Case 27: Movement After Bilateral Knee Replacements

Presentation

A man in his 50s who works in construction had undergone knee replacements on both knees several years earlier. He continued to find many daily and work tasks difficult. He couldn’t alternate legs on stairs, could only pedal a bicycle through half a rotation, and felt unsteady while walking. Running was painful, and kneeling for ground-level work wasn’t possible, which limited him significantly at work.

AI-generated illustration of a clinician observing a man's knee alignment as he steps up onto a low box during a movement assessment
AI-generated illustration. Not the client in this case.

Approach

Care used a structured, movement-based approach focused on lower-limb coordination, how the hips, knees and ankles worked together, and overall movement efficiency.

What the client reported

Over the course of care, he reported that he could alternate legs on stairs, pedal through a full rotation, swim comfortably, kneel for ground-level work and run again. He now plays field hockey three times a week, and has talked about trying gymnastics-style movement training.

Reflection

Recovery after joint replacement varies widely, and the surgery is only one part of how a person moves afterwards. This case is a reminder that coordination and whole-body movement may be worth assessing when everyday tasks remain difficult years later.

Anyone with a joint replacement should check with their orthopaedic surgeon before taking up running, kneeling-intensive work or high-impact sport, as advice differs between individuals and implants.

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Clinical reflection disclaimer: This case documents a clinical observation from my practice as an exercise scientist and remedial massage therapist. It is intended for professional education and reflection only. Individual results vary significantly and cannot be predicted. Outcomes may reflect natural recovery, other care or factors beyond the care provided. This is not medical advice, diagnosis or treatment recommendation. All cases are de-identified and shared with client consent. I do not diagnose, treat or cure medical conditions. For medical concerns, please consult a qualified healthcare practitioner.
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