Cross-country Skiing following Total Knee Replacement
He runs a biomechanical assessment clinic, advises on footwear and custom orthotics.
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Cross-country skiing is a popular sport in Scandinavian countries. Its popularity has increased worldwide, as it is a full-body sport that can exercise several joints with little chance of injury. Interestingly, it has been reviewed that a return to downhill skiing is deemed a higher risk for a novice skier than those of advanced level following a Total Knee Replacement (TKR).
What is a Total Knee Replacement?
A Total Knee Replacement, also known as knee arthroplasty, is an operation to reduce pain and restore the function of the knee joint. This surgery is usually offered to people with severe knee arthritis.
A Total Knee Replacement involves replacing both sides of the knee joint. A common goal for patients is to resume sport following surgery: if cross-country skiing is what you love, here is what a rehabilitation program will look like.
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Total Knee Replacement: first 6 weeks from your surgery
Generally, you will spend the first week of your recovery in the hospital following your knee arthroplasty. The initial rehab phase involves reducing pain and swelling and early recovery of your range of movement. In particular, the recovery of your knee extension will be vital. To achieve this, your Physiotherapist will provide specific exercises and manual therapy techniques.
You will begin basic strengthening exercises for your quadriceps, hamstrings, and gluteal muscles. You will be initially walking on two crutches and weight-bearing as tolerated whilst progressively walking on 1 crutch only and finally unassisted.
Total Knee Replacement: after 6 weeks from your surgery
The focus of this stage will be to improve strength and endurance around your knee to increase stability and your overall confidence level. This is usually done with simple double-leg squats, bridges, front and lateral leg raises, and general balance exercises. Once you are pain-free and your range of movement allows it, you could start using a stationary bike to start working on your fitness level whilst recovering the range of movement of your knee.
Cross-country skiing following total knee replacement: after 3 months from your surgery
At this stage, you should be able to walk pain-free. You should be able to progressively increase your resistance training and continue working on your aerobic fitness.
Ideally, you might try relevant exercise machines for cross-country skiing, such as the elliptic trainer, which allows simultaneous movement of your arms and legs. This will help prepare your body and brain for returning to skiing after TKR. Another suggestion is to start with Nordic Walking before you head back to the slopes.
In this exciting study on knee joint forces when steering in alpine skiing, it was found that novice skiers lean back more when turning. This leads to nearly double the force through their knee joint compared to a highly skilled skier. It was recommended that novice skiers place greater force through the knee joint than highly skilled skiers in icy conditions or when there are more moguls.
It can be concluded that flat-smooth cross-country skiing following a total knee replacement is relatively safe once you have completed a thorough rehabilitation program with your Physiotherapist and are discharged. We recommend wearing a skiing knee brace for extra protection.
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We are specialists in treating Knee conditions such as a Total Knee Replacement, and you can see one of our Sports Injury Physios in our clinic in Fulham, South West London. We also offer running gait analysis and biomechanical assessments.