Sporting after knee surgery

Sporting after knee surgery is important. Many want to pick up their lifes or have decided to live a healthy lifestyle or to lose some weight. But what kind of sport are suitable? How do you make your choice? You should choose a sport that suits you and your newly operated knee.

When you would like to sport

There are many sorts of major knee operations. The big three are: Total knee replacement ( often in case of osteoarthritis, mostly in elderly, also after a huge trauma), repair operations after a traumatic fracture (all ages, sometimes variable results because of the amount of damage in the knee to start with, ask your doctor some advise), and repair operations after a torn cruciate ligament (mostly athletes). So there is an enormous variety of people concerned. This variety of people will want to do all sorts of sports.

Generally, after a total knee prothesis operation most doctors recommend to abstain from high-impact sports. Low-impact sports are okay. Intermediate-impact sports are only recommended if you have done them before and if you know very well what you are doing. When in doubt, be protective of your knees or ask advise.

First a few remarks on sporting and knees:

1. High-impact sports after knee arthroplasty

A recent study suggests people could do high-impact sports after a total knee replacement surgery. In this study a group of people was followed doing high-impact sports against the advises of their doctors. A control group did low-impact sports. After 7 years no statistically significant differences in wear or in mechanical failure were found between the two groups. With only one clear exeption: Power lifting which involves squatting and heavy weights is really bad after a knee replacement. The absence of differences between the two groups in the study is possibly due to improvements in knee prostheses. Maybe 7 years post surgery is too short a period to see significant differences in wear or mechanical failure, the article suggested. Maybe it is better to await results after 15 years, for by then differences could really have occured. Until then most docters still advise to do only low-impact sports or intermediate-impact sports done with caution. For the full article, see this site by the Arthritis Foundation,

2. Sports and bodyweight

The weight of a heavy body overloads an operated knee, obviously. Sports together with a reduced calorie intake leads to less weight and less overload of the knees. This goes for all knees…. So please, resume an active lifestyle.

3. Impact of running on ostoearthritis

Research shows that osteoarthritis does not develop faster or in an earlier age in high impact sports like running. But once osteoarthritis is present, running agravates and accelerates arthritis. Someone who has had a knee replacement (arthroplasty) due to arthritis should consider whether the other knee also could be afflicted with arthritis, before he starts running again.

4. Taking up pivoting sports after an ACL tear

Anterior cruciate ligament (ACL) injury happens mostly to (professional) athletes. For them a quick return to their pivoting sports is, of course, very important. They have an arthroscopic operation 4-8 weeks after the tear, when full range of motion is eshtablished and any joint swelling has disappeared, (to prevent arthrofibrosis). They are put on a rehabilitation schedule immediately after surgery and can play again in 4-12 month. In a number of cases, people are not operated after a cruciate ligament tear. If their knee is sufficiently stable (well trained muscles) and they are willing to take the risk, they also can resume their sports.

Re-rupturing the anterior cruciate ligament happens after resuming pivoting sports. Other knee problems like a torn meniscus or osteoarthritis (OA) occur more often after an ACL tear, whether operated or not. On the long run people with a previous ACL tear quit pivoting sports more often and earlier than people without an ACL tear, even when they resumed their sports after treatment. On the long run it could be better for the health of the knee to stop pivoting sports altogether. ACL surgery improves knee stability by reparing structures within the knee, but it can not prevent secundary knee problems. The athlete should talk about the pros and cons with his surgeon and make an informed decision.

Several low-impact sports

Low-impact sports can be enjoyed by most people after knee surgery. But be sure to always asking advice from your doctors!

  • Walking is just fine and highly recommanded. It is healthy. WhatBoots more do I need to say? Walking gives a lower impact to your knee than running.
  • Nordic walking is a good sport. Part of the body weight is taken over by the shoulder girdle and the sticks, you are forced to walk upright and are less likely to limp in an effort to spare the leg. Take a few lessons to obtain a good technique.
  • Swimming. Perfect! If you have acces to a swimming pool while you are still recovering (when you feel safe and have permission from your physician of course), walking in a pool and doing exercises in the water are a perfect way to recover your mobility and strength. When you have fully recovered, swimming is a good way to work on your strenght and mobility. Fitness classes are provided in many swimming pools.
  • Bicycling. Biking is a exellent way to work on your muscle strenght Bicycleand shape and the souplesse of your knee. The Netherlands (where I live) are a rather flat land where biking is easy. If necessary, buy an electric bike, they are great and help you up the ramps. Indoor biking is also very good. Start with a light resistance and preferrably on a flat trail. Dutch people often regard biking not as a sport but as a mode of transportation. We use our bikes (many people have more than one bike) in stead of a car or train. Biking is part of our life in the Netherlands.
  • Calisthenics, gentle aerobics. All your muscles are strengthening. An excellent choice, but avoid the high impact exercises.
  • Zumba. Only the low-impact movements, try to avoid twisting movements.
  • Pilates. Perfect! Some exercises involve kneeling down. Try a thicker mat, or even a double stack, or just skip that particular exercises and concentrate on the other ones.
  • Low-resistance weightlifting to keep the muscles toned. Do not use heavy weights.
  • Low-resistance rowing. Be sure to not bending the knees in a smaller than 90 degrees angle.
  • Yoga. Some exercises are demanding, be careful.
  • Elliptical machines (crosstrainers) are very good to train strenght and stamina. Heart and lungs have to work!
  • Ballroom dancing and gentle modern dancing. Avoid twisting!

High-impact sports to avoid after a knee operation

  • Baseball
  • Jogging and running
  • Powerlifting, weight lifting with heavy weights
  • Gymnastics
  • High impact aerobics. Aquarobics are fine!
  • Soccer
  • Hockey
  • Football
  • Basketball

Intermediate-impact sports, ask for caution

  • Golfing is dubious, because of the forces on the knee while swinging. On the other hand, if you could manage to be cautious, you could play golf after a knee surgery. Do not wear spiked shoes.
  • Tennis. Doubles games have less impact than singles. Don’t run and be cautious. Ever tried triples games?
  • Bowling, but perhaps with a lighter ball.

More information about knees and surgery?

Problems after knee surgery like pain, swelling and stiff knee

Arthrofibrosis, scar tissue in the knee

Keeping a pain diary if pain does not seem to diminish

If you have any comments or perhaps additions or advice for fellow sufferers, would you please give a reaction?