Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 117: Six Months After Knee Replacement: What to Work on Next (Strength, Walking, and the Activities You Want Back)

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Episode 117: Six Months After Knee Replacement: What to Work on Next (Strength, Walking, and the Activities You Want Back) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

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  A short rocky trail may be much more demanding
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  than a longer, smoother path. A maintained trail
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  with firm footing and an easy way back may fit
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  an earlier outing better. Hiking itself can also
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  help you get better at hiking. Are you ready
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  to 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. Around
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  six months after knee replacement, you may be
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  doing much more than you could before the operation.
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  You may also have a few activities you'd still
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  like to get back to. Maybe a longer outing wears
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  you out. The path you'd like to hike feels too
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  challenging. or getting down on the floor with
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  a grandchild seems difficult. What you work on
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  next can be connected to those activities. This
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  is the first episode in our series protecting
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  your progress for the long term. By the end of
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  this episode, you'll have a better idea of what
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  can still be improved around six months after
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  knee replacement, how to recognize what may be
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  holding you back, and why continuing to challenge
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  yourself appropriately is part of making progress.
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  Six months is one point along the way. Your body
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  can continue responding to exercise and practice
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  well beyond that point. Muscles can become stronger,
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  endurance can improve, and movements can become
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  more familiar with continued work. That ability
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  to adapt is one of the remarkable things about
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  the human body. Regular activity helps you maintain
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  your abilities, and an appropriate challenge
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  encourages further improvement. Use it or lose
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  it is a familiar reminder to keep using those
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  abilities. A 2025 research review of exercise
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  programs during the later stages after knee replacement
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  found improvements in abilities such as standing
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  from a chair and climbing stairs. That's encouraging
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  when you're six months out and wondering whether
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  continuing to exercise can still help. That takes
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  effort, including at six months. An exercise
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  that was demanding earlier may now be easy. Your
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  usual walk may keep you comfortable with that
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  distance while leaving you unprepared. for a
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  much longer outing. Your therapist can help you
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  progress the challenge safely with guidance that
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  fits your health and your surgical instructions.
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  Another thing worth checking at six months is
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  how you're walking. You may still be limping
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  or favoring one leg even as your strength improves.
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  Improving strength doesn't always correct an
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  established walking pattern. Your physical therapist
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  can assess how you're walking and help you work
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  on the specific movements that need attention.
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  For reminders about what to notice in your steps,
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  my free top 10 walking tips download is linked
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  in the show notes. It's easy to get the free
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  download as you work toward walking and feeling
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  more like yourself. Now let's look at how a different
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  limitation can show up during an activity you
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  enjoy. Let's start with an afternoon out. David
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  is fictional and he's about six months past his
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  right knee replacement. He and his daughter enjoy
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  visiting a museum together. Early in the visit,
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  his walking feels comfortable. After a few hours
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  of walking and standing, his steps get shorter
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  and he starts looking for somewhere to sit. For
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  someone like David, endurance may need more work.
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  Endurance is your ability to keep doing an activity
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  over time. It involves your muscles as well as
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  your heart and lungs. Walking through your home
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  takes a brief effort. Walking from a parking
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  lot, standing in exhibits, and then getting back
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  to the car can keep you on your feet for much
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  longer. If this sounds familiar, gradually building
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  endurance can be a specific goal in your plan.
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  Your physical therapist or trainer can help select
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  a suitable activity and decide how it should
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  progress. What you can do now, other health conditions,
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  and how you feel during and after activity all
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  influence that progression. One way to build
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  endurance for a longer outing is to practice
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  spending more time on your feet. Doing the activity
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  that you want to improve and gradually building
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  up how much you do can be a part of your training.
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  Now imagine that the outing goes well until you
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  sit on a low bench, your knee feels stiff when
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  you stand, and you need your arms to push yourself
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  up. A low seat requires more hip and knee bending,
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  and your legs have farther to lift your body.
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  The muscles along the front of your thighs, your
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  quadriceps, help straighten your knees as you
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  rise. If bending is uncomfortable or those muscles
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  have difficulty lifting you, getting up can remain
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  challenging even when level walking feels comfortable.
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  Walking around the house and standing from a
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  low seat place different demands on your legs.
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  Your therapist can check whether you need more
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  strength, more comfortable knee movement, or
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  changes in how you're using your legs. Building
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  more leg strength can also give you a reserve
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  to draw on. That way, even when your muscles
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  are tired after a long outing, you may still
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  have enough strength to get up from a chair quite
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  easily. A 2022 research review compared quadricep
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  strength before and after knee replacement. Strength
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  was substantially reduced soon after the operation
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  and improved over the following months, with
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  considerable variation between studies. Early
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  on, swelling and changes in muscle activation
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  can make it harder to tighten your thigh fully.
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  Reduced activity can also lead to loss of muscle
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  size. Your muscles may need continued strengthening
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  after your knee pain has improved. If reduced
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  strength is limiting chairs or stairs, progressive
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  strengthening is something you can work on. Progressive
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  means the challenge is adjusted as your muscles
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  become stronger. Your therapist can assess which
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  muscles need work and whether your current exercises
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  provide enough resistance. The goal is to build
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  the strength the activity requires within a program
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  that's safe for you. On stairs, your legs lift
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  you going up and control your lowering coming
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  down. The lowering takes muscle work too. In
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  a study of people six months after one knee replacement,
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  greater quadriceps strength on the surgical side
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  was associated with faster stair performance.
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  If stairs remain difficult, listen to episode
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  14, Mastering Stairs After Knee Replacement,
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  and episode 115, Curbs and Stairs After Knee
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  Replacement, for more guidance on stair climbing,
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  curbs, and support options. A railing can remain
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  useful while you work on strength and control.
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  For another person, the next goal might be a
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  hike. You can walk a comfortable distance on
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  pavement, but when you reach a trail with roots,
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  stones, or sideways slope, you feel less steady.
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  Your feet land at different heights and angles,
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  and you need to adjust your body as you transfer
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  weight from one leg to the other. That may call
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  for balance and coordination practice along with
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  whatever strength or motion work your assessment
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  identifies. The latest clinical practice guidelines
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  for physical therapists published in 2026 recommend
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  balance training and walking exercises after
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  knee replacement. Practice can be chosen to prepare
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  you for changes in direction and ground conditions.
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  with the support and supervision that work for
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  you. One suggestion for planning a hike is to
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  check the surface and elevation as well as the
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  mileage. A short rocky trail may be much more
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  demanding than a longer, smoother path. A maintained
• 7:23
  trail with firm footing and an easy way back
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  may fit an earlier outing better. Hiking itself
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  can also help you get better at hiking. You might
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  start with a shorter distance on a manageable
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  trail, then gradually increase the distance or
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  difficulty as you build your ability. For more
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  on choosing a trail, preparing for hills, and
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  building toward longer distances, take a listen
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  to episode 103, Hiking After Knee Replacement.
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  Maybe your goal is closer to home, sitting on
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  the floor of the grandchild, gardening at ground
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  level, or joining an exercise class that uses
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  mats on the floor. You may walk well and still
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  be unsure how to lower yourself to the floor
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  or stand again. Those movements involve a sequence
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  you may have had little reason to practice for
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  several years. Your legs and arms need to support
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  you as you change positions and your balance
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  and available knee bending affect which positions
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  are comfortable. Kneeling sensitivity may also
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  influence the technique. General strengthening
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  can help prepare you while practicing an appropriate
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  floor transfer technique teaches the movement
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  itself. For gardening, a raised bed or stable
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  garden seat may let you enjoy the activity while
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  you work on floor level skills. Listen to episode
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  97, getting back to gardening after knee replacement,
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  for more on gardening positions, tools carrying,
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  and gradually returning to the work you enjoy.
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  For time with a grandchild, a supported position
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  can fit better than the middle of an open room.
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  Before going down to the floor, have a plan for
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  getting back up. A physical therapist can help
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  you choose a supported technique and practice
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  the parts that are appropriate for you. Listen
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  to episode 96, getting down on the floor and
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  back up again. for kneeling -based, non -kneeling,
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  and supported approaches. For more about kneeling
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  itself, listen to Episode 93, Why is Kneeling
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  So Difficult After Knee Replacement? It can help
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  you prepare which technique fits your body and
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  the activity you have in mind. If outdoor cycling
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  is one of your goals, you can build your endurance
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  on a stationary bike by gradually increasing
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  how long you pedal. When you're ready to ride
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  outdoors, start with shorter rides on a familiar,
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  manageable path and gradually build your distance.
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  Getting on and off the bicycle, stopping, and
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  putting a foot down steadily are also skills
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  worth practicing. For more on building up your
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  rides and bike setup, listen to episode 104,
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  Getting Back on a Bicycle After Knee Replacement.
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  And remember, this podcast provides general education.
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  Follow your surgeon's and physical therapist's
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  instructions for your own exercise, activity,
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  and progression. If you've finished physical
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  therapy, you can ask for a reassessment of an
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  activity that remains difficult. Talk to your
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  physical therapist about the specific activities
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  you're still finding challenging. That gives
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  your therapist a starting point for evaluating
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  what might be limiting you and helping you update
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  your plan. Improvement takes effort, and your
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  program can grow with you. As you get stronger
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  or can stay active longer, the amount of challenge
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  may need to increase. Your therapist can help
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  distinguish the effort of training from symptoms
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  that call for a change. New or increasing knee
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  pain, repeated giving way, or increasing swelling
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  needs a medical review. A hot swollen knee with
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  fever or a sudden inability to bear weight warrants
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  more urgent assessment. Notice progress in the
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  activity you're practicing. You might need less
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  help getting up, feel steadier on the same section
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  of path, or finish a familiar outing with more
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  energy. Comparing similar conditions makes a
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  change easier to recognize. You can keep working
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  toward more of the activities you enjoy beyond
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  six months after knee replacement. Choose an
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  activity, find out what's limiting it, and give
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  that ability some focused practice with appropriate
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  guidance. Progress may be gradual, and it can
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  be worth the work. My book, Walking Like Yourself
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  Again After Knee Replacement, goes deeper into
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  the strength, knee movement, balance, and coordination
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  involved in walking. You'll find the link in
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  the show notes. In episode 118, exercise after
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  knee replacement, building a long -term routine,
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  we'll look at keeping that work going. Thanks
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  for joining me. I'm Michelle and this has been
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  the Total Knee Success podcast. This podcast
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  is for educational purposes only. Discover more
• 11:46
  at TotalKneeSuccess .com and be sure to subscribe
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  and share because every step forward takes you
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  closer to living the life you love.