Tag Archive for: running

On the Road Again

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To say that I’ve had a little agony over not running would be an understatement. I certainly don’t want to do anything that’s going to impact the new joint in my knee; on the other hand, my frustration continued to grow over the inability to exercise as hard as I want to exercise. I did what I always do: I looked at the research. Here’s what I found.

Total Knee Replacement and Revision Rates

I decided to look at the most recent research on revision rates in people who ran or started running after total knee replacement. Revision is the word used to describe replacing the original knee replacement because it has loosened or gotten worn. I wanted to see the most recent research because the prosthetics themselves have evolved over the years, as have surgical techniques. There were two research papers that were large enough for me to help make a decision. The references are both open access if you want to read them.

The first study was a meta-analysis of research done on the difference between low physical activity and high physical activity in people who had total knee replacements. While the focus was not on running alone, there were no differences in revision rates in over 4,000 subjects who participated in high physical activity versus low physical activity over a follow-up period of 12 years.

The second study was a cross-sectional study of over 4,000 people who had total knee replacement or total hip replacement. The researchers used online questionnaires to determine activity modes and intensities, postoperative characteristics, revision surgeries, and the Commitment to Exercise Scale and Brief Resilience Scale. The patient-reported follow-up reached five years.

Of the 549 subjects who described themselves as runners before knee replacement, 65 subjects either returned to running or started running after the surgery. After the follow up, 6.2% of those who took up running again required revision surgery while 4.8% of those who didn’t run required revision surgery. The results were not significantly different—about one person. The prevailing recommendation from physicians was to stay active, but don’t run.

On the Road Again

I made the decision to start running again on July 1st. The research that I found was sufficient to give me the confidence to know that if done properly, a return to running can be safe.

What does that mean? Start slowly. While I like to think I’m running, I’m actually talking about a very slow jog. One of the reasons that I decided to return to running was because my fitness level had reached rock bottom, in my opinion. I also know it’s going to take some time.

I began with 20 seconds of jogging about every five minutes. On the day that I wrote this, I did 30 seconds every four minutes. And that’s about the way I’m going to progress: slowly. I’m not interested in running continuously anymore. I got used to a combination of walking and running before the replacement and before my knee got so bad I couldn’t run.

The Bottom Line

I’m glad that my irritation level got high enough to check the research on revision rates after knee replacement. Perhaps it was really more about gaining confidence that, after a year and a half of recovery, the healing of bone to prosthetic was at a point that could support running as I’ve described it. I’m not suggesting that anyone else should do it without checking with their physician. This is my decision and my decision alone. I’m basing it on the best information available today. However, I’d recommend walking or jogging over tennis or pickleball, which include a lot of side-to-side movement; even golf with its twisting motion would be more problematic. You should definitely resume exercise after knee replacement, but talk to your doctor first and make a plan to get where you want to be.

No matter what health, weight loss, exercise, or nutrition goal you set, basing it on the most current scientific information is the best that you can do. I’ll keep you posted on my progress.

What are you prepared to do today?

        Dr. Chet

References:
1. The Knee 2022; 39: 168–184
2. JAAOS Glob Res Rev 2023;7: e23.00019

Knee Replacement Update

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It’s great to be back! I hope your 4th of July holiday was great. Spending some time in Nashville with a few thousand of my closest friends just before the 4th, one of the questions that I was often asked was “How about an update on your knee?” I’ll tell you how I’m doing, but before I do, I just wanted to let you know that Paula will be getting her left knee replaced later this month and probably the right one next year. My knee was bad because of the 20-degree sideways deviation of my lower leg. Paula’s knees are much worse due to arthritis, and she’s really going to benefit from having them replaced.

As for me, I think the thing that surprised me the most was the length of time it took to gain the confidence in the knee to return to full mobility. I had reached the range-of-motion target within a few weeks. Strength I’m still working on. But the fine muscle control necessary for side-to-side movements, turning, posture, and especially balance took at least a year. That doesn’t mean I was inhibited from walking, climbing steps, and doing yard work, but walking downstairs, moving quickly side to side, and even turning sharply is not always there yet. I feel like I’m at about 95% right now.

I’m also terribly frustrated. I’ve been using the recumbent bike, elliptical trainer, and upright bike to exercise. I’ve also been walking outside when the weather permits in the winter and most days of the week now that it’s summer, but for me there’s nothing like running. Could I go back to it, even in some limited capacity? We’re told we can’t run after a knee replacement, but is that accurate? I’ll tell you what I found on Saturday.

Next Wednesday is the next Insider conference call. You have plenty of time to sign up for an Insider membership so you can participate. Get your questions answered and listen to the answers to other Insiders’ questions. Sign up by 8 p.m. on the 19th and you can participate live or listen to the rebroadcast at a later time.

What are you prepared to do today?

        Dr. Chet

Race Volunteer: My Observation

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Before I get to where you could be in a year, I’m going to give you my final observation on working the finish line at the Fifth Third River Bank Run a week ago. Before I do, I want you to understand that I respect every runner, walker, and wheelchair competitor. One woman did the 25K on a knee-walker to show it takes more than two kinds of cancer and a fractured heel to stop her. I’ve done every distance in the race . . .

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Race Volunteer: You Must See It to Believe It

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This is what I saw and what I experienced working the finish line at the Fifth Third River Bank Run.

Rain
From the moment I got there at 5 a.m. and pretty much throughout my entire time at the finish line, it rained. Almost seven hours. Even the medals were wet. I’m glad it was 65 degrees with no wind or it could have been more uncomfortable. But for a runner, that’s perfect weather: every step cools you down. And of course rain is no obstacle to the dogs intent on winning their race bandanas . . .

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Race Volunteer: Why I Did It

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The Fifth Third River Bank Run is the premier running event in Grand Rapids every year. When I say “event” I mean it: this year, close to 14,000 men, women, children, and dogs participated in the various races. There is a 5K, 10K, and the USA Track and Field 25K Championship, along with wheelchair and handcycle races. There is also a 5K walk and a 5K walk with your dog—Fido gets his own Riverbank Run bandana.

I’ve run the 25K several times and intended to do it this year. I was training for it as I got . . .

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