Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 82: Prehab for Worriers and Warriors (How to Get Ready So the First Two Weeks Go Better)

Transcript

Episode 82: Prehab for Worriers and Warriors (How to Get Ready So the First Two Weeks Go Better) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

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  Some people go into surgery leaning more toward
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  worry. They read everything, replay every possible
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  problem, and try to think their way through the
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  whole experience before it even happens. Other
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  people lean more toward toughness. They decide
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  they will push through, stay strong, and not
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  need much help. Are you ready to get back to
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  what you love after knee replacement? The Total
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  Knee Success Podcast is your trusted guide with
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  practical tips, evidence -based strategies, and
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  no fluff. It's not personal medical advice, just
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  solid education to help you manage pain, regain
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  mobility, and get back to living the life you
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  love. Let's dive in. Welcome back to the Total
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  Knee Success Podcast. I'm Michelle. This is the
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  fourth and final episode in our four -part prehab
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  series, what to do before you have knee replacement
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  surgery. If you want to go through the full series
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  in order, start with episode 79 first. In episode
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  79, we talked about knee stiffness, range of
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  motion, swelling patterns, and the daily habits
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  that can make your knee easier to work with after
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  surgery. In episode 80, we talked about weak
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  quadriceps, activation, and strengthening. In
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  episode 81, we talked about low stamina, steps,
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  pacing, and building a more repeatable base.
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  Today we're closing the series with something
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  that can be really useful before surgery, what
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  to practice so the first two weeks go better.
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  By the end of this episode, you'll better understand
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  what to practice ahead of time so those first
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  two weeks feel more familiar. And just as a reminder,
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  this podcast is for education only. It's not
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  medical advice. Before you start, stop, or change
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  any exercise program, talk with your surgeon,
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  physician, or physical therapist so the plan
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  fits your health history, medications, and current
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  symptoms, especially if you have heart -lung
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  circulation or other medical concerns. Some people
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  go into surgery leaning more toward worry. They
• 2:03
  read everything, replay every possible problem,
• 2:05
  and try to think their way through the whole
• 2:07
  experience before it even happens. Other people
• 2:10
  lean more toward toughness. They decide they
• 2:13
  will push through, stay strong, and not need
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  much help. Most people are a mix of both. Both
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  patterns can make the first two weeks a little
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  harder. Worry can pull a person into every pain
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  spike, every awkward step, and every hard night.
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  Toughness can push a person to do too much, use
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  too little support, and treat the early phase
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  like a test. So I want to keep this episode practical.
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  There are a few specific areas to work through
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  before surgery that can make those first couple
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  of weeks go better. And there is good support
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  for getting specific before surgery, not just
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  hoping you'll figure it out as you go. I'm going
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  to stay with my same example from episodes 79
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  through 81. Megan is not a real person, but she
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  reflects what many people describe before knee
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  replacement surgery. By this point, she has already
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  worked on knee stiffness, swelling, quad activation,
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  and stamina. But as surgery gets closer, her
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  attention shifts. She is not mostly thinking
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  about one exercise anymore. She's thinking about
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  the first couple of weeks after surgery. She's
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  heard that those first couple of weeks can be
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  really hard. And that's true. But that does not
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  make them something to fear. Makes them something
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  to prepare for. How is she going to get out of
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  bed? What if the pain feels bigger than she expects?
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  What if she falls behind? What if she does too
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  much? What if she does too little? Those are
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  exactly the kinds of questions this part of prehab
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  can answer. Instead of trying to prepare for
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  everything, it helps to focus on the things that
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  are most likely to come up right away. The first
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  thing to work through is your setup. Which chair
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  are you going to use the most? Is the chair too
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  soft or too hard? Too low? What side of the bed
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  is easier? What does the path to the bathroom
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  look like? If stairs are going to be a part of
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  your life right away, what's the plan for that?
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  This is less about practicing ordinary life skills
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  and more about taking a close look at the places
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  and tasks that can become harder in the first
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  two weeks after surgery. For warriors, that cuts
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  down on unknowns. For warriors, it keeps them
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  from assuming they will just figure it out in
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  the moment. Planning is truly important here.
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  For Megan, This first kind of preparation is
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  straightforward. She checks the chair she expects
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  to use the most and realizes it's too soft and
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  it's too low to the ground. It's going to be
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  hard to stand up from. She chooses a firmer chair
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  with armrests. She looks at the bathroom setup
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  and decides she does not want to be figuring
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  all that out for the first time after surgery.
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  She thinks through the path from the bed to the
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  bathroom and where she will spend most of her
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  day in her home. Some hospitals also offer a
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  pre -op joint class, and that can support the
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  first step when it's done well. In one 2025 study,
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  people who went to that kind of class got home
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  sooner and were more likely to go straight home
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  after surgery. That doesn't mean every class
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  is perfectly useful to give you every piece of
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  information, but it supports a simple point that
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  thinking through the early setup ahead of time
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  can be very helpful. The second thing to practice
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  is the first group of exercise you're likely
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  to see after surgery. The exact plan may vary
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  by surgeon, therapist, and hospital, but the
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  early phase is usually built around a small group
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  of simple drills repeated often. That may include
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  ankle pumps, quadricep work, bending practice,
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  straightening your knee, short walks, and some
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  version of a sit to stand or transfer practice,
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  depending on your team's plan. The details may
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  change. The pattern usually does not. For warriors,
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  that makes the first exercise session less mysterious.
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  For warriors, it's a reminder that the early
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  phase is usually built on small, repeated effort,
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  not one big dramatic and harsh effort. This is
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  where prehab becomes very concrete. If you have
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  already practiced what it feels like to do quad
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  work when the muscle feels slow to respond, or
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  to bend the knee when movement is uncomfortable,
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  then those sensations are less unfamiliar following
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  surgery. A 2022 patient -specific integrated
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  education program combined preoperative education,
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  prehabilitation, in -hospital education, and
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  follow -through after discharge, and the study
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  found lower pain during hospitalization and before
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  discharge, lower anxiety during hospitalization,
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  and better patient -reported and clinician -reported
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  function. I don't take that as a proof of one
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  perfect program, but I do take it as support
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  for something really meaningful. Practice plus
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  education plus follow through can change your
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  early experience. For Megan, this changes the
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  way she looks at pre -hab. Before surgery, a
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  lot of this can feel a little abstract. People
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  don't always fully understand why it helps to
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  practice those things until after surgery. Why
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  would they do it beforehand? When they realize
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  how often they come up after they've had the
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  surgery, then it becomes meaningful to them.
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  And this is exactly why it's worth giving it
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  a chance ahead of time. She starts asking a better
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  question. What are the specific things I will
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  probably be asked to do right away? And then
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  she practices those. She works on quad activation.
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  She practices the bending and straightening within
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  what she tolerates. And she practices short standing
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  tasks. She doesn't need a perfect rehearsal.
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  She just needs enough familiarity that the first
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  couple of weeks feel less new. The third thing
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  to practice is the rhythm of the day. The first
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  two weeks are usually not about one big exercise
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  session. In fact, they never are. They are about
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  repetition, small little bits. Get up. Walk a
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  little. Do a few exercises. Sit back down. Elevate
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  your leg. Use your cold packs. Change position
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  again. Use the bathroom, walk again, rest, repeat.
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  A visible rhythm helps here. It gives warriors
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  something concrete to follow, and it can keep
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  warriors from packing too much, too soon, and
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  all in one stretch. This connects directly to
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  episode 81, building stamina before surgery.
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  It's not about proving how much you can do in
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  one day, but it is about building a more repeatable
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  base. The first two weeks after surgery work
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  the same way. They usually go better when the
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  effort is spread throughout the day instead of
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  packed into one tight stretch. That's exactly
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  when it helps to put the plan to paper. For some
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  people, when they're tired, sore, and taking
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  medication, simple things are easier to miss.
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  It can be helpful to write down the rough shape
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  of the day ahead of time. Where will you sleep?
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  Which chair will you use? Where will the walker
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  go? When will you usually do the exercises? Who's
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  helping with meals? Who's helping drive you to
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  appointments? Where will the ice packs be? Those
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  decisions are easier to make before surgery than
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  after it, when you're feeling pretty rough. For
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  Megan, this is where the first two weeks stop
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  feeling like one giant unknown. She starts to
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  see them as a series of ordinary tasks that will
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  be harder than usual, but still doable. She clears
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  the path from the bed to the bathroom. She puts
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  often used items where she can reach them easily.
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  She talks with the people around her. about the
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  help she may actually need. The fourth thing
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  to practice is how you'll respond to a hard day.
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  Worry and toughness can pull people in different
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  directions here. One person may read a difficult
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  day as a sign that something's going badly, back
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  off too much, and lose trust in the plan. Another
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  may decide that it's something to overpower and
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  respond by adding extra walking, extra exercises,
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  one more time in their feet. Both reactions can
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  pull you away from the steady middle ground that
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  people usually need in the early phase. A 2021
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  study helps explain why. In the first 10 days
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  after knee replacement, some people were up and
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  moving faster, and others were a little slower.
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  But those early differences, that little variation,
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  didn't predict who was doing better later on.
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  So the goal is not to panic over a hard day or
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  chase a great day. The goal is to stay steady.
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  pay attention, and make thoughtful adjustments
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  instead of dramatic ones. Before surgery, it
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  helps to decide what you'll do if you had a hard
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  day early on. A harder day may call for a closer
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  look at what you did, how you spaced things out,
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  and what your provider told you to expect. A
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  better day is often a good time to stay consistent
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  with the plan you already have. Having that response
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  ready can keep one day from pulling you too far
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  off course. For Megan, That means thinking through
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  what she will check if tomorrow is a harder day.
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  Did she do more the day before? Did she stack
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  too much together instead of spreading it out?
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  Did she skip the usual elevation and position
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  changes? Does she need to adjust timing of her
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  activities? Is this the kind of hard day her
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  provider told her to expect, or is this the kind
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  she was told to call them about? Having that
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  plan ahead of time keeps one harder day from
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  taking over the whole week. Now, the fifth thing
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  to practice is the follow -through plan. The
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  first two weeks usually go better when people
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  already know who's on the team, when the first
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  follow -up happens after surgery, when outpatient
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  physical therapy is expected to begin, if that's
• 11:55
  part of the plan, and what kind of help they
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  will need at home. For warriors, that cuts down
• 12:01
  on guesswork. For warriors, it makes it less
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  likely that they'll skip the support they actually
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  need and try to improvise. If anxiety is already
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  high before surgery, tell your provider. That
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  gives you a chance to ask questions, get clearer
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  answers about what to expect, and make a better
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  plan for the early days. It can also be a good
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  time to ask for a referral to prehab so you can
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  meet the physical therapist ahead of time, start
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  working with that clinic before surgery, and
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  feel more comfortable going back there afterward.
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  There is also expert support for getting outpatient
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  physical therapy lined up early after surgery.
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  This fits right into the planning piece. It helps
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  to know before surgery what the plan will be,
• 12:45
  when therapy is expected to start, and where
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  you'll be going so you're not trying to sort
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  that out once you're already home. Megan handles
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  these details before surgery. She checks when
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  the first appointments are. She knows how she's
• 12:58
  getting there. She has talked through the home
• 13:00
  setup. She has a clearer sense of who is helping
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  in the early days. She's not trying to solve
• 13:07
  all those problems after surgery. If you're getting
• 13:10
  ready for surgery, this is the work to do ahead
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  of time. Get your setup figured out, get familiar
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  with the first exercises, think through the rhythm
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  of the day, decide what you will do if you hit
• 13:21
  a harder day, and line up the follow -through
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  plan before you need it. So for Meg, in the first
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  couple of weeks, no longer feel like one big
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  unknown. She's still a little worried, and that's
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  natural. She still wants to do well, but she's
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  going into surgery with a much clearer sense
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  of what those early days are likely to ask of
• 13:40
  her and what she can do to be ready for them.
• 13:43
  If you're getting ready for a knee replacement,
• 13:45
  the next step is to download the free two -week
• 13:48
  knee replacement launch plan. It lays out the
• 13:50
  final 14 days before surgery, so you have an
• 13:53
  idea of what's important to prepare, what to
• 13:56
  expect, and how to set yourself up for a smoother
• 13:59
  first week after surgery. It also puts some of
• 14:02
  the things we talked about today in a simple
• 14:04
  checklist you can actually use. It's educational
• 14:06
  and not medical advice, and it's totally free.
• 14:10
  All you need to do is click on the link in the
• 14:12
  show notes or go to TotalKneeSuccess .com to
• 14:16
  download the free two -week launch plan. If you
• 14:20
  want more education and a clearer plan to learn
• 14:22
  about, I will be publishing a prehab book soon
• 14:25
  called The Knee Replacement Game Plan. Stay tuned,
• 14:28
  and if you want to be notified when it's ready,
• 14:30
  sign up on TotalKneeSuccess .com. If you're getting
• 14:33
  ready for a knee replacement, you will not want
• 14:36
  to miss episode 83, the Glad You Have It Guide,
• 14:40
  all about the supplies and setup you'll be happy
• 14:42
  you have when you get home after knee surgery.
• 14:46
  Thanks for joining me. I'm Michelle, and this
• 14:48
  has been the Total Knee Success podcast. This
• 14:55
  podcast is for educational purposes only. Discover
• 14:58
  more at TotalMeSuccess .com and be sure to subscribe
• 15:02
  and share because every step forward takes you
• 15:05
  closer to living the life you love.