It was a bluebird January day and Kim Jackson was standing atop a green circle trail at Vermont’s Pico Mountain.
She was at once giddy and nervous that she – as a pretty much a lifelong skier – had ever been on a green trail before.
As her husband taped, she carved out lovely, arcing turns, her face lit up with joy.
Jackson was discovering what many realize today: Skiing after a total knee replacement (TKR) is totally doable.
“It was such a relief,” she said of that first run. “It was very much ‘thank God I can do this again.’”
Up until about 10 to 15 years ago, the idea of a total knee – and other joint – replacement usually meant that skiing was possible, but not a sure thing.
Today, with the precision of robotic surgery, the improvement of the artificial joints themselves no longer having cement to wear down over the years and a better understanding of how to prepare for and recover from TKR.
I speak from experience. In late August 2020, I had my left knee replaced. This winter I’m carving turns and savoring ski days almost like it never happened.
Dr. Scott Oliver, President of Plymouth Bay Orthopedics (https://pbortho.com), knows this from every angle. He’s performed countless surgeries over the years, and has had both his knees replaced. An avid lifelong skier, he’s back to the sport full speed. That’s his goal for his skiing patients.
This writer is one of them.
Oliver said that while TKRs have been improving over the past 30 years (the first was in 1969; he witnessed his first as a med student in 1975), it’s been the last 10 years that “Things have really taken off.”
Oliver said things like regional pain blocks that allow for immediate movement after surgery, injections done during surgery that speed up the physical therapy (PT) process, robotic technology and no longer using cement are key.
So can any skier or rider get back to their sport post TKR? For the most part, and with the right dedication to recovery, Oliver said, yes.
His advice to those hesitating to have the surgery due to fear of not skiing again? Have a smart plan and stick to it.
And that plan should begin before you go under the knife.
“Prehab is important,” Oliver said. “It’s paramount that a patient understand the need to have strong thigh muscles.”
He suggest patients begin – as long before a possible TKR as possible—building those leg muscles and the core muscles.
“You have to do the work,” he said. “That’s key.”
So how should one approach a TKR as a skier?
Don’t be afraid: Jackson, like others, tried all kinds of patchwork solutions to keep skiing with a hurt knee. Braces, slower skiing, over the counter pain meds, and more. Last year, she took one run and realized – worried or not – the time had come. Her only hope to ski again would be the TKR.
But she wasn’t worried. Her team at Dartmouth Medical Center, she said, encouraged her – as Oliver did me – that with the right plan she’d be back out again. Plus, she said, living in Vermont (where she moved to live the ski life), she’s surrounded by folks who have taken on a TKR and gotten back out on the hill. They’re hardy souls up there.
“I was very much of the mindset that I’m going to get back. So many people up here have. I focused on their success to lead me to mine,” she said.
Don’t half-arse your PT plan: Do everything your PT and ortho tell you to – it’s way more than just those two to three appointments a week.
To help me, Oliver suggested I get on a stationary bike as often as I could – right from the time it took me a full minute to loosen my joint up enough to even do one rotation, I did. He suggested I lower the bike seat as much as possible – that stretches the joint more—and pedal every chance I could.
I did, as well as getting in a pool for water workouts.
Jackson was the same; dedicated to her plan. It is paying off, she said.
For me, dropping some weight was also helpful. Oliver suggested to me, prior to surgery, that while I’d done well skiing at my current fitness level, if I wanted to ski well after it, I may want to work more on that. I did. It paid off.
Do be patient: You may have heard some story about the gal who had a TKR and hiked and skied Everest the following Tuesday. That’s probably not you – and it might not even be totally true.
Getting back to skiing after TKR takes time.
“It’s not just a six-month thing,” Oliver said. “it’s usually up to about two years for a full recovery, not just six months or even a year.”
For me, Oliver suggested last winter that a day would come when I’d feel like trying. Pick a sunny, soft snow day, he said, and head out and just do greens. I did that late February, seven months after my TKR. It was glorious. But, I knew to just do that.
Jackson had the same experience in January. She took her team’s advice and stuck to groomed and green. She felt great, but did feel a little pain after – more like a “Hey! We haven’t done this in a while!” pain, she said. It’s passing.
But she also had the thrill of remembering why the hard work is worth it: the joy skiing brings.
“I was nervous, but I kept saying ‘I’m an advanced skier! I can do this! Just do it!’ and then I did,” she said. “It was new snow, mid-week and first chair. And it was perfection.”
Oliver said he felt fully recovered two years after both replacements. His goal now?
“To ski free as an 80 year old,” the Waterville Valley regular said.
And with TKR going so well—and most done now should last a lifetime, he said – there’s may just be more like him when they hit that age.
“We’ll all be the titanium streaks instead of the silver streaks,” he said.
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