TKR Downhill skiing (green runs and gently) 8 weeks post op

[3pin]

I just found this forum when googling when to return to skiing, I am 8 weeks post op left TKR, I have read many skiing threads regarding when people return to skiing, but not quite as early as I was advised. My surgery date was Jan 30 2019. I did about 15 days of “gimpy” skiing before surgery but could ski no where near my actual level. Have always had valgus deformity and other issues with the knee, many injuries and recoveries, and a very active lifestyle (cycling, hiking, backpacking, cycle touring, snowboarding, skiing...) due to my age I tried everything before being told it was the only option left at age 52. In no way expected to return to skiing this season.

At my 7 week post op, after being told my extension/flexion and general recovery were excellent, I was advised that if I wanted to get the skis on and do some green runs to see how I was doing to go ahead and proceed with the utmost caution. At 7.5 weeks a perfect day and I went up, skied 5 easy groomers with none of my pre op pain and just a little discomfort. Spoke with PT afterwards and he advised maybe get another few days in before the end of the season if I am up to it.

Our discussion revolved a lot around me not wanting to screw up all the hard recovery work I had put in or jeopardize any part of my recovery. Just curious when others have returned to gentle skiing post TKR. To clarify, I have never alpine skied, I am a telemark skier, that has pretty much exclusively parallel skied on tele gear for the past two years at resorts. And will not make tele turns this season.

 

[Celle]

Hello @3pin - and

I think it may be a bit soon to return to skiing. You've had major surgery, from which your tissue will take a full year for complete recovery. It might be wise to wait a while longer, to give your muscles and tendons some time to heal a bit more.
However, I'm going to ask @skigirl to advise you about her experience. She returned to work as a ski instructor after her knee replacements.

Meanwhile, here is the recovery reading we give to everyone with a new knee:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Jaycey]

@3pin The title of your thread says it all so I will be brief. Too early for skiing - give that knee time to heal. Next season you will be good to go!

 

[3pin]

Thank you so much for the quick responses and the knee recovery guidelines, I had read most before posting but I will read them all now. I do not want to jeopardize my healing. Much that I have read on TKR indicates that everyone’s healing process is so different that I just wasn’t sure. I will stick with my PT exercises, weight training, cycling and walking for now. I look forward to hearing input from skigirl in the future. Thanks!

 

[Jamie]

It sounds like you're having a great recovery and I think you're wise to continue to be cautious about skiing. After all, this surgery and recovery are just a temporary blip in your life. You certainly don't want to risk a fall. That can happen even with the utmost care and only gentle slopes. Skigirl will be along shortly to share her story with you.

 

[rustic]

I'm also a Telemark skier, who sometimes skis parallel on tell gear (mostly when I get tired).
My left tkr was at the end of September and I took this whole season off skiing. I still get pain from twisting forces and I wanted extra time to build up my legs.

 

[JDinCT]

@3pin Sounds like your recovery so far is nothing short of excellent.... best of luck on the remainder of your journey to full recovery!

 

[DIYSteve]

Wow, skiing 8 weeks post-op is surely quite early. Sounds like you're doing great. Maybe I could have done some mellow XC skiing at that stage, but that was mid-September, and the closest snow (high in the mountains) would have been difficult.

Yesterday I did 3000' verts of skin laps with my wife, ski day 71 of the season for me. (71 breaks down to 45 alpine/AT tour, 26 Nordic; I'm a bit past 8 months post-op). My flexion is still limited to 95-100, which sometimes makes it tricking getting off the lift. I had no problem skiing black diamond runs 5 months post-op. FTR, I try to avoid moguls, especially frozen bumps, ski them only when such is required to get down.

I exclusively telemarked for 15 years, forced to switch to AT gear 10 years ago when my knee was unable to bend sufficiently to make tele turns (bone spurs). FWIW, I doubled my touring days per season after switching to AT gear (which, as you know, is now lighter than tele gear). All of my touring/ski mountaineering buds switched to AT several years ago.

Good luck as you move forward!

 

[3pin]

Thanks so much for the words of encouragement! And a few tele skiers to boot! I started XC as a teen and a ski buddy happened to be a tele skier. We would hike and ski, but he recommended going to a local resort and buying the beginner pass to get my tele technique down and I have pretty much been a tele resort/side country skier since then. Skiing all conditions and terrain. I will not do hard bumps again, just softer uneven terrain (thats the plan anyway). My average over the last 25+ years is 50-80 days/year and maybe an average of 700,000 vert/year.

Always skied on very light tele gear until the last fall over two years ago that ultimately sent me to TKR. Switched to NTN hoping the release system would save me in the event of another fall and that gear is heavy! But stable. Learned to parallel in more conditions to take some stress off the knee, but plan to return to tele turns next season if possible. Have considered switching to AT, but skiing with my heels locked down seems beyond bizarre to me now just because my heel has always been free, but who knows what the future will look like!

 

[skigirl]

I skied at five months on both knees---I always ski with alpine gear. did you have any swelling or discomfort after skiing? I would be a little reluctant to ski this early for two reasons, one a fall, even on a green run would be a problem. Second, your muscles are not full supporting your knee at this point and so some of your weight is supported by the joint itself, I am not sure I would want to torque that joint---but, what do I know? If your doc told you it was okay, then you can decide for yourself.

However, if there was extra swelling after skiing, I would be careful.

 

[3pin]

Ok thanks for the advice! No swelling after skiing just a little stiff. I skied Monday, walked Tuesday and did upper body weights and my knee and leg were a little more sore and stiff. Wednesday (today) I cycled just over 10 miles with some longish hills, but pretty easy riding and felt great. Generally just take about 250 mg of naproxen,PRN/day.

I have no reason to doubt my surgeon or PT as I had the procedure done at an extremely reputable university hospital and clinics provider. I just wasn’t expecting them to give me the green light to “ski” at the end of this season so I wanted some opinions from skiers that had actually already lived through the situation. Thanks so much for all the feedback, it has been amazingly helpful! Enjoy the rest of your season for as long as it may last!

 

[skigirl]

Of course, if you have no swelling, then go for it, if you want to do so. I also biked about 20 miles with my bike group starting at 8 weeks. I did find that I was really slower than usual and I was so tired after the first few rides.