 took part in a guided three -month
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  hiking program two or three times a week, while
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  23 continued their usual daily activities. The
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  hiking group had moderate improvements in stair
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  descent. some knee -related quality of life measures,
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  and function, with no acute harmful effects reported
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  during the study period. In a 2025 Australian
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  study, 257 people who were one to three years
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  after total knee replacement reported on their
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  activities. Among those who had gone bushwalking
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  before surgery, 96 returned to it, an 84 % return
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  rate. Bushwalking is the Australian term commonly
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  used for hiking or walking on natural trails.
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  Those results are encouraging. They show that
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  hiking can be part of life after knee replacement,
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  while your own starting point depends on your
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  situation. Reviews of activity after knee replacement
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  give hiking more individual consideration than
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  ordinary walking because trails differ so much.
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  Experience counts too. Someone returning to familiar
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  trails may already know how to judge footing,
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  weather, and distance. Someone who's new to hiking
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  may prefer to begin with a maintained route and
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  an easy way back to the car. Strength, balance,
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  walking endurance, general health, and your surgeon's
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  guidance all help shape when and where you begin.
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  One place to begin is the route itself. Distance,
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  elevation, and terrain give you the basic picture.
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  The official website for the Park, Forest, Preserve,
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  or local trail system often lists those details.
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  A trail map or reputable trail app may add an
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  elevation profile, recent photos and reports
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  from people who've been there. Official sites
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  are also a good place to check closures, construction,
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  washouts, seasonal restrictions, parking information,
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  and current alerts. For distance, it helps to
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  check whether the number is one -way or round
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  -trip, and whether the route is an out -and -back,
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  a loop, or a point -to -point trail. An out and
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  back gives you control over the turnaround point.
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  A loop may require you to finish the entire route
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  once you pass the last shortcut. The total can
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  also include the walk from the car to the trailhead,
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  side trips to an overlook, and any distance added
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  by parking changes. Those extra pieces still
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  count to your legs. For elevation, look at total
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  elevation gain rather than only the highest elevation.
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  A trail that starts at 500 feet and reaches 1
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  ,000 feet may include one sustained 500 foot
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  climb. A rolling trail may accumulate the same
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  total gain through several smaller climbs and
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  descents. The elevation profile shows where those
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  changes occur. A steep climb near the beginning
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  may affect the rest of the outing. If most of
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  the descent comes near the end, your legs will
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  be controlling downhill steps after already covering
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  most of the route. Distance and elevation also
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  need to be considered together. 500 feet of gain
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  spread across five miles feels different from
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  500 feet packed into one mile. Numbers provide
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  part of the picture. They help you compare one
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  route with another and recognize when a short
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  trail may be physically demanding. For terrain,
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  try to read beyond the rating of easy, moderate,
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  or hard. Ratings vary among parks and trail systems.
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  Look for words such as paved, packed dirt, gravel.
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  rocky, rooted, narrow, exposed, muddy, or washed
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  out. Check whether the route includes natural
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  steps, stream crossings, side slopes, boardwalks,
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  or places where the edge drops away. Recent photos
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  and condition reports can reveal mud, fallen
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  trees, loose gravel, or damage that an older
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  description misses. Carol found recent photos
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  of the loose descent and a comment that one section
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  stayed muddy after rain. She also noticed that
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  the overlook had no bench and the trail had no
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  shortcut back to the parking lot. Now she could
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  picture the actual outing rather than relying
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  on the mileage and the word moderate. Once you
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  understand the route, compare its demands with
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  the walking you've been doing. Recent comfortable
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  walking on familiar even ground gives you information
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  about distance and general endurance. The trail
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  adds other work. Hills change the effort through
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  your legs. Uneven surfaces require ongoing adjustments
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  at your feet, ankles, knees, hips and trunk.
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  Variable step heights affect balance and control.
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  A backpack adds load. Heat, cold, wind, rain
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  and altitude can change the experience again.
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  This is where preparation becomes more specific.
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  When possible, changing one demand at a time
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  gives you a better idea of how your knee responds.
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  If your current walking is mostly flat, You might
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  try dental hills before choosing a trail with
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  a long climb. If the route includes packed dirt
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  and scattered roots, you might spend time on
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  easier natural surfaces before walking several
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  miles of them. If you plan to carry a day pack,
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  a light pack on familiar walks can show you how
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  the added weight feels. Changing distance, elevation,
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  terrain, and pack weight all at once can make
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  it difficult to know which part might have exceeded
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  your current capacity. Uphill walking requires
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  repeated work from the muscles around your hips
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  and knees. People often shorten their steps and
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  lean forward slightly as the grade increases.
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  A hill that feels comfortable for 30 seconds
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  can feel very different after several uninterrupted
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  minutes. Practicing on a gentle grade gives you
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  a better comparison than adding more flat mileage
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  alone. Downhill walking deserves its own preparation.
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  Your muscles control your body as you lower from
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  one step to the next. and the demand increases
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  as the slope becomes steeper. Research in people
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  with total knee replacement has found differences
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  in knee motion and muscle performance during
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  downhill walking. One study found that people
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  bent their knees more and the forces and demands
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  around their knees increased as the slopes became
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  steeper. Another study linked altered downhill
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  hiking patterns with deficits in both knee flexor
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  and extensor strength. That helps explain why
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  someone may reach the top of the hill and then
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  find the descent harder on their legs, even though
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  breathing feels easier. A physical therapist
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  can assess the specific demands involved and
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  may use controlled step -downs, strengthening,
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  balance activities, or graded slopes when they
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  fit the person and the stage of healing. Episode
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  99 of the Total Knee Success podcast goes further
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  into adjusting resistance, range, and speed while
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  rebuilding strength. Check it out if you're interested.
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  Uneven ground adds a second layer. Outdoors,
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  one step may land on firm dirt and the next on
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  a root, a tilted rock, loose gravel, or even
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  mud. A side slope keeps one foot higher than
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  the other and changes the positions of the ankles,
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  knees, hips, and pelvis. Natural steps vary in
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  height. These surfaces require you to keep adjusting
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  your foot placement and body position while continuing
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  forward. An easier place to start might be a
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  maintained dirt path, grass, a gentle slope,
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  or a short section of uneven ground near an easy
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  exit. These surfaces can bridge the gap between
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  pavement and a longer trail. Footwear should
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  fit the route and already feel familiar. A hiking
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  shoe or boot with secure fit and usable tread
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  may improve traction compared with worn walking
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  shoes. A heavier or stiffer boot can increase
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  fatigue or change how you walk. Wearing the footwear
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  on shorter walks first gives you a chance to
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  check the tread, heel fit, pressure points, and
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  room around your toes, especially if swelling
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  in your operated leg or foot changes the fit
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  during the day. Trekking poles can be helpful
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  and are optional. Research suggests they can
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  reduce some lower extremity forces during downhill
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  walking, although they also increase upper body
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  work and overall energy use. If you plan to use
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  them, practice on familiar ground and gentle
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  slopes so the pole placement and rhythm feel
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  comfortable before the first trail. Pole length
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  and technique affect how they work. A physical
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  therapist can help you compare poles, a cane,
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  or another device when that choice affects balance
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  or safety. After Carol researched the original
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  trail, she chose a shorter maintained route for
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  her first outing. It was an out -and -back trail
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  with packed dirt, gentle elevation, reliable
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  signs, and a small overlook less than a mile
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  from the trailhead. She practiced on neighborhood
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  hills, walked a local dirt path, worked on downhill
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  control, and used her trekking poles on familiar
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  ground before taking them with her. Carol also
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  made a plan for the day. She checked the forecast
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  for the trail area and reviewed current alerts
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  before leaving. Rain can create mud and slick
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  roots. Heat increases fluid needs and fatigue.
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  Cold can make stops less comfortable. Wind can
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  affect balance on exposed sections. A route that
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  fit yesterday may be a poor choice today after
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  the surface changes. Knowing there are likely
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  no changes in trail condition can give you confidence
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  in your plan. Carol packed water identification,
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  a charged phone, necessary medication and supplies
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  for the route. She kept the pack light and close
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  to her body to limit swinging as she walked,
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  and she told a family member where she and her
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  friend were going when they expected to return.
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  Cell coverage and the way to contact park or
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  local emergency services are other details to
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  consider, especially on a more remote trail.
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  Before they started, Carol and her friend agreed
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  that the overlook was their likely turnaround
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  point. On an out -and -back trail, the turnaround
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  point is halfway. It can help to consider whether
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  the return includes more downhill work, direct
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  sun, or fewer places to pause. Repeated toe catching,
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  a growing limp, increasing reliance on the poles,
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  increasing pain or a sense that balance is fading
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  may be reasons to shorten the outing. During
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  the hike, Carol paid attention to whether discomfort
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  stayed around the same level or continued to
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  build. Pain that continues to increase, repeated
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  instability or progressive changes in walking
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  could indicate that the combination of distance,
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  elevation, terrain, pace or load is too high
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  for that day. Sudden chart pain, a fall, inability
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  to bear weight, or a new sense that your knee
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  will not support you requires a safe exit and
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  medical guidance. She also monitored how her
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  knee responded later that day and the following
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  morning. That response helped her judge how well
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  the combination of distance, elevation, terrain,
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  pace, and pack weight fit her current capacity.
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  Some muscle fatigue or a temporary stiff knee
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  may follow a new challenge. A marked increase
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  in swelling, loss of motion, worsening pain or
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  altered walking that continues into the next
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  day could indicate that the outing was too much.
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  If you can, changing one variable for the next
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  hike can make the response easier to interpret.
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  You might keep the terrain and reduce the distance.
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  Keep the distance and choose less elevation.
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  Lighten the pack or slow the pace. Remember that
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  persistent pain, swelling, repeated buckling
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  or declining walking ability deserves a medical
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  evaluation, a fall with injury, sudden inability
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  to bear weight, or other serious new symptoms
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  need prompt medical attention. Carol and her
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  friend reached the smaller overlook, stayed for
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  a few minutes, and turned back while her walking
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  still felt steady. The next day, her knee felt
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  a little stiff for part of the morning and then
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  returned to its recent pattern. She repeated
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  that route before adding a little distance. The
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  original two and a half mile trail stayed on
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  her list and she now knew exactly what she was
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  preparing for. Carol's experience is an example
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  of how this can come together. She learned what
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  the route involved, compared it with what she
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  had been doing, prepared for the hills and surface,
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  chose an easier first outing and monitored her
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  response. Your process may look similar or different
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  and those pieces give you the information you
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  can use to make your own call. I linked optional
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  examples of hiking shoes, trekking poles, and
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  some lightweight packs in the show notes. Some
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  are affiliate links, which means I may earn a
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  commission if you purchase through them. Thank
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  you. If walking still feels uneven or requires
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  more attention than you expected, walking like
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  yourself again after knee replacement can help
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  you understand what may be affecting your gait
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  and identify the next questions or skills to
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  work on. The paperback and Kindle links are also
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  in the show notes. Getting back outside can be
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  one of the best parts of building the life you
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  want after knee replacement. Choose a trail that
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  fits today. Keep the bigger ones on your list
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  and enjoy seeing what is around the next bend.
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  In episode 104, we'll complete our travel and
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  outdoor activity series with getting back on
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  a bicycle after knee replacement. We'll compare
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  stationary and outdoor cycling, discuss knee
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  bend and seat height, and look at mounting, stopping,
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  balance, resistance, hills, and the additional
• 15:52
  skills involved in returning to the road or trail.
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  Thanks for joining me. I'm Michelle and this
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  has been the Total Knee Success podcast. This
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  podcast is for educational purposes only. Discover
• 16:07
  more at TotalKneeSuccess .com and be sure to
• 16:11
  subscribe and share because every step forward
• 16:14
  takes you closer to living the life you love.