1) Patient Education:  It’s the authors opinion, that majority of the depression and anxiety is due to fear of the unknown.  Pre operative fear about the procedure, what to expect, and post operative fear: Am I healing right? Am I bending enough? What if I have a blood clot? Was getting this surgery a big mistake? etc…..  I have seen countless numbers of patients not understand what to expect or understand what they are got themselves into. Suddenly they are 4 days post-op, in more pain than Day 1 with less mobility, and feeling like they made a huge mistake.  If they were not prepared for this normal physical set back, anxiety and depression can quickly set in.

2)Get a head start on pre operative depression:  Depression before the surgery is highly correlated with depression after.  If necessary, seek psychological help prior to the surgery. Any physical therapist doing a pre operative visit should screen for depression.  

3) Setting appropriate goals and timelines:  A patient severe multi joint arthritis, fibromyalgia, COPD and heart disease will not heal as quickly as someone who is otherwise totally healthy.  If you are a therapist, take this into consideration when designing a plan of care. If you are a patient, do not compare yourself to others or your neighbor.  Everyone’s rehab process looks a little different.  If you are 4 weeks post op and only at 95 degrees of flexion with multiple health problems, do not compare yourself to others who might have had more flexion at 4 weeks.  

4) Get fresh air: Sunshine and natural light are proven ways to improve depression and feelings of well being. Set up a place to sit outside and make being able to get to and from that outdoor sitting location safely a #1 priority upon getting back home.    

5) Interdisciplinary care: If you are having severe depression symptoms and it is not being improved with patient education or improving as your function improves. See a healthcare professional who is licensed to treat you for mental health. 

Bonus #6)  Don’t lose sight of what is important! Function so you can get back to living your life is the #1 outcome. Focus on function, not a degree measurement and not making your therapist happy. Example: I had a client who was 3.5 Weeks post operative.  She was doing well and decided to go to her grand sons soccer game and then go to her daughters afterwards to for some family time.  All the walking caused her to have increased pain on Sunday and Monday. I had to scale back her exercises on Monday because she was in a little more pain than normal.  She was beating herself up and frustrated at the set back. She felt as if she let me down because she could not do her exercises.  She lost sight of the fact that 6 weeks ago her leaving the house and walking though a field was not possible because of her knee pain being so bad. I think she was surprised when I told her how proud I was of her for being able to get out of the house and was not the least bit disappointed at having to scale back some of her exercises for a day or two.  

The reality is that many people following a total knee replacement are not getting the support they need. With current demands on therapists and surgeons it has left many people in the dark and needing more guidance.  If this is you, we would love to help provide you with additional coaching to supplement your journey. Schedule your free zoom assessment HERE