Can You Kneel After A Knee Replacement?

Considering or just had a knee replacement? You may be curious to know whether you can kneel afterwards. Often, this is probably the last question you think of before undergoing a life-changing procedure. Getting your knee replaced can be daunting. Fortunately, our article has been written to guide you through this process.

Initially, it would be best if you always spoke to your surgeon about when you can kneel. There are many factors to consider, such as your recovery, wound location and overall fitness (e.g. flexibility, strength, etc.). Fortunately, most people who undergo a knee replacement will eventually be able to kneel. 

However, there are many challenges that may prevent you from kneeling. As a physiotherapist who regularly consults patients with knee replacements, let me show you some strategies that can help you kneel again.

Why is Kneeling Important?

Kneeling is an essential daily activity for many people. It can be a subconscious movement for some while being critical for others. Examples of activities that may require you to kneel include:

  • Daily activities (e.g., cleaning, gardening, praying, etc.)
  • Sports and exercise
  • Employment and work
  • Self-care (e.g., tying up shoelaces, picking up items from the floor, etc.)
  • Participating in family and social activities
kneeling knee replacement digital physio

Is It Possible to Kneel After Surgery?

It is generally possible to kneel after a knee replacement surgery. Still, it is essential to discuss this with your surgeon. Kneeling may put additional stress on the replacement joint, so it is vital to be cautious and to gradually build up your strength and range of motion after the surgery.

 

Your surgeon and physical therapist will likely provide specific instructions and exercises to follow after surgery to help you regain strength and mobility in your knee.

 

Knee pads and kneeling pads may also give support to the knee whilst kneeling. It is essential to follow these instructions and attempt to kneel too early, as this can increase the risk of complications or injury.

kneeling pads knee replacements digital physio

Crucial Factors to Consider Before Being Able to Kneel

There are several factors to consider before being able to kneel safely, which include:

1. Recovering from your wound

 

For most knee replacements, there will be a wound that marks the incision area (where the surgeon cuts into). Generally, the wound will eventually heal into a closed scar. However, even when the scab has fallen, and the scar has formed, the area can still be slightly sensitive. 

Make sure that your wound has fully closed and is not sensitive. Too much pressure on the knee before the wound has healed can cause it to re-open, leading to complications, such as infection and slow recovery. 

 

2. Controlling your Pain

 

Knee pain is another common barrier to knee bending (let alone kneeling). Almost everybody reports post-surgical pain over the incision and the natural healing process. Additionally, numbness over the wound after surgery can also be a limiting factor.

Being patient is essential for allowing the knee to recover to a point where you can begin to start kneeling again. 

 

3. Reduce your Swelling

 

Swelling is another consequence of surgery. Fluid pools inside the knee joint due to bleeding and inflammation. This is particularly obvious in the first three weeks after surgery. 

Too much swelling can restrict your ability to bend your knee and ability to put pressure on the knee. Additionally, it’s also a sign that more healing is needed before attempting to kneel.

 

knee flexion bend knee replacement

4. Having Sufficient Knee Range of Motion

 

Range of motion describes how far a joint can move. The knee joint is a simple joint that flexes (bends) and extends (straightens). After your knee replacement, your knee will feel stiff. Swelling, pain and scar tissue are just some factors that may restrict your knee’s movement. 

Getting enough knee flexion or bend is the priority here. Ideally, you want at least 90 degrees knee bend to kneel comfortably [1]. However, it may take up to 110 degrees to kneel fully.

It is possible to achieve 90 degrees by six weeks after surgery and, on average, 114 degrees by three months [1]. However, everybody deals with recovery and healing differently. It’s important not to compare yourself to others recovering from a knee replacement. 

5. Improving strength and muscle activity

 

Getting into a kneeling position requires your muscles to be able to hold you in this position. After your surgery, you’ll find that the muscles around the knee are weaker and more difficult to activate. There are several reasons for this, including pain, the incision made by the surgeon and deconditioning. 

It’s essential to begin and continue with exercises that help rebuild your overall fitness and muscle strength. Several muscle groups around the knee require attention, including your quadriceps, hamstrings, glutes, and calves. Please visit here for a general guide about exercises for knee replacement rehabilitation.

6. Confidence

 

It is normal to feel fearful of kneeling after surgery. Many reasons may make you question your confidence in kneeling, including pain, worry about damaging the replacement, or even misinformation by health professionals. However, the more frequently that you can perform a task, the more confidence you can anticipate. Practice makes perfect.

knee strength knee replacement

How Long Will it Take to Kneel After Surgery?

The time taken to kneel will vary from person to person. Your surgeon and physical therapist may have more intimate knowledge about your recovery knee replacement.

 One study showed that 72% of patients with total knee replacements could kneel for 12 months [2]. Another study showed that 68% of those with replaced knees could kneel with either minor or no difficulty by 18-24 months [3]. In the same study, around 80% of patients could kneel, albeit with difficulty for some individuals.

 How early you may start kneeling will usually depend on your recovery and the factors listed above. Surgeons I have worked with advise waiting up to 3-4 months before trying. This seems consistent with recommendations from other organizations, such as Versus Arthritis

Why Can't I Kneel?

Kneeling after surgery can be a daunting process. The two most common reasons for not being able to kneel are fears that the replacement might be damaged and pain from the incision [1]. 

 It’s important to understand that kneeling after sufficient recovery is appropriate for most people. Currently, no evidence suggests that kneeling damages the prosthesis or the kneecap [1].

 Unfortunately, this is not helped by the fact that other health professionals, such as nurse practitioners and doctors provide incorrect advice (i.e., not being able to kneel after a knee replacement). 

 For optimal recovery and expectation management, I’d advise seeking advice from an experienced physiotherapist. Physiotherapy consultations before and after your surgery ensure that you’re well prepared. 

 If you are expecting or have a knee replacement, make sure you make a telehealth appointment with one of our experienced physiotherapists to optimize your recovery. Click here to get started today

physiotherapy knee replacement

Can I Improve My Ability to Kneel?​

Yes. Even if you’re struggling to kneel after 3-4 months, you can still improve your ability to kneel. One study showed that 56% of patients with knee replacements reportedly were unable to kneel [1]. Yet, when asked to, 80% were observed to be able to.

 For many people, this may only be a temporary problem. Specific rehabilitation and exercises can help restore your kneeling capacity. Rush University Medical Center researchers showed that all it takes is a specific 6-week return to kneeling rehabilitation program [3]. After being unable to kneel for 18-24 months after surgery, 81% of patients could kneel after participating in the program. 

The following 6-week kneeling protocol can start around 3-4 months after knee replacement surgery. Make sure to consult your physiotherapist or surgeon before commencing this. It may not be appropriate for everyone within this timeframe.

kneeling protocol rehabilitation total knee replacement

Knee Pads for Kneeling

Pressure across the knee is one of the key reasons why kneeling can be so challenging. Consider purchasing knee pads for kneeling to help provide comfortable cushioning for your knees. You don’t need an expensive knee pad for optimal support as long as there is enough support to alleviate pressure from the ground.

Seek Help Today!

Need help preparing for your knee replacement? Or perhaps you’d like to assist with your rehabilitation. Seeking assistance from an experienced physiotherapist in orthopaedic recovery is vital for optimal recovery. For expert advice from the comfort of your home, book a telehealth appointment with one of our physiotherapists today.

References

  1. Wylde, V., Artz, N., Howells, N., & Blom, A. W. (2019). Kneeling ability after total knee replacement. EFORT open reviews4(7), 460-467.
  2. White, L., Stockwell, T., Hartnell, N., Hennessy, M., & Mullan, J. (2016). Factors preventing kneeling in a group of pre-educated patients post total knee arthroplasty. Journal of Orthopaedics and Traumatology17(4), 333-338.
  3. Wallace, S. J., & Berger, R. A. (2019). Most patients can kneel after total knee arthroplasty. The Journal of Arthroplasty34(5), 898-900.

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