Knee Replacement: Prehab Exercises & Nutritional Advice

Looking for prehab exercise and nutritional advice. Surgery scheduled Nov 7

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What is the surgery for?

Knee replacement. Been bone on bone for a while

Thanks

Steve Butler

Steve,

No doubt there is pain, but is it specific to certain movement(s)?

Pat

September of 2020

September of 2022

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@prisonsports ,

Our general prehab guidelines for knee replacement fall into 3 categories of things you want to do:

  1. Movement: We want to move the joint in as full of a range of motion as possible, WITHOUT PAIN (pain is a skill your brain learns, so we don’t want to train to get good at it). Examples would be unloaded/open chain knee flexion & extension (if any loading is painful) or deep split squats (if light/bodyweight loading is not painful), always ensuring perfect form with the knee traveling in line with the middle of the toes. Another important mobility drill we use is Tibial Rotations (Seated Tibial Rotation (instructional) - YouTube). Again, I can’t emphasize enough only using a pain-free ROM. We find that a lack of tibial rotation is often what messes up folk’s knees (outside of a contact injury).

  2. Isometrics: Isometrics are highly UNDERUSED, and are the least neurologically threatening form of strength training. Often folks can do isometrics pain-free, whereas dynamic resistance is uncomfortable or painful. Example for the knees: Standing Knee Flexion Isometrics - YouTube

  3. Sensory Input: Even before surgery, we want our clients’ brains to have a really good “map” of the knee, since the surgery itself will cause damage to many kinds of nerve endings. Using sensory input such as vibration, skin stimulation (knuckles or stiff brush), percussion, hot/cold packs, and kinesiology taping is a great way to ramp up sensory input from the knee to the brain, building a better map, thus improving outcomes and the eventual rehab process. Target the musculature surrounding the knee joint (quads, hams, calves). Use for 5-10 minutes multiple times a day is best, and even better is doing it WHILE you do mobility drills (i.e. percussion gun on the hamstrings while doing the Tibial Rotations).

Hope that helps,

Coach Pat

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I had a total ACL rupture repaired in 2019. That’s more soft tissue damage that what you’re going thru, but I did a lot with my diet and supplementation that i believe helped my recovery and may help you.

BEFORE

About a month out from the surgery I went on an Anti-inflammatory diet. I cut all sugar, refined carbs, booze, ect. I did this to prime my immune system to be ready to only have to deal with the inflammation caused by the surgery.

I also started taking doses of Curcumin (also for inflammation control) and Milk Thistle. My wife had issue with “Anesthesia Brain” after some surgeries she had a couple years ago, and I was pretty worried about that, so I started the Milk Thistle to clean out the liver and get it ready for the anesthesia.

I used this from THORNE Research, which is Curcumin, Milk Thistle, and Artichoke, all of which was good for the liver - https://www.thorne.com/products/dp/s-a-t-reg

Also, try to keep active and training as much as you can before the surgery. The amount of atrophy from the nerve block and the procedure will be kinda shocking. I called my right leg my “baby leg” for a while.

After

After Surgery I kept on the Anti-Inflammatory diet and the Curcumin, Milk Thistle, and Artichoke. I also added Lionsmane Mushroom to help get past the brain fog and rebuild any brain cells killed off by the anesthesia. I used this coffee from Four Sigmatic that has Lionsmane in it. The Packets are instant and it’s easy to make

https://us.foursigmatic.com/products/mushroom-coffee-with-lions-mane-chaga

I also added Collagen Peptides twice a day, one dose either right before or right after PT. Current research show that collagen ingested right before or right after exercise is used to build connective tissues (ligaments, tendons, ect) rather than hair or finger nails. Research also shows that taking the collagen with Vitamin C makes the collagen more absorbable.

I used this collagen, it’s available at Target or Whole Foods - https://www.vitalproteins.com/collections/all-products/products/collagen-peptides

It doesn’t have a flavor, so I just put it in my coffee.

If you do use it, make sure it’s the only protein source you take it with. If you add whey or eggs to it the collagen won’t absorb as readily.

I also saw some research that Vitamin A and E helped with the reconstruction of connective tissues, so I added that as well.

I got the C, A, and E from GNC

More research mentioned Creatine for connective tissue repair, so I added 5g to each of the collagen doses. Again, just in coffee.

If you’re surgery is like mine you’ll be pretty… colorful. You can use Arnica Gel to break up the bruising, but once they took my sutures out I started using this:

https://battlebalm.com/

it’s like Tigerbalm, only better. It has arnica in it and after 2 days my bruising was almost totally gone. I got the sample pack and used the extra and Daemon Strenth. It’s good stuff. The owner had his ACL done and wrote several blog posts on it. See below:

https://battlebalm.com/blogs/news/the-1-thing-you-need-to-do-to-improve-acl-recovery-after-surgery

https://battlebalm.com/blogs/news/recovering-from-major-knee-surgery-without-ice

https://battlebalm.com/blogs/news/109858311-battle-balm-one-skin-staph-infection-zero

https://battlebalm.com/blogs/news/38889985-3-big-reasons-to-use-battle-balm-to-prepare-you-for-acl-reconstruction-surgery

Once you start rehab, make that your new mission. I left every session feeling half dead. The stationary bike will be your new worst enemy.

Let me know if i can help you with anything else.

La’

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Good work @redsol1 ! Thanks for the great work!
Of course, follow your doctor’s guidance, especially if you are taking other medicines. Even natural supplements are medicine and can cause harm! However, most of what @redsol1 mentioned here is good, and I recommend it.

Thanks Doc!

La’