Kneeling After Knee Replacement —
Doing activities such as gardening or cleaning around the house likely became impossible before your knee replacement. Pain during kneeling is a common reason people get their knees replaced and a major goal after surgery.
So what is the expectation after knee replacement regarding kneeling? Can you comfortably kneel after knee replacement? The truth about knee replacement surgery can be surprising to many.
In general, kneeling after knee replacement is not something you can expect to do for long periods of time after surgery. It depends on the type of knee implant your surgeon used so be sure to ask them if kneeling is allowed or expected. Good news for you is there are ways to get back to kneeling after knee replacement using supports and kneeling devices.
Your Patella (Kneecap) And Its Importance to Kneeling
Let’s discuss why knee replacements are not meant to be knelt on for long periods of time. The discussion starts with the kneecap or patella and its involvement after your knee is replaced.
Pain under or around the kneecap was likely a pain area for you before your surgery. Clicking or popping around the kneecap area is a common complaint if you have knee osteoarthritis.
When you get a total knee replacement, your surgeon will keep your original kneecap at all costs. Artificial kneecaps have not been perfected to a point where they provide good enough strength and support so keeping your original is priority.
Your surgeon will likely put a liner or button on the back side of the patella to provide a smoother surface for gliding during knee bend. Grooves on the back of your kneecap are needed to glide smoothly against the new knee joint.
The patella plays an important role in kneeling in both your old and new knees. Having a new surface on your patella in combination with a new knee joint does not give the same kneeling strength.
Prolonged pressure on your new knee will cause pain in the standard kneeling position unfortunately. There are however ways around this issue which will be discussed below in depth so all hope is not lost.
Can You Kneel on Knee Replacements?
Yes, you can kneel on a knee replacement but there are many factors involved that you will need to address. If you are able to maximize everything discussed below then you will have a good chance of returning to some kneeling activities.
The more of the below factors you can maximize, the better your chances of being able to kneel on your total knee replacement. Again, don’t forget that knee replacements are not designed to be knelt on. Ask your surgeon for permission to attempt kneeling and activities on all fours before you attempt.
Below are a number of factors you will need to return to kneeling for long periods of time.
Age – If you are at a higher age when you have your knee replaced, the surrounding tissues including ligaments, tendons and muscles are that much older. Having these older structures does not work in your favor.
Those who are under the age of 60 will have a much easier time returning to kneeling activities than those over. Body tissues at a younger age have more elasticity and stretching capabilities. Returning to kneeling will rely heavily on these features of your body.
Knee Range of Motion – A normal knee bends from 0 to 130 degrees however this does vary based on your body type and age. After your surgery you will perform physical therapy exercises to regain this range of motion over the first 2 months.
Some people struggle to get back to the normal range of motion for a variety of reasons. Included in those are pain, swelling, scar tissue buildup and previous range of motion issues.
In order to kneel for any length of time you will need to be at the maximum level of range of motion. Getting as close to 130 degrees of knee flexion (bend) is suggested for anyone returning to activities requiring full knee bend such as kneeling or squatting.
Getting this full bend will not come easy and will require dedicated daily PT sessions with discomfort expected. Do not skimp on this bending and make sure your physical therapist knows this is a primary goal for you.
Weight/Body Type – If you are moderate or severely overweight you will be placing additional load on your new knee in bent or kneeling positions. Attempting to maintain a kneeling position with this extra body weight will not be a success.
It would be highly suggested to get down to your normal weight and even lose some additional pounds if you want to successfully kneel. Dropping those extra 5-10 pounds will go a long way to allowing less stress to your knees.
Previous Kneeling Capability – Maybe THE most important factor to you returning to kneeling is how much you could kneel BEFORE your knee replacement. Were you an avid gardener kneeling daily or have you not knelt for many years?
Our bodies are very smart and learn to adapt quickly, both good and bad. They learn to know when you need to do something and when certain activities are no longer in demand.
If kneeling during gardening is something that you continued to do even with your knee pain then you have a much better chance of getting back to it. Sorry in advance to the couch potatoes looking to return to heavy gardening, that’s not going to happen.
So to answer the question ‘Can you kneel on knee replacements?’, the answer is maybe.
How Soon Can I Kneel After Total Knee Replacement?
In order for you to safely kneel after your knee is replaced, you will need to regain your maximum range of motion. Usually this takes at least 2-3 months if not longer with dedicated physical therapy and exercise.
Be sure to check with your surgeon to make sure you are cleared to kneel on your specific knee joint. Your surgeon may limit you on kneeling for a variety of reasons one of which being the specific type of device implanted.
I would suggest to my patients to do 5-10 minutes of stretching and warmups including quad and hamstring stretching before attempting to kneel. It would also be wise to take frequent stand up breaks and not kneel for more than 10 minutes straight.
Best Knee Pads for Kneeling After Knee Replacement
A frequently asked question is whether or not to use knee pads for kneeling and the easy and correct answer is yes. However, it may not be necessary to wear the old fashioned ‘roofer’ knee pads often seen amongst kneelers.
For those looking for a specific recommendation on knee pads, these pads sell for under $20 and have excellent customer reviews and construction. No Cry Flooring and Roofing Knee Pads on Amazon (https://a.co/d/8GZ2pP6).
While these knee pads do force you to place body weight on the knee directly, they can at least provide some cushioning and comfort to protect the knee. Proceed with caution and make sure you do everything to maximize your kneeling potential.
Alternatives to Knee Pads for Kneeling
There are a few videos on YouTube that smartly demonstrate various ways to protect the knee during kneeling by using padding below not on the knee. By setting up supportive but comfortable padding around the upper shin region during kneeling this allows practically zero direct weight on the knee joint.
However in the videos they do not mention or discuss the exact padding they use for the demonstration. I found one highly rated knee foam that should work for this purpose selling for under $15. You can find it on Amazon here: https://a.co/d/aMuPLtb.
In any case, be sure to give your new knee a ‘leg up’ when you try to kneel again. It will need all of the support, setup and prep you can give it to succeed in you return to kneeling
Final Thoughts on Kneeling After Knee Replacement
- Knee Replacements Are Not Designed to Be Knelt On But There Is A Chance
- Your Kneecap Is Very Important In Your Return to Kneeling
- Maximize All Rehab and Body Issues to Increase Your Chances of Kneeling
- Using Knee Pads or Padding Should Be Part of Your Return to Kneeling