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Gardening after a total hip or knee replacement – professional advice from physiotherapy

August 9 2018

  • A new hip or knee doesn’t mean you have to give up on your allotment or garden
  • Professional advice gets gardeners back to their plots safely
  • 5 key areas for consideration
  • Dos and don’ts – what you need to know

National Allotment Week is 13th to 19th August, marking one of the busiest weeks in the gardening calendar. 

There’s no doubting it - we are a nation of keen gardeners. As well as creating beautiful environments for our home, and growing fruit and veg to maintain a good diet, research has also shown that being active outdoors in the allotment or garden is good for general mental and physical health too.

Having a new hip or knee doesn’t mean that you have to give up on your allotment or garden. If you take the following advice in 5 key areas from our Physiotherapy Team, both you and your allotment or garden will thrive.

1. Protect - Initial tissue healing takes up to three months after surgery and so physical activity during this time period is limited to range of motion, stretching and strengthening exercises as advised by your physiotherapist. The range of motion is typically limited to 90 degrees of hip flexion for the first 90 days while tissues are repairing themselves. The maximum potential of the joint and complete healing following a total hip replacement or knee replacement is achieved between one and two years after your operation.

2. Strengthen your Muscles – Usually strengthening exercises should begin eight weeks after surgery, and, it is always better to consult your physiotherapist before you start. These exercises develop strength in your muscles which in turn reduces the load on the joint, and prepares you for advanced activities like gardening and so on. By three months after your operation, strength and flexibility will have improved to a point where most patients are able to walk fairly comfortably without an assistive device, get in/out of chairs easily, and drive easily.

3. Kneeling – patients who have had a total knee replacement are allowed to do kneeling only after six months if they are comfortable. Kneeling may never be completely comfortable but should become easier as the knee regains maximum potential. After a hip replacement many patients can kneel down after completing the precautionary period of three months. The safe way to do this is to perform a single-legged kneel whereby the patient kneels on the knee of the operated side only. This means that the other hip has to bend whilst the operated hip stays extended. The reverse is true after a knee replacement as it may be too painful to kneel on the operated side whereas a single-leg kneel is possible on the opposite side.

4. Gardening - Resumption of gardening tasks such as shovelling, walking over uneven surfaces, and squatting/bending to the ground will vary from individual to individual depending upon level of strength prior to surgery, level of health, and length of healing time since surgery. Typically, between three and six months most individuals can begin attempting gardening tasks.

5. Gardening Tools & Assisted Devices - Returning to your garden and flower beds can be assisted with adaptive equipment. A planter’s stool or reacher can enhance your ability to get to the ground when strength and range of motion are limited. Use special knee mats or special knee pads for the work involving kneeling which will reduce the strain on the joint.

A cane can improve your balance walking across the yard or through the garden. In addition, modifying body mechanics can reduce the workload on your new joint – so, when carrying heavy loads such as plants and potting soil, keep them close to your body. Use the ‘unoperated’ leg to apply pressure on a spade or shovel to reduce the stress on the operated side.

Always seek the advice of an expert professional on how to get up/down from the ground and bend safely from the hips to assist with weeding and planting. There are also several long-handled gardening tools available which can aid with such tasks avoiding the need to kneel/bend down.

Reasonable health, motivation, paying attention to body signs (“listening” to your hip or knee) and time will allow returning to gardening in a relatively shorter period following total hip or knee replacement surgery.

Don’ts

  • Avoid spending hours stooping over flowerbeds to weed and plant.
  • Do not stay in one position for long time as it puts a strain on your whole body.  It is good to keep changing your position or do other work, which involves change of position. Also, have a short break every 30 minutes while working in the garden.
  • Do not use tools which are heavy to handle - buy tools which suit your needs and capabilities.

Do

  • Carry a communication device (mobile phone or pendant alarm if you live alone) and stay hydrated while working in the allotment or garden.

The Chartered Society of Physiotherapy's website carries a feature offering advice and information on how to be safer in the garden.  Chartered physiotherapist Gwyn Owen, a professional adviser with the CSP, said: 'Most people do not consider gardening an exercise, but it is hard work and after a long winter break, few people are physically prepared for it.”