Knee pain that won't go away and the recuperation process after knee replacement surgery.

Making the decision to have knee replacement surgery after suffering for years with pain and dysfunction can be both stressful and depressing.
When conservative measures fail to restore mobility and decrease pain, through physical therapy, non-steroidal anti inflammatory medications, or cortisone injections, then surgery is the next alternative.

The knee is a hinge joint supported by cruciate and collateral ligaments and reinforced by the quadriceps, hamstrings and gastrocnemius muscle groups. They help to provide stability to the knee joint. The meniscus (cartilage) helps to cushion and absorb shock from compressive forces. The patella (knee cap) is embedded in the quadriceps tendon and allows for a greater mechanical advantage during knee extension, due to its location.

Golfers find it a burden to play with a degenerative knee joint, because they can’t pivot very well, due to pain and continuous loss of stability. Distance and accuracy start to suffer and then the golfer starts to lose interest in playing.

During the initial stages of a degenerating knee, there is swelling and some discomfort around and inside the knee. As the process continues, there are increased arthritic changes occurring, the cartilage loses its integrity to give adequate support to the joint, the swelling and discomfort increases, and the supporting structures around the knee strain to give support to the joint. Finally there becomes a noticeable deformity on how the tibia is positioned in comparison to the femur. The pain at times becomes unbearable, the grinding increases and mobility and weight bearing activities diminish. This would be a good time to have surgical intervention.

After surgery, there will be discomfort, swelling and pain with weight bearing activities. Depending on the physician and the procedure, usually you will need crutches or a walker for a while, in order to protect the surgical knee. Touching down to partial weight bearing is usually indicated for a few weeks. Restoring range of motion while controlling the swelling is of first importance. Non-weight bearing exercises are first given to start building up the strength around the knee, and progress to weight bearing activities.

In order for golfers to enjoy the game again after a knee replacement, it may take months before the integrity of the knee is strong enough to handle the grind again. Even though you are feeling good there is still a critical period for healing that must be addressed.

I have had some patients in the past start back too quickly and it took them several months to start up again because they were too anxious to return to the game. Even though you have gone through some physical therapy and have restored mobility and function, you must take into consideration that golf is played on unforgiving angles. If all you did was strengthen in a single plane at a time, your knee is still susceptible to injury even if you haven’t prepared it to handle rotational forces in all three planes.
Using cable machines, balance boards and swiss balls are good tools to use to restore integrity to the knee. They will challenge you in all planes of movement, and there is a progression that is carefully followed to insure that balancing out the rest of the body occurs.

It is important to start back to golf slowly!! You may want to swing with high irons first and watch how many buckets that you have used. Starting with a small bucket would be a good start, and then progress from there.
Playing an actual round of golf should only be attempted after you have successfully warmed up and have not experienced any pain or discomfort from hitting ball at the driving range.

Wear soft spikes and be aware of the conditions that you will be facing, such as weather and ground surface changes.
If you have had a knee replacement, please seek out a physician’s approval before attempting to play golf.

Michael K Butler is Co-Owner Of Kinetix Health and Performance Center and specializes in sports performance conditioning and rehabilitation from injuries. He can be reached at 760-200-1719 or at kinetixcenter.com.