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lechatblanc 06-17-2011 11:05 AM

Riding after knee replacement surgery
I had to give up riding 8 years ago because of severe pain in my knees - I could no longer mount from the floor or cope with rising trot, to mention two problems. Last year I had a full right knee replacement, and I will need the left one doing as soon as I can cope with the surgery. I thought my riding days were over but I have recently started with a Western Style coach and I think it might be the answer. I am not planning to go in for competitions or anything, but to be able to do some arena work and the occasional hack/trail ride would be wonderful, and I am full of hope again. Does anyone here have any experience of riding after such surgery, and any tips for me?

JustDressageIt 06-17-2011 11:23 AM

Many TKR patients are able to ride again, it seems to be about comfort and safety.
I'm sitting here recovering from my second knee surgery (not replacement) actually. Your knee will tell you when too much is too much. Don't let it hold you back from activities you love if you can ride comfortably! Speak to your surgeon and your physiotherapist as well - they may fashion some exercises to limber you up and strengthen it for riding, and discuss any concerns you may have.
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maura 06-17-2011 12:15 PM

I've been coping with severe knee pain for about 7 years.

I never actually stopped riding, though it became quite difficult. I gave up mounting from the ground and used a very tall mounting block. I continued to ride using NSAIDs, pain meds and icing before and after.

I had TKR on my left knee a little over a year ago and was back riding after a month. I am now riding more comfortably and with more range of motion than before surgery. I ride hunt seat and mostly trail ride. I do find I am more comfortable on a horse without a "big" trot.

At some point in the next couple of years I will need TKR on my right knee, and I expect to be back riding shortly after that as well.

So it's completely reasonable to return to riding; and how much you can do depends on individual factors.

Let's see - tips. Get the tall mounting block! Get either endurance style stirrups for Western, or flexible stirrups for English. If posting is a problem, well, then, switching disciplines to ride sitting makes sense to me!

Good luck!

ridesapaintedpony 06-23-2011 10:57 PM

Maura may I ask your age group? that you were able to ride again a month after your surgery is incredible. the rehab time after surgery is one of the reasons I have put it off for years. I show dogs as well as ride horses and I'm afraid I would have to give up both for a long time.

lechatblanc 06-24-2011 04:08 AM

I think it depends on the type and extent of the surgery. Years ago, when I first started getting athritis in my knees, my doctor said that if I could be improved with keyhole surgery then the rehab time would be much shorter. But by the time I had it done I needed a complete prosthesis and that can take anythng from 6 months to two years to recover from. Apparently knees are worse than hips when it comes to recovery time. I have to get the other one done, but because I am not yet fully recovered a year after after the first op, I am putting it off as long as possible.

By the way, I have now had two riding sessions, and am so happy to be back in the saddle. This week my instructor allowed me to jog and canter so I am getting my confidence back. The only real problem was dismounting, when none of my limbs seemed to want to obey my brain! My final dismount was not the most graceful thing you have ever seen - more like a sack of potatoes being unloaded from a cart.

maura 06-24-2011 07:35 AM

pony and le chat -

I am 52, I was 51 when I had the surgery. I had full total knee replacement; I went in hoping for the partial, but the central and medial compartments where too damaged. I have the beautiful 12" long suture line down the front of my leg. Frankly, my doctor did not want to do the total at my age, but we had exhausted all other options, and I could only walk short distances, couldn't sleep at night, could only ride because I'm incredibly stubborn and was taking a lot of NSAIDs and pain medicine.

My result is not typical by any means. I believe my recovery was so rapid for a couple of reasons 1.) I was highly, highly motivated in PT and did everything I was asked and more. 2.) I was SO relieved to have a reduction in pain and improvement in mobility that it motivated me further.

When I rode at one month out, it was on the husband/child/guest horse, mounted form the very tall mounting block, and it was a walk/trot trail ride. However, at six weeks out, I was riding the horse that really moves out, and doing everything I usually do.

I will eventually have to have my right one done as well, my hope is to wait a few years.

DaraT 06-24-2011 10:30 AM

Thanks for a positive story on TKR and riding, Maura. I'm over 50 & also looking at both knees being replaced as soon as I can't stand the pain anymore. I still ride as much as possible. I can actually ride for longer periods of time than I can walk or stand. I just hope I have a recovery as good as yours has been. I've already told my Hubby that not being able to ride is not an option for me.

ridesapaintedpony 06-25-2011 10:27 AM

Thanks Maura. We're the same age. I will have to have a total since there basically isn't anything left of my right knee. No cartilage, so it's bone one bone whenever I take a step. Plus the ligaments are shot and the knee is not very well supported. I live on Motrin.

waresbear 06-25-2011 08:08 PM

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I am in the same age group. 9 years ago I tore the large ligament in my knee. When the original inflamation settled down, I still rode, both english & western and still competed. I could no longer kickbox though, would get fluid on the knee and I would limp. I had ACL surgery close to 2 years ago, and I saw no improvement to knee strenghth or pain other than the fluid did not return. I always did low impact aerobics, then I just decided, lets go for it and see if the knee gives out or gets stronger. I put together a crazy high impact, plyometric, almost hour long workout. First 2 weeks of it, I had shinsplints, was limping & sore, but I could feel muscle coming back. I powered thru the workout, now the knee is strong again & I can kickbox. So maybe the key is building back the muscle?

maura 06-25-2011 08:39 PM

Here's the rest of my medical history, because it is relevant to the discussion.

I am an ex-professional horsewoman. In my twenties and thirties I rode 5 - 10 horses a day, for brief periods when I was working with TBs bound for the track, it was 10 - 14. I had a career ending injury when I was 39; I shattered my right ankle so badly it took 5 surgeries, including 2 bone grafts, pins and screws and a lot of rehab to put it back together again. I spent a lot of time on crutches and in a wheelchair and I believe that contributed to the accelerated degeneration of my left knee.

After that, I rode on the average amateur's or pleasure rider's schedule. Late forties, my knees started to bother me a LOT. I went through the entire gamut of non-prescription and prescription NSAIDs. I had fluid drawn off the left knee several times. I had cortisone shots every 3 months for 4 - 5 years (had them on a less agressive schedule in the right knee and right ankle as well) tried the hyluranic acid injections, and had two surgeries previous to the TKR - a standard arthroscopy and clean up of the meniscus and a lateral release - cutting the lateral patellar tendons on one side to allow the knee cap to track differently. During this period, I frequently walked with a pronounced limp and sometimes had to use a cane. I started taking non-narcotic prescription painkillers, with narcotic ones for break through pain. In order to ride, I iced before and after and doubled up on meds.

After all of that, my doctor finally agreed to TKR at 51. I had to go off the presciption NSAIDs and pain meds beforehand, and could barely walk well enough to walk into pre-op on my own.

So I loved my TKR. They gave me a spinal block to perform the surgery, and I woke up after surgery in less pain than I had been in *years*. The pain relief from the spinal block carried over for the first few days of PT, a huge advantage.

One year out, my functional level is much, much higher, but I still take the NSAIDs and pain meds for my right knee. I still sleep with a pillow between my knees. The only limitation on my left knee is that I can't kneel directly on the prothesis. Also, if I overdo it, the left knee swells dramatically.

To sum up? If I could control the pain with OTC meds, and I was relatively functional, I'd wait for the surgery. Even thought my result was incredibly positive, I'm in no hurry to do the right knee. I will manage my right knee with cortisone injections and oral meds for as long as possible before considering the second TKR.

BUT the big good news is that you absolutely can ride, and ride well, after TKR.

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