Hip & Knee Pain and Surgery

Been told you need knee surgery?

If you have been told that you need knee surgery, try physical therapy first. Physical therapy may eliminate the need for surgery if you respond well to treatment. If your knee pain is due to a soft tissue injury, physical therapy may do wonders for you. However, if your doctor has told you that you need a total knee replacement (TKR for short), physical therapy before and after surgery can help speed the healing process along after surgery. If all conservative therapy and treatments have been unsuccessful and need surgery, you may wonder what life will be like after the surgery.

Been told you need hip surgery?

If you’ve been suffering from hip pain, have a condition such as arthritis, you may not need hip surgery. Conservative treatments such as physical therapy can be extremely effective for decreasing pain and increasing function for conditions such as arthritis, bursitis, tendonitis, or labral tears. However, if all conservative treatments have been ruled out and you’ve been told that you need surgery, this article will cover the pre-op and post-op procedures.

Some questions you might be having:

There are so many questions that are probably going through your head. Will the surgery help alleviate your pain? Will you still have hip or knee pain? What will the recovery time be like? Having all of those questions is entirely normal! At Forward Motion Physical Therapy, we want to help quell any fears and answer any questions you might have about your upcoming hip or knee surgery.

Preparing for the Surgery:

1. Stop smoking. If you smoke, stop smoking for 4-6 weeks leading up to your surgery to increase oxygen levels, reduce the risk of blood clots, reduce your risk of infection, and help speed up the healing process. It is easier said than done. Quitting smoking before surgery can help speed up recovery times and is highly recommended. Talk to your doctor to get some tips and help with quitting smoking if you need some support!
2. Eat healthily! Start eating a healthier and more nutritious diet. Eating a more plant-based diet, getting more fiber, and eating more protein are great ways to speed up recovery times after surgery. Plus, we could all benefit from eating healthier!
3. Exercise more. Getting in shape before your surgery is the best way to make for a quick and easier recovery! Ask your physical therapist about which exercises you should be doing before your surgery. For example, if you need a knee replacement, you will need a walker, cane, or crutches for a few weeks. It is advisable to learn how to use a walker, crutches, or cane prior to surgery. Strengthen your upper body to help prepare for life after surgery during those crucial weeks post-op. If you are overweight, your doctor may also recommend losing some weight before the surgery so that less stress is put on your replacement joints post-surgery. Losing weight will also make sure you are healthy enough for surgery. Exercising before surgery also reduces your risk of getting blood clots. Get moving! At Forward Motion Physical Therapy, we can help you prepare for surgery and help you post-op by creating a personalized plan of care customized to your needs.
4. Recovery plan! Make your meals in advance and freeze them so that you don’t have to worry about cooking. You can also prepare your home for ways that will make getting around easier. If there is a rug you’re constantly tripping on or a couch that you always bump into, move them temporarily to minimize your risk of hurting yourself when you are healing. Buy things that will help make life easier for you as you heal– a grip for the shower, a shower chair, a grabbing tool, ice packs, or anything you could think of that would help you. 
5. Ask for help. In the days after surgery, you will need help doing everyday activities like walking the dog, doing the laundry, driving, etc. Ask friends and family for help doing these things because you should rest and heal instead of doing chores. Plus, who doesn’t like being pampered from time to time? If you don’t want your friends and family to see you while recovering, hire a home health aid to help you.

What to Expect After Surgery:

From the moment you wake up from surgery, the beginning of your recovery journey has begun. Here’s what you should expect in the next few weeks post-op.

1. If you sit or lay in bed too long after surgery, you will start to get stiff, causing the pain to worsen. Talk to your physical therapist and surgeon. Your surgeon and physical therapist should have given you at-home exercises you should start doing after surgery. Don’t skip any at-home exercises! It is easy to forget to do these exercises or put them off, but at-home exercises will help increase your mobility and decrease pain. You may also benefit from receiving home care physical therapy. As Dr. Hanna Vazquez says, “Motion is lotion!” 
2. Do expect to see swelling. Swelling is a common and expected part of the recovery process. Remember to take any prescribed medications before the pain becomes too much to bear. Be sure to apply ice to the area for 20 minutes 3-4 times throughout the day to help minimize swelling and relieve pain. Elevating your leg will also help minimize swelling in your knee. Elevate your leg when sleeping and through the day when you are resting. Make sure you keep the knee straight when resting. Don’t place anything behind the knee to keep the knee bent.
3. Start outpatient physical therapy as soon as you get the ok from your doctor. Doing the right exercises/treatments while in recovery will help your knee heal faster and prevent blood clots from forming. Physical therapy will also help prevent scar tissue from building up, improve flexibility, mobility, balance, and strength.
4. Learn how to use a walker/cane. Ensure to see a physical therapist and learn how to use a walker/cane if you are not accustomed to it already. This is especially useful when it comes to walking up and downstairs. It might seem simple enough; however, there can be a learning curve involved in adapting to life using a walker or cane. 
5. Move. Expect to start walking and using your new joint as soon as you awaken from your surgery. Walk 2-3 times a day. Something as simple as a gentle walk to your mailbox to get the mail would help prevent you from getting stiff and prevent your pain from increasing. 
6. Take it easy. Please do not lift heavy objects, be mindful of your form, how you bend your knees and twist your hips. Be sure to turn your entire body instead of twisting your knee when you want to face a different direction. Talk to your physical therapist regarding how you should adjust your movements to minimize the risk of injury. 
7. Being cautious to avoid injury makes sense, but when you start feeling better, it is easy to forget that you are still in recovery and could slow down your recovery if you are not careful! Be sure to follow all care tips that your doctor and physical therapist tell you to follow until you get the ok to resume regular activities.

Hip & Knee Pain Affects People of All Ages

People of all ages get knee pain. Below is a short questionnaire filled out by someone experiencing issues with their knee and an example of some questions we would ask during an evaluation.

Knee Pain Questions:

1. How old are you? 30
2. What do you do for a living? Does your knee pain get in the way of your job? Engineering. I feel discomfort while walking. Sometimes it gets in the way of my job because I can’t walk and work smoothly like before. 
3. On a scale of 1-10, how bad does your knee pain get? 3
4. How does your knee pain impact your day-to-day life? Not much. 
5. What aggravates your knee pain? What makes it feel better? Bending the knee for a while makes it worse.

Hip Pain Questions:

1. How old are you? 29
2. What do you do for a living? Does your hip pain get in the way of your job? I’m a digital marketing specialist. My hip pain does get in the way of my job since sitting at a computer for hours aggravates my hip pain. I need to get up and walk periodically to help keep my pain manageable.
3. On a scale of 1-10, how bad does your hip pain get? My hip pain can be a level 8 on a bad day but is a level 5 most days.
4. How does your hip pain impact your day-to-day life? It limits exercises and activities that I enjoy doing like hiking, running, and certain yoga poses. 
5. What aggravates your hip pain? What makes it feel better? Sitting makes my hip pain worse, but if I walk too much or go for a run, that also makes it worse. Walking, certain yoga poses and physical therapy make my hip pain feel better.

Hip and knee pain are incredibly common, and just because you are experiencing pain does not mean you need surgery. Think about a papercut: it hurts like crazy when it happens, but no blood comes out. You wouldn’t get surgery for a papercut, would you? Of course not! Try physical therapy first to see if that helps improve any pain you may be having.

We’re here to help!

If you are experiencing hip or knee pain and aren’t sure why or if physical therapy is for you, come in for a complimentary 30-minute physical therapy session to see if physical therapy is right for you. Call us at 973-799-3314 to schedule your appointment today. You may be amazed by the results! Our physical therapists will tell you if they think you are a candidate for surgery during your evaluation.