The Centre For Balanced Medicine
Home » Articles » Yoga After Joint Replacement
Yoga after Joint Replacement
Information for teachers and students
by Dr Rowena Nicholson
MB, BS, MRCGP, DRCOG, Dip PCouns, Dip NSpH, Dip THY&R.
Hip, knee and shoulder replacements are becoming ever more commonplace, and many people are keen to start or continue yoga after their surgery. There is no reason why this should not be so, provided the teacher has the experience and knowledge to allow the yoga to be modified to their student’s unique needs. In general, it is important for people with arthritis to preserve their range of movement. I have often told my arthritic patients to ‘use it or loose it’!
There is only one reason why a joint replacement is carried out: to relieve pain. It is not done to correct deformity or improve function in itself, though the reduction in pain often allows the person to be more mobile. It is important to be aware that an artificial joint will never have the range of movement of a natural one. I remember as a medical student watching a consultation with a man whose knees were so badly deformed by arthritis that they had a severe degree of angulation, such that I couldn’t imagine him being able to walk. When the surgeon discovered that the man still played tennis, he advised him against the surgery, saying “you won’t be allowed to run when you’ve got one of my knees”!
It is important that the student gets the permission of either their surgeon or their physiotherapist to attend yoga classes. I wouldn’t usually expect someone to start yoga until they have been discharged by their physiotherapist, although individual yoga therapy focusing on the rest of the body may well be possible before this. Generally I would expect a student to do stage 1, not stage 2, after any major joint replacement, the exception being possibly after hip resurfacing. Many people who have had one joint replaced have arthritis in other joints as well, and may even be waiting for another new joint, so their needs with respect to their other arthritic joints must also be taken into account. Depending on the number of ‘problem’ joints and mobility, a chair yoga class or individual yoga therapy may be appropriate. If the student has recently had a joint replaced, they may have been ‘favouring’ their other side for some time, so posture and alignment are very important to consider. Many people who have had a knee or hip replacement take some time to get down onto the floor and up again, and this should be taken into account when planning their class, to avoid too many position changes. For some students, it may be preferable to give some chair alternatives rather than them getting onto the floor. Prolonged standing may not be comfortable, but a well balanced class should in any case avoid this.
You should also bear in mind the student’s medication, as some pain killers and other drugs for nerve pain and depression can cause drowsiness, so it is important to specifically ask about this.
Make sure that any arthritic joints are well warmed up, with particular attention given to the joint circles. (However, use the hip roll rather than a single leg hip circle after hip replacement).