TKR: work “smarter” and not “harder”


Former BoneSmart staff member
Dec 21, 2007
Northern Part of the Buckeye State
United States United States
Too often we fall into the mindset that “If I work really hard at this, I will recover so much faster that I can get my life going again. I will amaze myself!” Then what happens is that we try to work harder, and we paradoxically do not see the progress---we get frustrated and work even harder and still no progress---in fact, there is often less progress! We have been taught since we were children that we should work hard at everything we do; that “if it is worth doing, it is worth doing right and with hard work and dedication.” Sound familiar? Why the, does this TKR become so slow and frustrating?

The problem is that we are working, ironically, too hard at trying to recover; we need to work smarter, not harder! The harder we work at recovery, the longer and more frustrating recovery can be. We try to do battle with our knees and we also do battle with ourselves---two battles that we will lose. The knee is in charge of recovery---we cannot force the issue; the more we work, the further behind we get. If we try not to fight our inner self and just do what we need to do to gain strength, stamina, and ROM, ironically, we will be more successful than if we work really, really hard and try to get the knee to respond.

First, we have to understand that the knee is in charge of our recovery, not us. We are “not on that committee.” It will not take our input; it will not take our advice; it will not take our dedication and determination. By working smarter, we work to resolve the issues with surgical trauma, therefore, we are keeping the knee “happy.” We do not want to upset the knee; a “happy knee” is one which will allow you to recover---albeit slowly. Keep the knee happy!

If we give in and lose the battle with ourselves, we then run the risk of working too hard; this means that the knee will work too hard when it does not want to and it is indeed unable to. Why then, do we do this? We have to be at peace with the fact that this TKR recovery may take quite some time.

Don’t fight a battle with you knee; do not fight a battle with yourself; do not give into temptation and over work your knee and yourself. All you are doing then is setting yourself up for more pain, frustrating, and a slower recovery. Understand that this recovery means that you are “in it for the long haul” and that there is nothing you can ultimately do to speed things up.

Be smarter about your exercises---find your “comfort zone” and stay within it. Be smarter about your activities---it is our nature to try to push this and see what we can do---and, most of us have been “slow learners” in this regard. Once you find out what you can and cannot do, work smarter and stay within the envelope. Understand that if you go too long with exercise or without icing or without resting---any of those components, you will pay the price. Be smart---work smarter---and do not give into the temptation of “working harder.”

Paradoxically, by doing less, we gain more ground in our recovery than if we worked really hard. Don’t fight it; that is the way it is. Please keep in mind that recovery from a TKR can take a year to return to “normal.” If you are a week or even a month or two months removed from surgery, you have to understand that you will still have a ways to go before you are back to “normal” again. Resist the urge! Do not fight the battle with yourself---take it slowly; run the race here as if it is a marathon (or ultra-marathon) and you will do well. Remember, it is not how hard you work at this; it is how smart you work at this. Be patient, and be smart.
I had my BTKR surgery on November 8th of 2007. Thinking back, I couldn't wait to get home and watch the OSU/Michigan game. The trip home in the car was the most painful thing that I have ever experienced.

Thanksgiving that year was the worst holiday I have ever been through---I was drugged up on pain meds and my family (I sent them) went to my parent's house, so I slept most of the day.

Christmas was better, but I still was stiff and sore---I was looking forward to going back to the classroom; little did I know that it was too soon. Oh, yes, I spent much of the Christmas time tearing the adhesions that I developed in BOTH knees. (my son does a great imitation of me screaming when one popped while I watched White Christmas.

I went back to school following Christmas vacation; every day I woke up and wondered, "Is this the day I finally lose that limp?"

i was doing outpatient PT twice a week and I went to my gym to stretch and ride a bike two other times a week. I went shopping with my wife---and gimped and limped around the mall

I started umpiring baseball games during the first week of April---I STILL HAD A SLIGHT LIMP EVEN THOUGH I HAD MY SURGERY THE FIRST WEEK OF NOVEMBER.. It wouldn't be for another two weeks that the limp finally disappeared and I felt "pretty good.

At six months post-BTKR, I was about 80%---at about eight months, I was close to 100%.

Ladies and gentleman, this is one long voyage---it is not short day trip through "recovery land." It is trite and often repeated, but you just get up each day and take what the knee gives you, knowing that you will prevail. Practice patience and do not look to far down the road---heck---don't look down the road at all; just keep on keepin' on.

I will tell you this now; I never, ever doubted the decision that I made to have the BTKR, and I never, ever doubted that some day i would be as good as new. Was I miserable? Yep, for quite some time. Even shopping at Christmas time at the mall was awful! I had a cane and was slow and getting in other peoples' way. However, I knew that someday I would get my life back---it was going to take way longer than I thought, that was all.

Good things---yes, even great things--- will happen to you; you just have to be patient and bide your time. When you consider how long it took for your knee to become so bad that you had to have surgery, months of recovery are not so bad.

This recovery is like the settlers traveling across the continent in the Conestoga wagon---you are not in the high-speed lane on an interstate.

Just like the settlers, your trip can be arduous and frustrating, but, just like the settlers, you will arrive at your destination and enjoy the fruits of your travels.

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