‘Intelligent participation’ key to returning to sport post-knee replacement
Why taking up a new sport post-knee replacement surgery might not be the best course of action.
Patient: “Doctor, will I be able to play the piano after my knee replacement operation?”
Surgeon: “Yes you will.”
Patient: “That’s odd because I couldn’t play it before.”
If I had a pound for each time I’d heard that gag I’d be able to, well, perhaps not retire but I’d definitely be treating myself to a very nice bottle of wine. Behind the joke, of course, is a serious concern for many (if not all) knee replacement patients: will I be able to get back to doing the things I love?
We explore the activities you should be able to resume without worry in this post, but the issue is further explored by MS Kuster in his article Exercise recommendations after total joint replacement: a review of the current literature and proposal of scientifically based guidelines.
Kuster explores the concept of ‘intelligent participation’ which, put simply, suggests that following a joint replacement you are much safer returning to sports and activities of which you have previous experience.
On the face of it, this is common sense. Do any sport often enough and the muscles required for that activity will be well developed. You’ll also have developed the necessary skills to take part. But intelligent participation goes beyond muscle development, muscle memory and basic proficiency. It’s about being able to deal with uncertainty.
Expecting the unexpected
If, for example, you are an experienced skier, your muscles will be used to the rigours of skiing, and you’ll (probably) have the technical skill to stay on both skis more often than not. But more importantly, you’ll have the experience of the piste. Almost subconsciously you’ll know how to deal with a wide variety of situations. When things don’t quite go to plan, you can use experience to get out of trouble and avoid injury. A first-time skier typically can’t do that.
If you’ve been following Andy Murray’s recent exploits at the Australian Open, you’ll know that hip pain is threatening his career and the hip resurfacing procedure he underwent last week may not be enough to enable him to return to tennis’ elite levels. Yet despite the pain, Andy Murray has continued to play tennis at an extremely high level because he can factor out many of the elements that would wrongfoot a lesser player. He understands the bounce of the ball on a given surface. He knows, to some extent, how his opponents will play. Whether he should be playing on is another matter, but his ability to participate intelligently is beyond doubt.
That’s not the same for someone fresh from recovering from a partial knee replacement who decides now is the time to take up tennis. From an implant perspective, there should be no issue with playing a friendly game of doubles. From an intelligent participation perspective, however, you will be more likely to injure yourself playing an unfamiliar sport than one you know well.
The advice, therefore? Enjoy your sport post knee-op – but stick with what you know.
If you are experiencing knee pain, talk to the knee specialists at Yorkshire Knee Clinic on 03453 052 579.