Diligent rehab after knee replacements pays off

Painful knees had reduced her activity level, but surgeries restored it

Two images side by side of Jan Dahl near a waterfall and bundled up for a hike in Glacier National Park

Jan Dahl went into her knee replacement surgeries prepared to work — hard.

But she knew that the amount of effort she put into her rehabilitation after surgery would pay off with more mobility and less pain than she’d had in quite a while.

Dahl also decided that her early to mid-60s was the right time to replace her arthritic knees, rather than waiting. She watched her mother have knee surgery at 88 years old, when “she wasn’t all that interested” in the rehabilitation process, Dahl said.

“So then I decided, if I’m going to put all that investment into it, then I want to be able to enjoy it,” Dahl said.

Pain hindered active lifestyle

Dahl had always enjoyed a pretty active lifestyle. For one thing, her job as a nurse for Sanford Health’s surgical services kept her on her feet and walking a lot. At home, she and her husband enjoyed walks and bike rides together. And her personal habits encouraged movement, such as taking the stairs instead of the elevator, or choosing a parking spot far from the entrance.

Gradually, though, she noticed changes. Her right knee started to ache, and the pain worsened over time. Along with that, she started to lead a more sedentary lifestyle. She opted for the elevator over the stairs. She drove around looking for a closer parking spot. At home, she piled things on the stairs instead of making multiple trips with them.

Then came another sign, along with the intensifying pain. “Even if I was only going to get one gallon of milk,” Dahl said, “I would grab a cart at the entrance to a store so that I could lean on the cart as I walked through the store. And I thought, ‘It’s time.’ ”

The trim woman no longer would settle for a sedentary life.

‘Work begins when you leave the hospital’

Dahl, now 65 and retired, had surgery to replace her right knee in January 2017. Her surgery by orthopedic surgeon Brian Aamlid at Sanford USD Medical Center in Sioux Falls, South Dakota, went well, and she stayed in the hospital for two nights. The nurse had a new perspective now as a patient, and she appreciated her care.

“They make sure that you’re comfortable while you’re in the hospital and have all the information you need when you’re ready to be discharged,” Dahl said.

When she went home, she got busy. “With some surgeries, you go home and you rest and you just wait to get better,” she said.

A total knee replacement? Not that kind of surgery. “The work begins when you leave the hospital,” she added.

Dahl left the hospital with several things. She had an ice machine to ice and elevate her knee. She had medication to help quell the significant pain she was feeling. And she also had an appointment to see a physical therapist right away, which she calls crucial.

“They help you with any issues — questions that you may have. They work in close contact with the surgeons,” she said.

Dahl worked with a physical therapist on exercises for about 45 minutes three times a week. Then she went home with the expectation that she would repeat the exercises there several times a day. “I found those really helpful,” she said.

“Whenever I would have pain or stiffness, I would go get on the bike and just try to work it out. That helped. … Usually the pain — that would be my reminder that I’ve got to work through this,” Dahl said.

11-mile hike 4 months after surgery

After three months, she said she could resume normal activities — but that the recovery continues long afterward. “Things just get more and more easy. The more you work at it, the stronger you get. I would say for sure (for) a year, you’re still improving.”

After Dahl’s right knee replacement, her left knee actually saw improvement on its own. She thought she might avoid having that one replaced. But as it gradually started having the severity of symptoms as her right knee did, she knew it was time to get the left knee replaced, too, in February 2019 with a one-night hospital stay.

She has resumed her active lifestyle. Four months after her first knee replacement, she and her husband hiked the six-mile trek to Crazy Horse Monument. This summer, four months after her second surgery — “with two strong knees” — they hiked 11 miles in Glacier National Park.

Her diligent approach to physical therapy had paid off.

“I would say do it sooner than later. It’s a big process, and you have so much to gain,” said Dahl, who now moves easily around her home with no hint of her former pain.

“I never dreamed it would be this nice,” she added. “I hope to take care of them so that I’ve got years of good use.”

Dahl’s surgeries held a couple of surprise bonuses for her, too. Before, she had been having hip pain, but that has gone away now. And the other benefit dates back much further.

“I was very bow-legged, all my life, and Dr. Aamlid aligned my legs. My legs are straighter than they ever have been,” Dahl said.

“Maybe I’m taller now,” she quipped.

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Posted In Healthy Living, Orthopedics, Rehabilitation & Therapy

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