Great Expectations
Moderation should be your goal, post-surgery. Riders have considerably better odds of returning to their passion than athletes in "impact loading" sports such as running or skiing, according to Dr. Unis. "But you need to be careful about impact on the artificial joint, which can accelerate wear." In other words, he says, you can ride, but try not to fall off!
For horsewoman Lisa Caylor, multiple joint replacement surgeries have meant the difference between spending life in a wheelchair or walking, so protecting her new joints is important to her.
"I started out slow after my surgeries, on horses that were mellow and very well trained," explains Caylor, who drives horses as well as rides. "My surgeons have worked so hard to give me my new joints-I don't want to jeopardize my safety or their work."
Caylor has modified her tack and harness, as well as how she works with horses. Incidentally, Caylor is a student of the John Lyons' training methods, and has attended two Lyons riding clinics in Parachute, Colorado. She completed her second one last summer. She's careful about how long she spends in the saddle at any one stretch, uses a mounting block, and utilizes ground work exercises to instill patience, responsiveness and good manners in her horses. She wants them to be mentally and physically prepared before she climbs aboard or harnesses up for a drive. She adapts John's techniques to suit her own body's abilities to apply them, adjusting as she goes to take care of her joints, She has no intention or desire to give up her horse activities, an interest she shares with her husband, Rick.
"Knee replacement patients tend to experience a lot of irritation of the soft tissues around the joint when the knee is hyperflexed in the saddle," Dr. Lonner observes, "so I discourage patients from work which requires short stirrups, like galloping and jumping. Yes, you can return to riding, but you might want to make a minor lifestyle change and take up dressage, or consider switching to a gaited horse," he suggests.
How long will you be laid up? With the minimally invasive techniques, the main advantage is rapid recovery.
"The first two weeks after surgery are very uncomfortable, but it improves quickly," observes Dr. Lonner. "You might be walking without a cane two weeks after (a minimally invasive hip replacement). With a more conventional surgery, it might be up to three months. Remember that this recovery period doesn't mean you'll be back on a horse, either. That might be several months down the road, depending on how well your rehab routine goes."
It goes without saying that diligence with your rehab exercises will have long-term benefits. However, Cindy Schlener's orthopedic surgeon seriously under-estimated her dedication to the post-surgical rehabilitation program he assigned.
"Based on what my doctor said, the first month post-surgery you don't do anything but mild stretching exercises with a physical therapist. I did that at home three times a week. It was after my first follow-up check, a month later, that the doctor said I could lose one of the crutches and I could start exercising.
"The problem was that he never actually said how long I was supposed to bike for!" Schlener recalls with a smile. "What he meant was 10 to 15 minutes a day. But being very committed to my recovery and to getting back in the saddle, I was doing 45 minutes on the bike with far too much resistance! When I told him about it, he was horrified! I was ordered to stop biking for a week and then to start back slowly."
Pam Goodrich points out another hurdle you'll have to clear in order to be safe in the saddle after joint replacement surgery.
"The rehab exercises don't necessarily get you fit to ride. I found that because I hadn't really used my leg correctly for about three years, the muscles had atrophied. It's so important not to ride anything spooky in those first few months while the muscles are still weak."
I think there are two things that are very important," she adds. "The first is to make sure you have a good surgeon. The other is to follow the rehab instructions implicitly. It will feel like it's taking forever, but don't worry-you will ride again."
