Hi everyone. It is always enlightening to know my insight provokes others to share their experiences. One such reader response is worthy of sharing with everyone. It involves driving a stick shift after a tkr. Pour yourself a cup of tea, sit back, and be amazed. Thank you for giving permission to share your powerful and insightful comment, Chris Hansen.
I drove my stick shift pickup truck at 10 weeks post-op. What seemed like a fun trip to the mall about an hours drive, and mostly highway miles, turned into a nightmare physical reaction and a trip to the ER.
A stick shift requires using extensive leg pressure to continually utilize the clutch. You wouldn’t believe how much physical exercise this requires unless you actually paid attention .
The IT band is a ligament that is a key part of your quadriceps (upper leg) muscle. It runs from your hip al the way down your leg below your knee. It’s essentially what keeps you two leg pieces together.
One thing people are misinformed about is the amount of upper-leg trauma that occurs with a TKR. The most common procedure places a tourniquet on your upper leg to completely stop the flow of blood. This creates a cleaner and less complicated work environment for your surgeon to operate.
It also completely obliterates your upper leg muscles, and the IT band itself is repositioned and manipulated to make room for the TKR prosthetic. In short, the surgery dramatically weakens those muscles and connective ligaments. Wiped out would be a more accurate description.
Those same muscles are what gets exercised the most during stick shift driving. You wouldn’t believe how many reps you do just to make a simple cross town drive. I drove two hours straight. That night, I was subjected to agonizing pain along the entire IT band, including my quads and all around my knee joint.
I’m a healthy 52 year old male, incredibly active in sports and other activities and considered my leg strength and endurance to be ‘above average’ from playing / walking 70-100 rounds of golf every season. I ski in the winter.
Driving a stick shift for two hours straight was the equivalent of any PT session you ever did times 50. No joke. The pain I experienced was 9/10, and absolutely floored me. Within 24 hours I lost upwards of 70% of my mobility.
It was as if I had gone back in time to week 4 post-op. It took a week of minimal activity and bed rest to recover, and 2-3 weeks until I felt like I had fully recovered.
To make matters worse, my pain management situation regressed and this has been a problem with my orthopedic surgeon who is ultra conservative about prescription pain meds.
Because my situation involved an ER visit to get the proper pain management, I was immediately labeled as a drug seeking patient and put on further restrictions regarding pain management. It has been an ongoing struggle to receive proper care in this area ever since.
Weeks later I took another drive in the truck because I had to. My daily driver car was being repaired and I had chores to do after a 3 day road trip to see my daughter at Christmas.
I counted over 65 clutch reps to travel less than 10 miles round trip. Total drive time was about :15 in each direction. Put this into perspective. Did you EVER do 65 reps at PT? Never – you would be jelly and crying. Now imagine how many reps are involved in driving for two hours straight as I did unknowingly that one time? Hundreds of reps would be my guess.
TKR patients need to understand what is involved in manual stick shift driving. It is not enough to feel decent doing basic walking. This is a whole different category of exercise and use.
The muscles that you are using have been severely traumatized. The damage done to my quads, ligaments and tendons is equal to the damage of having the ends of my leg bones sawed off and capped, and having my knee cap modified.
In general, it’s been my overriding experience that my Orthopaedic surgeon has done a terrible job of informing me about the post operative complications from this surgery that go beyond range of motion and general mobility objectives. The need for extended pain management, my inability to get any kind of quality sleep for months has been a major problem.
Issues like IT band deficiencies and muscle trauma complicate my recovery immeasurably. Surely I am not the first person to ever experience this? So why is it that I feel like I am a Beta tester foraging new paths into uncharted territory? This is an area where medical practitioners need to spend more time communicating with patients.
The surgery is the easy part, but their roles are to help inform us about the typical complications during recovery. I would have much rather heard ‘no stick shift driving’ or at least a cautionary warning. To be finding these things out as a matter of trial and error is unacceptable.
There are 10’s of thousands of TKR surgeries done each year. Surely enough evidence is available to the medical practice community to help patients avoid these types of setbacks associated with driving a stick shift after a tkr.
Anyhow, my advice is do not drive a stick shift prior to 13 weeks, and if you do, expect consequences. You need to rehab those muscle groups extensively in order to drive stick properly, and the rehab that most patients are getting is not designed for this kind of use.
If you must drive a stick, you will need to take special care to build up repetition slowly. I would highly recommend that you count the number of times that you are depressing and using that clutch. You will be very surprised how even a trip to the grocery store can easily be 30-40 reps total (or more).
To all the surgeons out there: your patient’s total recovery requires a lot more attention than what is being provided or prescribed. Information is key, as is setting realistic expectations.
There is also no reason to force people to recover in pain and continual sleepless nights over weeks and months in today’s day and age. Less meat factory, more attention throughout the full life cycle of recovery.
Hope this info helps others avoid a potentially painful experience.
THANK YOU, Chris!
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AUTHOR NOTE: Booktoots Healing https://booktoots.com helps total knee replacement patients find support throughout recuperation and beyond. Its mission is for patients to understand they are not alone in their ordeal with either a tkr or other physicality concerns.
This award-winning site is owned and operated by Marie Buckner, a published author, tkr blogger, and tkr patient who has been living with various physicalities for over 40+ years. She enjoys sharing her experiences to help others going through the same thing.
Marie is also a proud WEGO Health Patient Leader.