7 Essential Exercise Goals After a Joint Replacement
A recent article published by the Wall Street Journal discussed the rise in joint replacements among younger people.
According to the article, there was a 211% increase in inpatient hip replacements among patients between 45 and 64 years of age.
Inpatient knee replacements increased by 240% among the same age group.
The article notes a few reasons why:
More people less willing to give up their favorite activities
The continued rise of obesity and its effects on the body’s joints
New prosthetics that last longer
More efficient procedures and shorter recovery times
But the article caught my attention for a few reasons.
First, two of my colleagues have recently undergone knee and hip replacement surgeries at relatively young ages.
Second, the Wall Street Journal's article is a sign of the growing need for personal trainers in San Francisco who can help clients get back to work, sports, and daily living after a joint replacement.
Trainers who understand anatomy, biomechanics, program design, and other areas critical to the joint replacement client.
And who can perform assessments, medical history reviews, and thoughtful planning so clients can achieve their goals with minimal risk of re-injury.
So what does this mean if you’re looking to start or resume exercise after a joint replacement surgery?
It means setting the right goals to develop a safe and effective plan.
Exercise Goals After a Knee, Hip, or Shoulder Replacement
Let's look at some common exercise goals that apply to joint replacements after you’ve completed physical therapy and your physician has given medical clearance for you to resume exercise.
1. Restore Range of Motion
Whether it's climbing stairs, sitting in a chair, or squatting at the gym, optimal range of motion makes efficient movement possible. Without it, you may compensate in ways that stress joints or lead to muscle imbalances.
Limited range of motion can keep you from fully engaging muscles you need to strengthen, causing them to become weaker.
A skilled personal trainer can measure your range of motion to accurately monitor your progress. This lets you see the actual changes resulting from a stretching program.
2. Start With the Involved Muscles
Strengthening the involved muscles after a joint replacement is essential to restoring function.
For a knee and hip replacement, this means targeting the hamstrings, quadriceps, and gluteal muscles.
You’ll also want to include muscle groups like the adductors and abductors that play a role in stabilizing the knees, hips, and pelvis.
For shoulder replacements, it means prioritizing exercises that strengthen the rotator cuff, deltoids, and upper back muscles.
Muscles become weak when immobilized or as a result of inflammation after surgery. So restoring muscle strength and size is critical to recovery.
Here's how your trainer can help you strengthen the involved muscles after a joint replacement:
Start with low-intensity exercises to minimize joint stress.
Use exercises that involve both limbs (bilateral) first before progressing to single-side (unilateral) exercises.
Emphasize joint stability, and then move on to strength.
Choose exercises that mimic the movements you use in your daily life (think step-ups and squats).
Modify your exercises if pain and/or swelling occur.
3. Manage Pain
Pain levels above 4 on a 0-10 pain scale typically require a referral to your physician or physical therapist.
But your personal trainer can help you manage lower levels of pain by showing you how to modify or avoid certain movements.
Also, pain should decrease over time. So you’ll want to address any sudden onset or increase of pain after starting an exercise program.
This is where communication between your trainer and doctor or physical therapist come into play.
Your trainer can update them on your progress, discuss modifications to your program, or refer you back to them if pain continues to interfere with exercise.
Knowing when to consult with your medical care provider is a vital skill that post-rehab exercise professionals have. It ensures you get the care you need to stay on track toward your goals.
4. Focus on Function
Functional capacity is your ability to carry out your daily tasks. This might include standing for long periods of time, walking up and down stairs, or reaching and lifting over your head.
Post-rehab exercise programs for hip, knee, or shoulder replacements can make these tasks easier by improving strength, endurance, and flexibility.
Your trainer can help you improve functional capacity after a joint replacement by:
Establishing a baseline to monitor future results.
Creating a structured plan focusing on stability, strength, endurance, balance, and other relevant goals.
Adjusting your program according to your progress.
Recommending home exercises that reinforce your gym training and increase your activity level.
5. Stabilize Your New Joint
The more stability you can develop around your new joint, the lower the risk of re-injury.
Hips and shoulders move in many directions. But as a general rule, the more mobile a joint is, the less stable it is. So we need to make sure these joints can resist external and internal forces after a replacement.
Improving stability reduces stress on connective tissues and allows the joint to move according to its design.
Also, joint stability is critical to overall strength development. So it can enhance performance once you move on to more advanced training methods.
6. Manage Inflammation
A physician can prescribe medications that help reduce inflammation after a joint replacement. And your physical therapist can use treatments like manual therapy, electrical stimulation, and ultrasound.
A personal trainer can supplement these efforts by choosing the exercises, sets, repetitions, rest periods, and frequencies that allow joint tissues to adapt without triggering inflammation.
Key guidelines to follow include:
Avoid high-impact activities.
Avoid excessive loading of the involved joint(s).
Increase exercise intensity gradually.
7. Do Your Homework
A home exercise program plays a vital role in restoring function after a joint replacement surgery.
Working with a personal trainer once or twice a week may not be enough to stimulate the tissues to adapt to exercise.
So you need to incorporate what you learn into your daily activities.
Your trainer will provide a plan you can follow at home to reinforce what you’ve learned and increase the frequency and consistency of your program.
Keep the following in mind to get the most out of your home exercises:
Follow your trainer’s recommendations for sets, repetitions, rest, and other parameters.
Pay attention to your body's response to prevent pain, swelling, and other complications.
Prioritize correct technique over "making it harder" or "getting it over with".
Consult with your trainer when increasing exercise intensity at home.
From Daily Function to High Performance
Getting back to daily function is the first step in recovery after a joint replacement.
And since we’re talking about the rise in adults opting for knee, hip, and shoulder replacements at an earlier age, many of these folks will want to get back to athletic activities.
But proceed with caution.
As the Wall Street Journal article points out, the reason we’re seeing these procedures in younger adults is because they no longer want to give up their favorite sports and hobbies.
These already active adults run a higher risk of pushing themselves too hard too quickly before they’ve fully recovered,
And the article mentions research showing that younger recipients of joint prosthetics may be more likely to have to undergo surgery again to repair damage.
All the more reason why working with skilled professionals at every step of your recovery is key.
Your physical therapist can help you during the acute and subacute stages of healing, when there is significant inflammation, pain, and loss of range of motion.
But once you reach the chronic stage of healing, where pain and inflammation have decreased, and your physician or physical therapist has cleared you for exercise, then working with a post-rehab exercise professional can help you progress to training that’s specific to your sport or chosen activities.
At the end of the day, it comes down to having a thoughtfully designed exercise program, sticking to it, and making modifications where necessary so you’re always moving forward.
As more adults undergo joint replacement surgeries at an earlier age, the need for safe and effective exercise programs specific to their medical history, needs, and goals will increase as well.
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Darwin Ruiz helps adults use strength, flexibility, and cardiovascular exercise to improve function while managing chronic medical conditions. If you’d like to learn more about Medical Exercise, or if you’d like to schedule a phone consultation to see if it an help you, visit the CONTACT page here.
References
Janin, A. (2024, August 22). Younger people opt for new knees or hips. The Wall Street Journal, p. A11.
Jones, M. (2007). Post Rehab Exercise Protocols (2nd ed.). American Academy of Health, Fitness and Rehabilitation Professionals.
Noyes, F. R., & Barber-Westin, S. D. (2019). Return to sport after ACL reconstruction and other knee operations: Limiting the risk of Reinjury and Maximizing Athletic Performance. Springer.