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Old 04-27-2020, 12:04 AM   #1
rbi99
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Climbing after a knee replacement

While my one knee is not yet to the point of needing to be replaced, there is a good chance I might be facing that procedure in a few years. My question to others here who have gone through it already or know people who have, how long were they out of commission after the surgery before climbing again? How different is it after as opposed to before? What restrictions or changes did you have to make afterwards? I'm the kind of backpacker who likes to go in maybe five miles or so and set up camp in one spot. Then climb a mountain or two over several days. Even when I was younger I wasn't the kind of climber who knocked off multiple mountains a couple times during any one trip.
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Old 04-27-2020, 07:50 AM   #2
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You'll hear stories from both sides - I know of a number of people with replacements who still hike like they did before knee problems. Mine didn't go so well, and four years later still hurts every day, in a different way than before, but actually worse. Choose your doctor carefully, and stay on top of the rehab after (and if you can, do as much 'prehab' as you can before the surgery).
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Old 04-27-2020, 09:29 AM   #3
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I had a total knee replacement on the right side 10 years ago; my left knee continues in its original state. My doctor told me I would have problems with rehab right from the get go because my legs were so strong due to all my outdoor activities. He explained that my muscles would be fighting the new joint. As it turns out, he was accurate with his prediction.

In my case the expectation was I'd be released from the hospital with a 90 degree range of motion (ROM). After a week I was sent home with only a 42 degree ROM. The beginning of my at home rehab didn't start off well and I was becoming very discouraged. Very simply, my PT was holding me back in my opinion. I discussed this with my doc and he said he was OK with my taking things into my own hands as I'd had 6 surgeries (two of them being reconstructions) on this knee already. He figured I'd know when I pushed myself and the joint too far so he was willing to give me the green light. Luckily he also found me a really astute PT who was very helpful in getting me to where I wanted to go.

In the end, with a lot of work, I was able to achieve a higher ROM than was expected. I was also released from PT two weeks earlier then scheduled due to all the work.

Throughout all of this I was out of work for 6 weeks. I slowly entered back into doing activities about 10 weeks after the surgery and was back to my usual round of activities
within 4 months. This was very important to me because I worked with a college outdoor program at the time and needed to be ready for the fall semester. As soon as school started up I was ready for our full slate of activities (hiking, paddling, rock climbing, etc.) and was able to xc ski & snowshoe that winter with no problems whatsoever.

Of course, like in anything, the phrase "your mileage may vary" comes into play. But, if you have a good surgeon on your side, and work diligently on your PT, you should expect to return to your normal life within a few months.

That's all for now. Best of luck with your knee going forward. Take care and until next time...be well.

snapper

PS - Feel free to PM me if you have any specific questions.
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Old 04-27-2020, 10:25 AM   #4
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I haven't had a knee replaced, did fracture one but that's something else. My wife has had 3 knee replacements [she wore one out after 20years] and two hips. And Snapper nailed it; Rehab/pt is the key to a good recovery but don't be lazy about it, so if you are that type that won't push yourself much then don't do it at home...go somewhere with a therapist.
Knee replacements hurt, expect it. That's part of the deal. Don't get hooked on pain killers. My wife said both hip replacements barely hurt at all.
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Old 04-27-2020, 11:49 AM   #5
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Good advice from others. Both my father and elder brother had knee replacements, so it may be in the cards for me. For now, at 53, my knees let me know they are there but no where near the pain I hear from folks who have them replaced. After my brother went in I sort of had a mental "uh-oh" moment. This could be in my future. So I am not experiencing what you are experiencing but have four thoughts.
  1. I focused on reducing my "front pack"; I am overweight and it was rather silly to spend money on lightweight backpacking equipment, become a "gram weenie" if I was toting around a gut. Your knees would benefit from losing even 10lbs if you can spare it.
  2. Someone recently brought to my attention the Adirondack Quest. It is goal oriented but does not involve hiking up 4k'. I know two things: not sure I can top the view from many of the peaks I have been on (Algonquin, Marcy, Rocky Peak Ridge). I am sure I can top the view from many of the peaks I have been on (Blake, Colvin). I have been in many scenic spots in ADK's that did not involve thousands of feet of knee pounding elevation gain.
  3. I hike four seasons. I find the trails less punishing in the winter. Snow has filled in all of the nooks & crannies. I wear spikes to keep knees from over extending, and I use hiking poles 4 seasons. Having the two extra sticks takes some of the stress off my knees. If I am teetering without poles the knees are doing a lot to keep me upright, with the poles I can just plant one to regain balance.
  4. Canoeing is fun. Building a canoe can be more fun!

Stay well!
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Old 04-27-2020, 01:33 PM   #6
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Quote:
Originally Posted by snapper View Post
I had a total knee replacement on the right side 10 years ago; my left knee continues in its original state. My doctor told me I would have problems with rehab right from the get go because my legs were so strong due to all my outdoor activities. He explained that my muscles would be fighting the new joint. As it turns out, he was accurate with his prediction.

In my case the expectation was I'd be released from the hospital with a 90 degree range of motion (ROM). After a week I was sent home with only a 42 degree ROM. The beginning of my at home rehab didn't start off well and I was becoming very discouraged. Very simply, my PT was holding me back in my opinion. I discussed this with my doc and he said he was OK with my taking things into my own hands as I'd had 6 surgeries (two of them being reconstructions) on this knee already. He figured I'd know when I pushed myself and the joint too far so he was willing to give me the green light. Luckily he also found me a really astute PT who was very helpful in getting me to where I wanted to go.

In the end, with a lot of work, I was able to achieve a higher ROM than was expected. I was also released from PT two weeks earlier then scheduled due to all the work.

Throughout all of this I was out of work for 6 weeks. I slowly entered back into doing activities about 10 weeks after the surgery and was back to my usual round of activities
within 4 months. This was very important to me because I worked with a college outdoor program at the time and needed to be ready for the fall semester. As soon as school started up I was ready for our full slate of activities (hiking, paddling, rock climbing, etc.) and was able to xc ski & snowshoe that winter with no problems whatsoever.

Of course, like in anything, the phrase "your mileage may vary" comes into play. But, if you have a good surgeon on your side, and work diligently on your PT, you should expect to return to your normal life within a few months.

That's all for now. Best of luck with your knee going forward. Take care and until next time...be well.

snapper

PS - Feel free to PM me if you have any specific questions.

Thank you for all that info and offer. I have been lifting at home for over 40 years, so when it comes to dedication and determination, I am pretty good at it. Living in Ohio, I only get up to the Adirondacks two, sometimes three times a year and get in one or more climbs based on how long we are up there. Favorite spot is Colden Lake. Have climbed everything there except Cliff and Marshal, and do want to climb them. I have taken good care of myself over my 69 years, but like I said before, I was never one to knock off a bunch of climbs in succession. A Great Range traverse would never be a possibility for me. My last backpacking trip last fall was up the herd path toward Grace. Spent three nights out, but have to admit my knee made me be extremely careful since no one was anywhere around. The climb was so straight forward, but it took it's toll on me. When I came out I was beat and I think a lot of that was due to being so careful with my feet placement.
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Old 04-27-2020, 01:40 PM   #7
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Im 30 and had my right knee done when I was 20 ( though I had issues before hand). My replacement did not go as it should have. I have limited range of motion between 5 degrees and 45 degrees on good days. I still hike in the high peaks but I use poles up and down to take some weight off my leg and hips. I also take my canoe with a full pack into pharaoh lake wilderness and west canada lakes wilderness.
It took me 5 weeks or so recover physically and before my replacement I didnt hike I biked 20 miles most days. After my surgery I couldnt do that and it took me some time to realize I could hike.
I can tell you also that I try to not go over 20% of my weight in my pack. If I do I take it slower and have some advil before and after. I also put a brace around my left knee ( the "good" knee) to give it some added protection. My max daily distance I also found to be around 10-13 miles depending on pack weight.
Choose your surgeon carefully and do A LOT of research into them. Make sure they know what you want to do after recovery. I had mine done at UPenn in Philly and wasnt overly happy with the results obviously.
Feel free to message me if you have any specific questions on your mind
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Old 04-27-2020, 01:53 PM   #8
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Speaking of what adknomad said, pick your surgeon carefully, there is no doubt a surgeon using robotic assistance lines up the joint with the bones far more accurately than one without.
If you can ever get to a demonstration/slide show of the robotic surgery do it.
A joint done by hand can be off by 25%. One done with robotics less than 1% thatts because an MRI is taken well before surgery and programmed into the robotics.
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Old 04-27-2020, 06:33 PM   #9
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Being from Cleveland usually means I can't brag too much, but we do have the Cleveland Clinic here so when the time comes I am pretty sure I will be able to grab a very good surgeon.

Again, thank you all for your help.
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Old 04-27-2020, 07:41 PM   #10
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Being from Cleveland usually means I can't brag too much, but we do have the Cleveland Clinic here so when the time comes I am pretty sure I will be able to grab a very good surgeon.

Again, thank you all for your help.
They have doctors in Cleveland?
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Old 04-28-2020, 09:03 PM   #11
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While my one knee is not yet to the point of needing to be replaced, there is a good chance I might be facing that procedure in a few years. My question to others here who have gone through it already or know people who have, how long were they out of commission after the surgery before climbing again? How different is it after as opposed to before? What restrictions or changes did you have to make afterwards? I'm the kind of backpacker who likes to go in maybe five miles or so and set up camp in one spot. Then climb a mountain or two over several days. Even when I was younger I wasn't the kind of climber who knocked off multiple mountains a couple times during any one trip.
I'm 70 and had a TKR in October of 2018. That February I was on xc skis and in May hiking some easy trails here and in the White Mountains. I did take it slow and easy though.
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Old 06-11-2020, 05:58 PM   #12
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I had ACL replacement 6 years ago. It's not a knee replacement but I'll explain the mental aspect of frightening major surgery. I was scared ****less of not being able to enjoy the outdoors. After surgery I was incredibly depressed as I could not walk for nearly 6 months(do not do surgery in summer). Once I recovered I grew immensely mentally. I have a completely different outlook on things and I know now, that even if I had to crawl to the top of mountain peaks, I would.

My point is, whatever the case is for you, you will adapt. On my last hike to Mt. Lafayette I came across an incredibly obese man solo hiking. He looked completely wasted just .5 miles in. But, he was determined. We spoke for a good ten minutes. I have no doubt he made the summit. And I'm sure once he was up there, that feeling of accomplishment was far greater than I had that day. Our struggles are what we make of them.

I offer this advice only because I know people fall into very dark places after surgeries, I've seen it a number of times. Don't let that happen.
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Old 06-23-2020, 01:15 AM   #13
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Thanks for those inputs. I should be grateful that at 69 I only have one knee bothering me and my other joints are in great shape. However, we are only as strong as our weakest link and it is depressing. I'm seeing another specialist tomorrow, so hopefully I will learn what has changed since my last visit six months ago.
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Old 06-29-2020, 08:31 AM   #14
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Turns out I tore my meniscus a few months back, which compounded the wear and arthritis I have in my knee. Have to say the pain at the time was excruciating. It resulted in me babying it because of the fear of another sudden shot of pain. Basically I am trying to get past the babying part and am being safely more aggressive with it. Feels better than it has in a long time. Coming up in September unless the virus prevents it, and plan on climbing Hopkins.
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Old 06-29-2020, 01:05 PM   #15
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I have a partially torn meniscus from about 10 years ago. Never got any surgery; it gradually got better. I'm 64. I've chosen to give up trail running, but I still hike multiple 4Ks, climb, ski (on Patrol at Gore, running sleds) etc.

Tenderfoot is right, too, about weight. I'm skinny (143) and the lighter load on the joints really helps.

No guarantee, but many meniscus tears become less symptomatic over time if you just keep up normal activity. Be careful to consciously monitor your gait, and "force yourself to walk normally." That was the hardest part for me; I had unconsciously developed some gait deviations to compensate for the injury, and those were causing me to develop aches and pains in other areas of the body, like lower back, opposite hip, etc.. It took a lot of awareness (every stride) to force that compensation to go away.
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Old 06-29-2020, 01:45 PM   #16
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Turns out I tore my meniscus a few months back, which compounded the wear and arthritis I have in my knee. Have to say the pain at the time was excruciating. It resulted in me babying it because of the fear of another sudden shot of pain. Basically I am trying to get past the babying part and am being safely more aggressive with it. Feels better than it has in a long time. Coming up in September unless the virus prevents it, and plan on climbing Hopkins.
Quote:
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I have a partially torn meniscus from about 10 years ago. Never got any surgery; it gradually got better. I'm 64. I've chosen to give up trail running, but I still hike multiple 4Ks, climb, ski (on Patrol at Gore, running sleds) etc.

Tenderfoot is right, too, about weight. I'm skinny (143) and the lighter load on the joints really helps.

No guarantee, but many meniscus tears become less symptomatic over time if you just keep up normal activity. Be careful to consciously monitor your gait, and "force yourself to walk normally." That was the hardest part for me; I had unconsciously developed some gait deviations to compensate for the injury, and those were causing me to develop aches and pains in other areas of the body, like lower back, opposite hip, etc.. It took a lot of awareness (every stride) to force that compensation to go away.
I am about to go in next week for a meniscus repair. It was torn about a year ago, and despite PT it remained a problem. MRI shows that it was a complex tear, which allows for the torn piece to pinch between the leg bones when going up stairs. The pain, when that happens, is nauseating.

I've already had one before on this knee, and four on the other knee prior to the ultimate knee replacement.

For now big mountains are out for me, but I just moved to Schroon Lake, so there are plenty of lower hikes and lots to paddle, so I'll move on to other activities.
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Old 06-29-2020, 01:50 PM   #17
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For now big mountains are out for me, but I just moved to Schroon Lake, so there are plenty of lower hikes and lots to paddle, so I'll move on to other activities.
Check out the Champlain Area Trails System (CATS). They have a lot of trails around Schroon Lake.

www.champlainareatrails.com
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Old 06-29-2020, 01:51 PM   #18
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Check out the Champlain Area Trails System (CATS). They have a lot of trails around Schroon Lake.

www.champlainareatrails.com
Awesome - thanks!
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Old 06-29-2020, 02:18 PM   #19
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I am about to go in next week for a meniscus repair. It was torn about a year ago, and despite PT it remained a problem. MRI shows that it was a complex tear, which allows for the torn piece to pinch between the leg bones when going up stairs. The pain, when that happens, is nauseating.

I've already had one before on this knee, and four on the other knee prior to the ultimate knee replacement.

For now big mountains are out for me, but I just moved to Schroon Lake, so there are plenty of lower hikes and lots to paddle, so I'll move on to other activities.
Yeah, if you have a loose piece that can get caught, then you probably will benefit from surgery. If, like me, you just have a tear with some rough edges, studies have shown that arthro surgery just to "clean up" the tear does not add value. In one study, patients who had "sham" surgery had the same long term outcomes as actual surgery patients.
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Old 06-29-2020, 08:33 PM   #20
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I had a meniscus repair just before Christmas, alpine skied on it 3 weeks later...
My tear must have been lingering for years, injured it 10 years ago lugging a washer/dryer combo up some stairs. It would flare up every now and then but turned markedly worse last November, I could barely bear weight on it!
I just noticed last week that my knee is completely back to normal, full extension and flex, full strength and no pain whatsoever.
I'm sure glad I had it repaired.
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