Knee replacement surgery is a common procedure that improves quality of life for individuals with severe knee pain, often due to osteoarthritis. A frequent and understandable question patients have concerns resuming specific activities after surgery, particularly kneeling. This article will explore the nuances of kneeling after a knee replacement.
The Question of Kneeling
For most patients, kneeling is indeed possible, but the experience often differs from kneeling with a natural knee. Comfort and ability vary significantly. While the prosthetic implant itself is designed to withstand the forces associated with kneeling, the sensation often changes due to altered anatomy and the presence of artificial components. Surgeons generally advise caution, acknowledging potential discomfort or a different feeling.
Factors Affecting Kneeling Ability
Several elements influence a person’s ability and comfort when kneeling after knee replacement. The type of knee replacement, such as a partial versus a total knee replacement, can play a role, with partial replacements sometimes allowing for easier return to kneeling. Whether the patella (kneecap) was resurfaced during surgery also has conflicting evidence regarding its impact on kneeling ability, with some studies suggesting it may improve the likelihood of kneeling, while others find no significant difference. The individual’s pre-operative range of motion can influence post-operative flexibility, as a knee that was less flexible before surgery may have less flexibility afterward.
Post-operative factors like soft tissue scarring around the incision, numbness, and general pain tolerance also contribute to discomfort. Swelling and nerve irritation can make the pressure of kneeling painful. The success of physical therapy in restoring strength and flexibility is a significant determinant, as strengthening quadriceps and hamstrings provides better support to the knee joint. Each patient’s recovery journey is unique, and factors such as fear of damaging the implant or concerns about sensation can also affect the willingness to attempt kneeling.
Safe Approaches to Kneeling
For patients who wish to attempt kneeling, a cautious and gradual approach is advisable. Consult a surgeon or physical therapist before starting, especially in early recovery, for personalized guidance. Start on soft surfaces like a pillow or mat to reduce pressure. Gradually increase duration and frequency, beginning with short intervals (2-5 seconds).
Some protocols suggest a desensitization process, progressively increasing pressure on the knee over several weeks. This might involve kneeling on a couch, then a cushion, followed by a thin pillow or thick carpet, before a bare floor. Listen to your body; avoid prolonged kneeling or any twisting motions while in a kneeling position. If one knee feels more comfortable, starting with a single knee, perhaps the non-replaced one, can be a gentle introduction.
Long-Term Outlook and Alternatives
Long-term, kneeling may become easier as healing progresses, though it may never feel completely “normal” or comfortable. It is important to understand that not being able to kneel comfortably does not mean the surgery was unsuccessful. Many individuals live full, active lives without regularly performing kneeling motions.
The primary purpose of knee replacement surgery is to alleviate pain and improve overall function for daily activities like walking and climbing stairs. For tasks that traditionally require kneeling, there are various alternatives. Using long-handled tools for gardening, sitting on a low stool, or finding other ergonomic solutions can help accomplish tasks without putting direct pressure on the knee. Patients are encouraged to discuss any concerns about specific activities with their healthcare team to ensure a safe and effective recovery.