Finding Your Flow: Yoga After Knee Replacement Surgery
/For many, knee replacement surgery offers a renewed chance at mobility and an active life. While recovery takes time, yoga can be a tool to support your journey back into the lifestyle you are searching for. This practice, known for its focus on strength, flexibility, and mindfulness, can be incredibly beneficial post-surgery when approached with care and guidance. Because you are healing—and due to the physical change in your anatomy—there are some things you should be aware of when coming to the mat.
Pain After Surgery
It’s completely normal to experience pain after knee replacement surgery. Here's why:
Surgical Trauma: The surgery itself involves cutting through skin, muscle, and bone, which naturally causes tissue damage and inflammation. This is the primary source of pain in the initial recovery period.
Inflammation: The body’s natural response to surgery is inflammation. This systemic inflammation is triggered by immune system, hormonal, and metabolic responses that cause swelling, redness, and pain.
Nerve Irritation: During the procedure, nerves in the leg may be stretched or irritated, leading to pain, tingling, or numbness.
Muscle Weakness: The muscles around the knee become weak after surgery, and using them again can cause discomfort.
Scar Tissue Formation: As the surgical incision heals, scar tissue forms. This tissue can sometimes cause stiffness and pain.
Though it is normal to experience pain, doing yoga shouldn’t increase your discomfort and you don’t have to “push through” it. Check with your doctor if you have ongoing pain.
Get Clearance
Before starting any physical activity, including yoga, it’s crucial to get clearance from your doctor or physical therapist. They will understand your specific recovery timeline and can advise on safe modifications for your practice.
When starting or returning to yoga after knee replacement surgery, take it slow. Begin first by focusing on moving other regions of your body, letting your legs recover, to reduce general inflammation, and then slowly work to increase strength in the legs. Note that you might never return to the same range of motion or yoga practice you once had. Deep flexion with new knee hardware, for example, may not be physically possible, and being in certain positions, like on hands and knees, may feel different or uncomfortable. However, knee replacements can still provide more opportunity for practicing yoga or movement than living with a painful joint.
Early Recovery: Gentle Poses
In the initial stages of recovery, focus on gentle, chair-supported yoga poses. These can help maintain upper body strength and improve circulation. You can practice yoga with a focus on your back and upper body, letting your knees recover. Your physical therapist and doctor will have treatment plans for your knees; you can support that recovery by just staying active and keeping mobility in the rest of your body. Here are some examples of poses that shouldn’t strain the knees:
Seated Cat-Cow: This pose warms up the spine and improves flexibility. Sit tall on a chair with your feet flat on the floor. Inhale, lift your sternum up toward the ceiling and look up if it is comfortable for your neck (Cow). Exhale, round your back, and tuck your chin (Cat). Repeat slowly.
Arm Circles: Circling your arms improves shoulder and upper back mobility and strength. Bring your arm up by your ears and make circles to the front and back. Also, try bringing your arms out into a T position at shoulder height and make circles going forward and backward.
Eagle Arms: This pose stretches the shoulders and upper back. Sit tall and extend your arms out to the sides. Bend one elbow and bring your forearm across your body, reaching the other arm underneath to clasp hands (or touch fingertips or bring your hands to opposite shoulders). Hold for a few breaths, then repeat on the other side.
Restorative Yoga: Finding Ease
Restorative yoga is a gentle practice that focuses on relaxation and can be particularly beneficial after surgery. It can help increase circulation and reduce tension and inflammation without strain.
Here is an example of a restorative pose that can help reduce inflammation and increase circulation to the legs and knees:
Leg(s) Up the Wall: Prop one leg up the wall while lying on your back, with a rolled-up towel under your knee for support. Search for the best angle and level of support by resting your leg on a wall, chair, or up on a couch or bed. If you are comfortable and have enough support from props, try both legs.
Returning to Strength: Modified Poses
As you progress in your recovery, with your doctor or physical therapist’s approval, you can gradually incorporate modified versions of standing and strengthening yoga poses. Here are some examples with modifications:
Mountain Pose: Stand with feet hip-width apart and try to balance your weight between both feet and distribute pressure evenly across the entire foot. Engage the front of the thighs as if you are lifting your kneecaps up toward your hips. Lengthen your spine and turn your palms forward. If the length of your leg has changed following your surgery (as can happen with joint replacements) you can read about ways to work with leg length discrepancies in Mountain Pose in this post.
Warrior II: Stand with your feet hip-width apart and step back with one leg. Bend your front knee and keep your back heel flat on the floor. Gently bend and straighten the front knee a couple times to get light movement in the joint and then hold the position with the knee bent for a couple of breaths. Only bend the knee as much as is comfortable and use a chair or wall for balance if needed.
Bridge Pose: Lie on your back with knees bent and feet flat on the floor. Lift your hips off the ground, engaging your glutes and hamstrings. Lift up as much as is comfortable. If you need additional support, you can put a block in between your things to increase engagement of your leg muscles or you can play with the position of your feet, bringing them in closer or further from your hips or a little wider apart.
Props like chairs, bolsters, blocks, and straps can be incredibly helpful for supporting your body and achieving proper alignment in poses as you build up your strength and balance. If you find you need help, make sure to consult a yoga instructor familiar with these props or your physical therapist.
Remember:
Listen to your body: Pain is a signal to stop or modify a pose.
Focus on proper alignment: This is crucial to prevent further injury and build even strength and mobility.
Start slow and gradually increase intensity: Don’t push yourself beyond your comfortable limits. Notice over time how your strength and flexibility improve and celebrate it!
By incorporating yoga into your recovery plan, you can find renewed strength, flexibility, and a sense of well-being as you return to an active life. Remember, this is a journey, and with patience and dedication, you’ll be flowing back on your mat and life in no time.