In Episode 12 of the Total Knee Success Podcast, we explore how activating your parasympathetic system through intentional breathing can ease pain and calm your body after knee replacement. You’ll learn about box breathing, the physiological sigh, and other simple, evidence-based tools to help your body relax and heal.

Learn more and access additional resources at TotalKneeSuccess.com.

As an Amazon Associate I earn from qualifying purchases.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle’s clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and that patients have found helpful.

References

1. Zautra AJ, Fasman R, Davis MC, Craig AD. The effects of slow breathing on affective responses to pain stimuli: an experimental study. Pain. 2010;149(1):12–18.
2. Busch V, Magerl W, Kern U, Haas J, Hajak G, Eichhammer P. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing—an experimental study. Pain Med. 2012;13(2):215–228.
3. Lehrer P, Gevirtz R. Heart rate variability biofeedback: how and why does it work? Front Psychol. 2014;5:756.
4. Saoji AA, Raghavendra BR, Manjunath NK. Effects of yogic breath regulation: a narrative review of scientific evidence. J Ayurveda Integr Med. 2019;10(1):50–58.
5. Huberman JA, et al. Rapid state-shifting breathing practices for anxiety reduction. Cell Reports Medicine. 2023;4(1):100898.
6. Varvogli L, Darviri C. Stress management techniques: evidence-based procedures that reduce stress and promote health. Health Sci J. 2011;5(2):74–89.Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 11 of the Total Knee Success Podcast, we bust myths #6 through #10 about healing after knee replacement. From kneeling and gym machines to ice versus heat, the treadmill, and swelling, this episode explains why these myths don’t hold up and what’s actually true instead. It finishes the Top 10 Myths series and helps listeners let go of outdated advice while focusing on what really matters. You’ll walk away with clear, practical insights that support your progress after surgery.

Learn more and access additional resources at TotalKneeSuccess.com. As an Amazon Associate I earn from qualifying purchases.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and patients have found helpful.

References

1. Jette DU, Hunter SJ, Binder DS, et al. Physical therapist management of total knee arthroplasty: a clinical practice guideline. Phys Ther. 2020;100(9):1603-1631.
2. Wylde V, Artz N, Bruce J, et al. Kneeling after total knee replacement. EFORT Open Rev. 2019;4(5):460-467.
3. Nadeem S, Tucker A, Heidari N, et al. Predictors of kneeling ability after total knee arthroplasty. Arthroplasty Today. 2021;7:224-232.
4. American Academy of Orthopaedic Surgeons (AAOS). OrthoInfo: Total Knee Replacement. “Kneeling is sometimes uncomfortable, but it is not harmful.” Updated guidance; accessed 2025.
5. Zimmer Biomet. Your Guide to Total Joint Surgery. Patient education booklet noting kneeling may be uncomfortable for a year or more; accessed 2025.
6. Stryker Orthopaedics. Patient materials for the Triathlon Knee system referencing activities such as kneeling in the garden; accessed 2025.
7. DePuy Synthes [duh-POY SIN-theez] (Johnson & Johnson). Patient information for total knee replacement; no kneeling prohibition stated; accessed 2025.
8. Smith+Nephew. Patient education materials for total knee implants; no kneeling prohibition stated; accessed 2025.
9. Brigham and Women’s Hospital. Total Knee Arthroplasty Rehabilitation Protocol. Institutional guideline recommending criteria-based progression to resistance machines; accessed 2025.
10. The Ohio State University Wexner Medical Center. Total Knee Arthroplasty Clinical Practice Guideline. Criteria for stationary bike initiation and later treadmill use; accessed 2025.
11. Liu C, Zhang Y, et al. Effect of continuous cryotherapy versus traditional cold application after total knee arthroplasty: a systematic review and meta-analysis. J Orthop Surg Res. 2023;18:67. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 2 of the Total Knee Success Podcast, we tackle one of the most common questions after knee replacement surgery: "When will I stop limping?" Discover why limping can persist after surgery, the science behind gait retraining, and practical, evidence-based strategies to help you walk with confidence again. We share step-by-step tips on weight bearing, using assistive devices correctly, correcting gait patterns, strengthening key muscles, and practicing in different environments. Whether you’re preparing for surgery or deep into recovery, this episode offers actionable advice to help you break old habits, improve your walking, and regain your independence. Tune in for expert insights, encouragement, and resources to support your total knee success Learn more and access additional resources at TotalKneeSuccess.com.

Educational Purpose Only

Total Knee Success provides educational information on total knee replacement, rehabilitation, and related topics. All content—whether on this website, the podcast, or linked resources—is intended for general educational purposes only. It is not designed to diagnose, treat, or replace individualized medical care. You should always consult your physician, surgeon, or physical therapist before making health decisions. Do not disregard professional advice or delay seeking it because of material found here.

No Professional or Academic Relationship Accessing this site or listening to the podcast does not create a physical therapist–patient relationship or a faculty–student relationship. Information is provided in a general context only and should not be considered personalized professional advice.

Affiliate Disclosure This site and podcast may contain affiliate links. Total Knee Success participates in affiliate programs, including the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by linking to Amazon.com and affiliated sites. If you purchase a product through an affiliate link, I may earn a small commission at no extra cost to you. Transparency matters—you should assume that links on this site or podcast may be affiliate links.

References

1. American Physical Therapy Association. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631. doi:10.1093/ptj/pzaa099
2. Mont MA, Beaver WB, Dysart SH, Barrington JW, Del Gaizo DJ. Local infiltration analgesia in total knee arthroplasty: a randomized controlled trial. J Arthroplasty. 2018;33(1):90-95. doi:10.1016/j.arth.2017.08.017
3. Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact. Musculoskeletal Care. 2011;9(4):201-209. doi:10.1002/msc.204
4. Smith TO, Chester R, Clark A, Donell ST. Cross-sectional study into peri-operative practices surrounding total knee replacement surgery in the UK. Knee. 2012;19(5):365-369. doi:10.1016/j.knee.2011.06.010
5. The Knee Journal. Reduced knee flexion in TKA patients: carryover of preoperative gait patterns. Knee. 2021.
6. McClelland JA, Webster KE, Feller JA. Gait analysis of patients following total knee replacement: a review. PMCID: PMC3754839.
7. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 1 of the Total Knee Success Podcast, we explore two common post-total knee replacement issues: pain and swelling. We share five effective tips to manage these, such as applying cold packs, elevating the leg, wearing compression stockings, balancing rest with gentle activity, and ensuring good sleep. We also highlight the importance of monitoring progress and recognizing when to contact your healthcare team for support. Future episodes will focus on gait retraining and advanced sleep strategies.

Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, nutritionist, dietician, therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and that patients have found helpful.

References

1. American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Knee (Non-Arthroplasty), Evidence-Based Clinical Practice Guideline. AAOS; 2021.
2. American Physical Therapy Association. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631. doi:10.1093/ptj/pzaa099
3. Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003;362(9399):1921-1928. doi:10.1016/S0140-6736(03)14966-5
4. Smith TO, Chester R, Clark A, Donell ST. Cross-sectional study into peri-operative practices surrounding total knee replacement surgery in the UK. Knee. 2012;19(5):365-369. doi:10.1016/j.knee.2011.06.010
5. Mont MA, Beaver WB, Dysart SH, Barrington JW, Del Gaizo DJ. Local infiltration analgesia in total knee arthroplasty: a randomized controlled trial. J Arthroplasty. 2018;33(1):90-95. doi:10.1016/j.arth.2017.08.017
6. Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact. Musculoskeletal Care. 2011;9(4):201-209. doi:10.1002/msc.204
7. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

Show Notes – Total Knee Success Podcast Trailer

Have you recently had a total knee replacement or are you preparing for surgery? Are you wondering what recovery will really be like?

You’re in the right place. The Total Knee Success Podcast is your trusted resource for:

• Practical tips to manage pain and swelling after knee replacement
• Strategies to start walking naturally again and rebuild mobility
• Physical therapy insights that speed recovery and improve confidence
• Guidance on bending, exercise, scar healing, sleep, and more
• What to expect before and after surgery—so you can move forward with clarity

Hosted by Michelle Losurdo, PT, DPT, OCS, Cert DN—an experienced, board-certified orthopedic clinical specialist—this podcast brings you evidence-based guidance, real-world advice, and encouragement for every stage of recovery.

Whether you’re preparing, in the thick of rehab, or looking ahead to long-term success, this show will help you make the most of your knee replacement journey.

Subscribe today so you don’t miss our first full episode!

Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, nutritionist, dietician, therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and that patients have found helpful.

Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 10 of the Total Knee Success Podcast, we break down the first five myths about healing after knee replacement. From the old “no pain, no gain” idea to concerns about range of motion, CPM machines, walking, and stairs, this episode explains what the research actually says. Listeners will learn why walking alone isn’t enough and why going downstairs is often harder than going up — so you can avoid the common myths that add worry to your healing. Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and that patients have found helpful.

References

1. Jette DU, Hunter SJ, et al. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631.
2. Baker PN, et al. Pain and function outcomes following primary TKA: registry data. J Bone Joint Surg Am. 2012;94(11):990-996.
3. Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: mechanisms and treatment perspectives. Semin Arthritis Rheum. 2010;40(3):250-266.
4. Issa K, et al. Does timing of manipulation under anesthesia affect ROM after primary TKA? J Knee Surg. 2014;27(3):195-199.
5. Werner BC, et al. The incidence of manipulation under anesthesia after TKA. J Arthroplasty. 2015;30(12):1962-1965.
6. Harvey LA, et al. Continuous passive motion following total knee arthroplasty. Cochrane Database Syst Rev. 2014;(2):CD004260.
7. Minns Lowe CJ, et al. Effectiveness of physiotherapy exercise after knee replacement: systematic review. BMJ. 2007;335:812.
8. Artz N, et al. Effectiveness of physiotherapy exercise following total knee replacement: systematic review & meta-analysis. BMC Musculoskelet Disord. 2015;16:15.
9. Skoffer B, Dalgas U. Exercise as treatment in knee OA/TKA patients. Scand J Med Sci Sports. 2012;22(6):e119–e127.
10. Villadsen A, et al. Intensive rehab after TKA improves function. Arthritis Care Res. 2014;66(12):1856–1866.
11. Taylor WR, Duda GN, Bergmann G, et al. Peak knee contact forces during stair ascent and descent in vivo. J Orthop Res. 2012;30(3):408-415.
12. Kutzner I, Heinlein B, Graichen F, et al. In vivo knee joint loading in ADLs. J Biomech. 2010;43(11):2164-2173.
13. Andriacchi TP, et al. Analysis of stair ascent and descent motions. Clin Biomech. 2006;21(5):467-474.
14. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 9 of the Total Knee Success Podcast, we explore the step-by-step process of regaining strength after knee replacement. You’ll learn why quadriceps weakness happens, how swelling affects muscle activation, and how healing timelines connect to strengthening goals. We also highlight a “minimal quad program” of research-backed exercises you should not skip, plus red flags that tell you when to pause and call your care team.

Learn more and access additional resources at TotalKneeSuccess.com. As an Amazon Associate, I earn from qualifying purchases.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement recovery and that patients have found helpful.

References

1. Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and functional recovery after TKA. J Bone Joint Surg Am. 2005;87(5):1047–1053.
2. Rice DA, McNair PJ. Arthrogenic muscle inhibition of the quadriceps: mechanisms & treatment. Semin Arthritis Rheum. 2010;40(3):250–266.
3. Goodpaster BH, et al. Loss of skeletal muscle strength/mass/quality in older adults. J Gerontol A. 2006;61(10):1059–1064.
4. American College of Sports Medicine. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687–708.
5. Jette DU, et al. APTA Clinical Practice Guideline: Physical therapist management of TKA. Phys Ther. 2020;100(9):1603–1631.
6. Brigham & Women’s Hospital. Total Knee Arthroplasty Protocol. 2022.
7. Ohio State University Wexner Medical Center. Total Knee Arthroplasty Clinical Practice Guideline. 2019.
8. Skou ST, et al. Early and late strength recovery after TKA. Clin Orthop Relat Res. 2018;476(6):1131–1141.
9. Mizner RL, et al. Quadriceps strength and activation failure in patients with TKA. J Orthop Res. 2005;23(5):1083–1090.
10. Villadsen A, et al. Intensive rehabilitation after TKA improves function. Arthritis Care Res. 2014;66(12):1856–1866.
11. Minns Lowe CJ, et al. Effectiveness of physiotherapy exercise after knee replacement: systematic review. BMJ. 2007;335:812.
12. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 8 of the Total Knee Success Podcast, we explore why pain may linger beyond the first few weeks after knee replacement. You’ll learn what’s normal, what’s not, and how to spot red flags that need medical attention. We’ll talk about common reasons for lingering pain, how to recognize patterns of progress, and strategies for easing discomfort - from pacing activity to calming the nervous system with simple breathing techniques. You’ll also hear how mindset and small daily choices can make a big difference in long-term outcomes.

Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement recovery and that patients have found helpful.

References

1. Jette DU, Hunter SJ, et al. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631. doi:10.1093/ptj/pzaa099
2. Wylde V, et al. Persistent pain after joint replacement: prevalence, sensory qualities, and impact. Rheumatology. 2011;50(2):215–221.
3. Beswick AD, et al. What proportion of patients report long-term pain after hip or knee replacement? BMJ Open. 2012;2:e000435.
4. Baker PN, et al. Pain and function outcomes following primary TKA: registry data. J Bone Joint Surg Am. 2012;94(11):990–996.
5. Lenguerrand E, et al. Risk factors for persistent pain after knee replacement: multicenter study. BMJ Open. 2016;6(12):e012166.
6. Wylde V, Blom AW. The failure of survivorship. Bone Joint J. 2019;101-B(6):629–631.
7. Skou ST, et al. Predictors of pain after total knee arthroplasty. Clin Orthop Relat Res. 2018;476(6):1131–1141.
8. Lewis GN, Rice DA, McNair PJ, Kluger M. Predictors of persistent pain after TKA. Pain. 2015;156(10):1930–1940.
9. Liu SS, et al. Predictors of prolonged pain after TKA. Anesth Analg. 2012;115(5):1066–1073.
10. Zautra AJ, Fasman R, Davis MC, Craig AD. The effects of slow breathing on affective responses to pain stimuli: an experimental study. Pain. 2010;149(1):12–18.
11. Busch V, Magerl W, Kern U, Haas J, Hajak G, Eichhammer P. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing—an experimental study. Pain Med. 2012;13(2):215–228.
12. Lehrer P, Gevirtz R. Heart rate variability biofeedback: how and why does it work? Front Psychol. 2014;5:756.
13. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 7 of the Total Knee Success Podcast, we focus on how to safely return to daily activities after knee replacement. You’ll learn how to pace your energy with the SET approach, adapt common home tasks, manage stairs and driving, and gradually reintroduce work, chores, and hobbies. We also explore kneeling, exercise momentum, and the signs that mean it’s time to call your care team. Whether you’re early in healing or further along, this episode gives you practical tools and encouragement for getting back to the things you enjoy most. Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement recovery and that patients have found helpful.

References

1. Jette DU, Hunter SJ, et al. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631. doi:10.1093/ptj/pzaa099
2. Peters MCWM, et al. Return to daily activities, work, and sports after total knee arthroplasty. Acta Orthop. 2024;95:353-360. doi:10.2340/17453674.2024.95.353
3. Giannoudis V, et al. Brake reaction time and return to driving after knee arthroplasty: a systematic review. Accid Anal Prev. 2021;153:106025. doi:10.1016/j.aap.2021.106025
4. Giannoudis V, et al. Predictors for return to driving after THA and TKA. J Clin Med. 2025;14(8):2536. doi:10.3390/jcm14082536
5. Pasqualini I, et al. Sports and return to work after total knee arthroplasty. Joints. 2023;11(4):217-226. doi:10.1055/s-0043-1777668
6. Kangas P, et al. Return to work following hip or knee arthroplasty: a systematic review. J Occup Rehabil. 2024. doi:10.1007/s10926-024-10147-6
7. Wylde V, et al. Kneeling after total knee replacement: a systematic review. EFORT Open Rev. 2019;4(5):460-467. doi:10.1302/2058-5241.4.180047
8. Nadeem S, et al. Surgery-related predictors of kneeling ability after total knee arthroplasty. Arthroplast Today. 2021;7:224-232. doi:10.1016/j.artd.2020.12.004
9. Kutzner I, Heinlein B, Graichen F, et al. Loading of the knee joint during activities of daily living measured in vivo in five subjects. J Biomech. 2010;43(11):2164-2173. doi:10.1016/j.jbiomech.2010.03.046
10. Taylor WR, Duda GN, Bergmann G, et al. Peak knee contact forces during stair ascent and descent in vivo. J Orthop Res. 2012;30(3):408-415. doi:10.1002/jor.21527
11. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 6 of the Total Knee Success Podcast, we focus on managing expectations with your surgeon and therapy team. You’ll learn how to ask the right questions at follow-ups, talk openly about pain and swelling, and recognize what’s normal versus what needs medical attention. We’ll also cover how to keep your providers aligned, embrace your role as decision-maker, and build a strong therapeutic alliance. With real-life examples and research-based tips, this episode shows how better communication leads to smoother, more confident healing.

Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer

The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer

As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement recovery and that patients have found helpful.

References

1. American Physical Therapy Association. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631. doi:10.1093/ptj/pzaa099
2. Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact. Musculoskeletal Care. 2011;9(4):201-209. doi:10.1002/msc.204
3. Mont MA, Beaver WB, Dysart SH, Barrington JW, Del Gaizo DJ. Local infiltration analgesia in total knee arthroplasty: a randomized controlled trial. J Arthroplasty. 2018;33(1):90-95. doi:10.1016/j.arth.2017.08.017
4. Tilbury C, Haanstra TM, Leichtenberg CS, et al. Unfulfilled expectations after total hip and knee arthroplasty surgery: there is a need for better preoperative patient information and education. J Arthroplasty. 2016;31(10):2139–2145. doi:10.1016/j.arth.2016.02.061
5. Mancuso CA, Jout J, Salvati EA, Sculco TP. Patients’ expectations and satisfaction with total hip arthroplasty. J Arthroplasty. 2009;24(4):502–508. doi:10.1016/j.arth.2008.02.005
6. Dauty M, Genty M, Ribinik P. Interdisciplinary rehabilitation after total knee replacement: functional outcomes. Ann Phys Rehabil Med. 2014;57(9-10):563–570. doi:10.1016/j.rehab.2014.08.004
7. Kennedy DM, Stratford PW, Riddle DL, Hanna SE, Gollish JD. Assessing recovery and establishing prognosis following total knee replacement. Phys Ther. 2008;88(1):22–32. doi:10.2522/ptj.20070051
8. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 5 of the Total Knee Success Podcast, we dive deep into how mindset and motivation can shape your experience after total knee replacement. We discuss why setting realistic expectations matters, and how progress often looks more like a staircase than a straight line. You’ll hear about the importance of celebrating small wins, keeping a gratitude journal, and surrounding yourself with supportive people who lift you up rather than bring you down. We also cover how to reframe setbacks, use positive self-talk, and work as a team with your physical therapist to create meaningful and specific goals that help you stay on track. Evidence-based strategies and practical tips throughout the episode will help you feel steady through the ups and downs, and remind you that every small step forward adds up to lasting success.

Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement healing and that patients have found helpful.

References

1. American Physical Therapy Association. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631. doi:10.1093/ptj/pzaa099
2. Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact. Musculoskeletal Care. 2011;9(4):201-209. doi:10.1002/msc.204
3. Marks R. Knee osteoarthritis and exercise adherence: a review. Curr Aging Sci. 2012;5(1):72–83. doi:10.2174/1874609811205010072
4. Garland SN, Carlson LE, Stephens AJ, Antle MC, Samuels C, Campbell TS. Mindfulness-based stress reduction compared with cognitive behavioral therapy for the treatment of insomnia. J Consult Clin Psychol. 2014;82(5):651–663. doi:10.1037/a0036734
5. Emmons RA, McCullough ME. Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003;84(2):377-389. doi:10.1037/0022-3514.84.2.377
6. Kerr SL, O’Donovan A, Pepping CA. Can gratitude and kindness interventions enhance well-being in a clinical sample? J Happiness Stud. 2021;22(5):2181–2198. doi:10.1007/s10902-020-00322-0
7. Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 4 of the Total Knee Success Podcast we explore the powerful role of nutrition in total knee replacement healing. We break down why protein, hydration, anti-inflammatory foods, vitamins, and minerals are essential for tissue repair, scar formation, and steady energy. We also look at how GLP-1 weight loss medications may impact muscle and success, and what steps patients can take to protect strength. Practical advice, red flags to watch for, and clear science-backed takeaways make this episode a must-listen for anyone preparing for or moving forward after knee replacement.

Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, nutritionist, dietician, therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and that patients have found helpful.

References

Bohl DD, Volpe KA. Nutritional optimization in total joint arthroplasty: a review of the literature. J Arthroplasty. 2017;32(9):2831-2839. doi:10.1016/j.arth.2017.05.016.

Zhang Z, Xu H, Ma J, et al. Anti-inflammatory dietary patterns and joint health after orthopedic surgery. Clin Nutr. 2020;39(11):3456-3463. doi:10.1016/j.clnu.2020.05.013.

Cross MB, Yi PH, Thomas CF, Garcia J, Della Valle CJ. Evaluation of malnutrition in orthopaedic surgery. J Am Acad Orthop Surg. 2014;22(3):193-199. doi:10.5435/JAAOS-22-03-193.

Miller PE, Van Elswyk M, Alexander DD. Dehydration and orthopedic surgical outcomes: a systematic review. Nutr Clin Pract. 2018;33(1):48-58. doi:10.1002/ncp.10028.

O’Neill SC, Queally JM, Hickey A, et al. Vitamin D status and surgical outcomes following knee arthroplasty. J Arthroplasty. 2017;32(9):3020-3024. doi:10.1016/j.arth.2017.05.002.

Hunger RE, et al. Individualized nutrition care improves strength and independence after knee replacement. Clin Nutr ESPEN. 2020;35:205–211. doi:10.1016/j.clnesp.2019.10.015.

Biolo G, Tipton KD, Klein S, Wolfe RR. An abundant supply of amino acids enhances the metabolic effect of exercise on muscle protein. Am J Physiol Endocrinol Metab. 1997;273(1):E122-E129. doi:10.1152/ajpendo.1997.273.1.E122.

Changes in lean body mass with GLP-1-based treatments for obesity. Curr Opin Endocrinol Diabetes Obes. 2024;31(5):223-229. doi:10.1097/MED.0000000000000863.

Zhou Y, Liu T, Zhang Y, et al. Inhibition of GDF8 and activin A protects against GLP-1 RA-induced muscle loss while enhancing fat loss. Nat Commun. 2025;16(1):1552. doi:10.1038/s41467-025-59485-9.

Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 3 of the Total Knee Success Podcast, we address one of the most common post-surgery complaints—lack of sleep. We discuss how issues like pre-existing sleep problems, pain, and swelling can worsen after knee replacement surgery and offer practical, research-backed strategies for improving sleep quality. Tips include establishing a bedtime routine, using pillows for support, reducing swelling before bed, calming the mind, and avoiding sleep disruptors like caffeine and light exposure. We also emphasize the importance of consulting healthcare providers for persistent sleep issues. Tune in for actionable advice to help you rest better and recover more effectively.

Learn more and access additional resources at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate DisclaimerAs an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement recovery and that patients have found helpful.

Chapters

00:00 Introduction to Sleep Issues Post-Surgery

00:53 Welcome to the Total Knee Success Podcast

00:57 Understanding Sleep Problems After Knee Replacement

01:57 Building a Consistent Bedtime Routine

02:56 Finding a Comfortable Sleeping Position

03:59 Managing Swelling for Better Sleep

04:48 Calming Your Mind for Restful Sleep

05:52 Avoiding Common Sleep Disruptors

07:19 When to Seek Professional Help

07:41 Recap and Final Thoughts

08:19 Preview of Next Episode and Closing Remarks

References American Physical Therapy Association. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631. doi:10.1093/ptj/pzaa099

Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact. Musculoskeletal Care. 2011;9(4):201-209. doi:10.1002/msc.204

Mont MA, Beaver WB, Dysart SH, Barrington JW, Del Gaizo DJ. Local infiltration analgesia in total knee arthroplasty: a randomized controlled trial. J Arthroplasty. 2018;33(1):90-95. doi:10.1016/j.arth.2017.08.017

Garland SN, Carlson LE, Stephens AJ, Antle MC, Samuels C, Campbell TS. Mindfulness-based stress reduction compared with cognitive behavioral therapy for the treatment of insomnia. J Consult Clin Psychol. 2014;82(5):651–663. doi:10.1037/a0036734

Huberman AD, Patel A, Zhang S. Light exposure and circadian rhythm regulation: implications for sleep and health. Curr Biol. 2023;33(12):R456-R458. doi:10.1016/j.cub.2023.04.015

Music used in this podcast is licensed for use through Descript. All rights to the reggae track are secured via Descript’s music library.

In Episode 16 of the Total Knee Success Podcast, Michelle explains how surgical incisions heal after knee replacement — from the healing ridge to safe showering and scar massage. She discusses drainage signs, modern closure options like medical-grade adhesives and wound VACs, silicone gels, collagen supplementation research. You’ll come away knowing what’s normal, when to call your surgeon, and how to protect your skin for steady, confident recovery. As an Amazon Associate I earn from qualifying purchases.

Collagen Gummies https://amzn.to/3KXnA0x. Organic Collagen Peptide Powder https://amzn.to/43qcuYf. Free Up Professional Massage Cream (what we use in the clinic) https://amzn.to/3WTsK05. Medical Grade Silicone Scar Sheets https://amzn.to/47mg0nH

Medical Disclaimer. The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle’s clinic or teaching roles.

Amazon Affiliate Disclaimer. As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and that patients have found helpful.

References

Jacobson ME, et al. Nerve injury during total knee arthroplasty. Clin Orthop Relat Res. 2007;464:135-140. doi:10.1097/BLO.0b013e31812f7c2c

Kerver AL, Leliefeld PH, den Hartog D, Kleinrensink GJ. The surgical anatomy of the infrapatellar branch of the saphenous nerve. J Anat. 2013;222(3):328-335. doi:10.1111/joa.12024

Hartin NL, et al. Wound dehiscence following total knee arthroplasty. J Arthroplasty. 2020;35(12):3647-3653. doi:10.1016/j.arth.2020.07.008

Lee J, et al. Modern wound closure techniques in total knee arthroplasty. J Orthop Surg Res. 2022;17(1):471. doi:10.1186/s13018-022-03328-3

Anderson MJ, et al. Allergic contact dermatitis from surgical adhesives and dressings. Dermatitis. 2014;25(1):15-20. doi:10.1097/DER.0000000000000005

Music used in this episode is licensed for use through Descript. All rights to the track are secured via Descript’s music library.

In episode 15 of the Total Knee Success Podcast, we take a close look at what really happens to the kneecap during total knee replacement. You’ll learn how surgeons decide whether to resurface the patella, how the small “button” fits on the underside of your own bone, and what the research shows about long-term outcomes. We also cover how ligaments like the ACL, PCL, and collateral ligaments are treated during surgery, and why it’s worth reviewing your surgical report or asking your surgeon exactly what was done. This episode brings clarity to one of the most common — and most misunderstood — aspects of total knee replacement.

Learn more at TotalKneeSuccess.com

As an Amazon Associate I earn from qualifying purchases.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with questions about your specific condition.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. If you click a product link in the show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions support the podcast and allow me to continue sharing free, evidence-based content.

References

1. Chen K, Li G, Fu D, Yuan C, Zhang Q, Cai Z. Patellar resurfacing versus nonresurfacing in total knee arthroplasty: a meta-analysis of randomized controlled trials. J Orthop Surg Res. 2013;8:10.
2. Fu D, Chen K, Li G, et al. Patellar resurfacing versus nonresurfacing in total knee arthroplasty: systematic review of randomized controlled trials. J Arthroplasty. 2018;33(2):666–673.
3. Wood DJ, Smith AJ, Collopy D, White B, Brankov B, Bulsara MK. Patellar resurfacing in total knee arthroplasty: a prospective, randomized trial. J Bone Joint Surg Am. 2005;87(10):2176–2181.
4. He JY, Jiang LS, Dai LY. The influence of patellar mobility on knee flexion after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2012;20(2):222–227.
5. Chen X, Li J, Peng L, et al. Patellar resurfacing versus non-resurfacing in total knee arthroplasty: a Cochrane systematic review. Cochrane Database Syst Rev. 2021;1:CD009898.
6. Fu D, Chen K, Li G, et al. Long-term outcomes of patellar resurfacing vs nonresurfacing in TKA. J Arthroplasty. 2020;35(5):1463–1470.
7. Stürmer KM, et al. Patellar complications following TKA with or without resurfacing: registry-based analysis. Orthopaedics. 2019.
8. Kim TK, et al. Patellofemoral complications after total knee arthroplasty: update on causes and management. Knee Surg Relat Res. 2022;34:32.
9. Feller JA, Bartlett RJ, Lang DM. Patellar resurfacing versus retention in total knee arthroplasty: ten-year follow-up. J Bone Joint Surg Br. 2020;102-B(5):593–599.
10. Music used in this episode is licensed for use through Descript. All rights to the track are secured via Descript’s music library.

In Episode 14 of the Total Knee Success Podcast, we explore how to safely and confidently master stair climbing after knee replacement. You’ll learn how to use rails and canes correctly, understand why descending often feels harder, and hear how research links stair ability with long-term mobility and independence. The episode blends practical safety reminders — including therapist supervision and home setup tips — with evidence-based encouragement to help you build both strength and confidence step by step.

As an Amazon Associate I earn from qualifying purchases.

The REHAND Walking Cane is foldable, adjustable, and lightweight. It stands on its own, which is convenient because you won’t have to hang it on anything when you need to let go. It is suitable for people ranging from approximately 5 feet 2 inches to over 6 feet tall. To determine the appropriate cane height for you, measure the distance from your wrist to the floor. Check the adjustment heights in the description.

The Homeland Foldable Rollator walker with seat is sturdier than most traditional four-wheeled walkers. It features 8-inch wheels and has adjustable handle and seat heights.

Learn more at TotalKneeSuccess.com

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. If you click a product link in the show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content.

References

1. Bade MJ, Kohrt WM, Stevens-Lapsley JE. Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther. 2010;40(9):559-567.
2. Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005;35(7):424-436.
3. Stratford PW, Kennedy DM. Performance measures of functional recovery after total knee arthroplasty. Phys Ther. 2006;86(12):1631-1638.
4. Bade MJ, Stevens-Lapsley JE. Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther. 2011;41(12):932-941.
5. Eves ND, Plotnikoff RC. Stair climbing as a health-promoting physical activity for adults: a review. Sports Med. 2006;36(9):871–879.
6. Bade MJ, Stevens-Lapsley JE. Step training improves functional mobility in TKA patients. J Orthop Sports Phys Ther. 2011;41(12):932-941.
7. Stevens-Lapsley JE, Balter JE, Kohrt WM, Eckhoff DG. Quadriceps and hamstrings muscle dysfunction after TKA: eccentric training intervention. J Orthop Res. 2010;28(9):1091-1096.
8. Music used in this episode is licensed for use through Descript. All rights to the track are secured via Descript’s music library.

In Episode 13 of the Total Knee Success Podcast, we demystify range of motion after knee replacement — what 0°, 90°, and 120° mean in daily life, how timelines typically unfold, and why patellar mobility can unlock better bending. We cover realistic targets with modern implants, the role of swelling control, and how consistent, short sessions beat painful overpressure. You’ll leave with a calm plan for progress and clear red flags for when to call your care team.

Learn more and access additional information at TotalKneeSuccess.com.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle’s clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement and that patients have found helpful.

References

1. Bade MJ, Kohrt WM, Stevens-Lapsley JE. Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther. 2010;40(9):559-567.
2. Ritter MA, Harty LD, Davis KE, Meding JB, Berend ME. Predicting range of motion after total knee arthroplasty. J Bone Joint Surg Am. 2003;85(7):1278-1285.
3. Rowe PJ, Myles CM, Walker C, Nutton R. Knee joint kinematics in gait and other functional activities measured using flexible electrogoniometry: how much knee motion is sufficient for normal daily life? Gait Posture. 2000;12(2):143-155.
4. Bade MJ, Stevens-Lapsley JE. Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther. 2011;41(12):932-941.
5. Issa K, Rifai A, Boylan MR, Pourtaheri S, McInerney VK, Mont MA. Do various factors affect the frequency of manipulation under anesthesia after primary total knee arthroplasty? Clin Orthop Relat Res. 2015;473(1):143-149.
6. He JY, Jiang LS, Dai LY. The influence of patellar mobility on knee flexion after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2012;20(2):222-227.
7. Lenssen AF, van Dam EM, Crijns YH, et al. Reproducibility of goniometric measurement of the knee in the acute phase after total knee arthroplasty. BMC Musculoskelet Disord. 2007;8:83.
8. Bade MJ, Stevens-Lapsley JE. Early rehabilitation and functional outcomes after total knee arthroplasty. J Orthop Sports Phys Ther. 2011;41(12):932-941.
9. Kim J, Nelson CL, Lotke PA. Stiffness after total knee arthroplasty: prevalence of the complication and outcomes of revision. J Bone Joint Surg Am. 2004;86(7):1479-1484.Music used in this episode is licensed for use through Descript. All rights to the track are secured via Descript’s music library.

In Episode 18 of the Total Knee Success Podcast, Michelle explains how to return to work after total knee replacement, with timelines for sitting and standing jobs. She covers practicing job activities before returning, staying consistent with therapy, and pacing for heavier work. You’ll also learn about blood-clot prevention, workplace accommodations, and the emotional side of resuming a schedule — plus a story about a bus driver who reclaimed her independence by week eight. Learn more and access additional resources at TotalKneeSuccess.com. As an Amazon Associate, I earn from qualifying purchases.

Episode Resources

For a full list of recommended products, complete reference details, and additional information discussed in this episode, visit: https://TotalKneeSuccess.com/episode18-return-to-work

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions about your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle’s clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products commonly recommended for knee-replacement healing and that patients have found helpful.

Evidence-Based Content Statement All information shared in this episode is based on current research and professional consensus guidelines available at the time of recording. The studies referenced are peer-reviewed and selected to ensure accuracy, clarity, and relevance for listeners navigating life before and after total knee replacement.

Music Licensing Statement Music used in this episode is licensed for use through Descript. All rights to the track are secured via Descript’s music library.

References

Tilbury C, Schaasberg W, Plevier JWM, Fiocco M, Nelissen RG, Vliet Vlieland TP. Return to work after total hip and knee arthroplasty: a systematic review. Rheumatology (Oxford). 2014;53(3):512-525.

Mazzoli C, et al. Worksite ergonomics and micro-breaks reduce musculoskeletal discomfort: a meta-analysis. Workplace Health Saf. 2020;68(3):128-137.

Persson G, et al. Task-specific functional training and return to work following lower-limb joint replacement. Clin Rehabil. 2021;35(10):1361-1372.

MacEwen B, et al. Standing desks and postoperative comfort following orthopedic surgery: a pilot trial. J Occup Rehabil. 2022;32(4):732-739.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation: analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-150.

Orange GM, Hince DA, Travers MJ, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15.

In Episode 17 of the Total Knee Success Podcast, Michelle explores when it’s truly safe to drive after total knee replacement. She explains braking-time research, range-of-motion goals, medication safety, and how modern driver-assist systems fit into real-world recovery. You’ll also learn how international driving setups compare, and why gradual practice helps you regain confidence behind the wheel. A true-to-life example shows why waiting a little longer can prevent unnecessary swelling and setbacks. As an Amazon Associate I earn from qualifying purchases. Find more helpful resources at TotalKneeSuccess.com.

Check out the Car Door Handle Assist https://amzn.to/43u4ANo

This set of two car door handle assist is great to keep in the door pocket. You can use it to help lower yourself into the seat and help boost you up when your knee range of motion is limited initially after surgery. It’s also a great safety tool.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle’s clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement recovery and that patients have found helpful.

References

1. Liebensteiner MC, et al. Brake response time after total knee arthroplasty: a prospective study. J Bone Joint Surg Am. 2010;92(10):1849-1854. doi:10.2106/JBJS.I.00863.
2. Pierson JL, Earles DR, Wood K. Brake response time after total knee arthroplasty. Clin Orthop Relat Res. 2003;416:159-165. doi:10.1097/01.blo.0000092971.41349.32.
3. Ganz SB, Levin AZ, Peterson MG, Ranawat CS. Improvement in brake response time after total knee arthroplasty. Clin Orthop Relat Res. 2003;416:162-170. doi:10.1097/01.blo.0000092972.28265.c0.
4. Meikle B, Devitt BM, Hooper G. Safe return to driving after total knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2015;23(7):1957-1966. doi:10.1007/s00167-014-2900-2.
5. MacDonald W, Owen JW. The effect of total knee arthroplasty on driving. J Arthroplasty. 1988;3(1):23-29. doi:10.1016/S0883-5403(88)80005-1.
6. AAOS OrthoInfo. Driving after total joint replacement (patient guidance). American Academy of Orthopaedic Surgeons. Accessed 2025.
7. Pierson JL, Earles DR. Return to driving following lower extremity arthroplasty: considerations for the clinician. Orthopedics. 2006;29(9):809-812. doi:10.3928/01477447-20060901-12.

In Episode 32 of the Total Knee Success Podcast, Michelle takes a clear, evidence-based look at minimally invasive knee replacement and what that label really means for patients. She explains how minimally invasive approaches compare with standard total knee replacement, why early experiences can feel different for some people, and what research shows about long-term outcomes. The episode also addresses surgeon experience, individual health factors, and the role of rehabilitation, helping listeners focus less on surgical labels and more on preparation, recovery, and long-term success after knee replacement.

More information at totalkneesuccess.com

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

American Academy of Orthopaedic Surgeons. Surgical management of osteoarthritis of the knee: evidence-based clinical practice guideline.

Cheng T, Zhu C, Guo Y, Shi S, Zhang X. Minimally invasive versus conventional approaches in total knee arthroplasty: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2014;9:43.

Lombardi AV Jr, Berend KR, Adams JB. Minimally invasive total knee arthroplasty: what is the evidence? Journal of Bone and Joint Surgery American. 2007;89(suppl 3):63–70.

Long WJ, Scuderi GR. Minimally invasive total knee arthroplasty. Orthopedic Clinics of North America. 2009;40(3):279–286.

Orange GM, Jones M, Murphy MC, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2025;55(1):1–15.

Arhos E, Ito K, Schmitt LC. Who’s afraid of electrical stimulation? Let’s revisit the application of neuromuscular electrical stimulation at the knee. Journal of Orthopaedic & Sports Physical Therapy. 2024;54(2):101–110.

Na A, Coronado RA, Poole JM, et al. Diabetes mellitus blunts the symptoms, physical function, and health-related quality of life benefits of total knee arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 2021;51(6):269–280.

Long WJ, Scuderi GR. Minimally invasive total knee arthroplasty: patient selection and limitations. Orthopedic Clinics of North America. 2009;40(3):279–286. Journal of Orthopaedic & Sports Physical Therapy. 2021;51(6):269–280.

In Episode 31 of the Total Knee Success Podcast, Michelle explains how the decision is made between home health physical therapy and outpatient physical therapy after total knee replacement. She walks listeners through why this choice is often driven by safety, medical stability, access, and insurance authorization rather than personal preference alone. Drawing from studies and clinical guidelines, Michelle clarifies how often each pathway is used, what early recovery really requires, and why starting in one setting does not determine long-term success. The episode breaks down what home health and outpatient therapy involve, how comorbidities and early mobility affect planning, and how patients can meaningfully participate in decisions about their care—even when options feel limited. This episode provides reassurance, context, and evidence-based clarity for anyone navigating physical therapy after knee replacement.

More information at totalkneesuccess.com

Get notified when the Knee Replacement Game Plan is released

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer This podcast is for informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, physical therapist, or other qualified healthcare provider with any questions you may have regarding a medical condition or healing process. Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast.

Amazon Affiliate Disclaimer Some links shared may be affiliate links. As an Amazon Associate, we may earn a small commission from qualifying purchases at no additional cost to you.

Evidence-Based Content Statement This episode integrates peer-reviewed research, clinical expertise, and current rehabilitation principles related to healing after total knee replacement.

Music Licensing Statement Music used in this podcast is licensed for use under applicable agreements.

References

Minick KI, Hunter SJ, Capin JJ, Stevens-Lapsley JE, Snow GL, Woodfield D, Dibblee P, Brennan GP. Improved outcomes following a care guideline implementation after total knee arthroplasty: part 1 of an analysis of 12 355 patients. J Orthop Sports Phys Ther. 2023;53(3):143-150. doi:10.2519/jospt.2022.11318

Capin JJ, Minick KI, Stevens-Lapsley JE, Snow GL, Woodfield D, Dibblee P, Brennan GP, Hunter SJ. Variation in outcomes and number of visits following care guideline implementation after total knee arthroplasty: part 2 of an analysis of 12 355 patients. J Orthop Sports Phys Ther. 2023;53(3):151-160. doi:10.2519/jospt.2022.11319

Graber J, Stevens-Lapsley JE, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty: a Delphi study. J Orthop Sports Phys Ther. 2023;53(9):566-576. doi:10.2519/jospt.2023.11915

Orange GM, Jones M, Murphy MC, Hince DA, Sharma S, Kim S, Wand BM, Stanton TR, Travers MJ. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15. doi:10.2519/jospt.2024.12163

In Episode 22 of the Total Knee Success Podcast, Michelle examines how prehab affects the early period after knee replacement surgery. She explains why preparing the body ahead of time can make the first few days more familiar and manageable. The episode breaks down what the research shows, which patients tend to benefit the most, and how the physical preparation helps create a more stable starting point. Michelle also discusses what to expect in the first therapy sessions after surgery and previews upcoming episodes on balance and functional testing.

https://totalkneesuccess.com/prehab-before-knee-replacement/

More information at totalkneesuccess.com

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer

The Total Knee Success Podcast is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. Always seek advice from your surgeon, physical therapist, or qualified provider regarding your specific care. Never delay or disregard professional advice because of this podcast. The show is not affiliated with my clinic or teaching roles.

Amazon Affiliate Disclaimer

As an Amazon Associate, I earn from qualifying purchases. If you click a product link and make a purchase, I may receive a small commission at no extra cost to you. These commissions support the show and allow continued production of free, evidence-based content. I only share products commonly recommended for post-knee replacement use that patients have found helpful.

Evidence-Based Content Statement

All episode information reflects current peer-reviewed research and professional guidelines available at recording time.

Music Licensing Statement

Music used in this episode is licensed through Descript.

References

Gränicher P, Mulder L, Lenssen T, Scherr J, Swanenburg J, de Bie R. Prehabilitation Improves Knee Functioning Before and Within the First Year After Total Knee Arthroplasty: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725. doi:10.2519/jospt.2022.11211.

Minick KI, et al. Improved Outcomes Following a Care Guideline Implementation: Part 1 of an Analysis of 12,355 Patients. J Orthop Sports Phys Ther. 2023;53(3):1-12. doi:10.2519/jospt.2023.11456.

Capin JJ, et al. Variation in Outcomes and Number of Visits Following Care Guideline Implementation: Part 2 of an Analysis Across Multiple Clinics. J Orthop Sports Phys Ther. 2023;53(4):1-14. doi:10.2519/jospt.2023.11457.

Duong SB, et al. Predictors of Adherence to a Step-Count Intervention Following Total Knee Replacement: An Exploratory Study. Arthritis Care Res. 2022;74(2):224-233. doi:10.1002/acr.24566.

Dandis M, et al. Latent Class Analysis to Predict Outcomes of Early High-Intensity Physical Therapy After Total Knee Arthroplasty. Phys Ther. 2021;101(9):pzab144. doi:10.1093/ptj/pzab144.

Goff AJ, et al. Physical Therapists Prioritize Providing Education About Exercise Therapy and Dispelling Misconceptions for Knee Osteoarthritis. Arthritis Care Res. 2022;74(12):2038-2048. doi:10.1002/acr.24759.

In Episode 21 of the Total Knee Success Podcast, Michelle explains why knee stiffness after surgery is common and often long-lasting for a substantial subgroup of patients. She covers swelling, quad inhibition, and movement patterns, and uses the Minick and Capin studies to show what structured rehab actually looks like. Michelle discusses diabetes, activity patterns, NMES dosing and effectiveness, and gives clear strategies for both bending and straightening. She also highlights the role of prehab and why it improves early outcomes.

As an Amazon Associate, I earn from qualifying purchases.

Learn more and access additional resources at TotalKneeSuccess.com.

https://totalkneesuccess.com/mid-rehab-total-knee-stiffness/

Medical Disclaimer: The Total Knee Success Podcast is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle’s clinic or teaching roles.

Amazon Affiliate Disclaimer: As an Amazon Associate, I earn from qualifying purchases. This means that if you click a product link and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content.

Evidence-Based Content Statement: All information shared in this episode is based on current research and professional guidelines available at the time of recording.

Music Licensing Statement: Music used in this episode is licensed for use through Descript.

References

Orange GM, Hince DA, Travers MJ, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1).

Gränicher P, Vienneau J, Lübbeke A, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725.

Minick KI, Capin JJ, Stevens-Lapsley JE, et al. Improved outcomes following a care guideline implementation: Part 1 of an analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in outcomes and number of visits following care guideline implementation: Part 2 of an analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151-158.

Arhos E, Sturgill L, Capin JJ. Who’s afraid of electrical stimulation? Let’s revisit the application of NMES at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-112.

Na A, Lim KY, Lee HJ, et al. Diabetes mellitus blunts the symptoms, physical function, and health-related quality-of-life benefits of total knee arthroplasty: a systematic review. J Orthop Sports Phys Ther. 2021;51(6):269-280.

Duong V, de Oliveira Silva D, Baker RT, et al. Predictors of adherence to a step-count intervention following total knee replacement: an exploratory cohort study. J Orthop Sports Phys Ther. 2022;52(9):620-629.

In Episode 20 of the Total Knee Success Podcast, Michelle explains what really matters once physical therapy ends: consistency, confidence, and connection. She shares how regular exercise sustains strength, why “use it or lose it” is simply how the body works, and how to handle fear and doubt using practical, research-backed strategies. Listeners learn simple ways to keep training safely at home, when to progress, and how to return to favorite activities responsibly.

As an Amazon Associate, I earn from qualifying purchases.

Learn more and access additional resources at TotalKneeSuccess.com.

https://totalkneesuccess.com/life-after-physical-therapy-tkr/

Medical Disclaimer: The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions you may have regarding your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle's clinic or teaching roles.

Amazon Affiliate Disclaimer: As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products that are commonly recommended for knee replacement recovery and that patients have found helpful.

Evidence-Based Content Statement: All information shared in this episode is based on current research and professional consensus guidelines available at the time of recording. The studies referenced are peer-reviewed and selected to ensure accuracy, clarity, and relevance for listeners navigating life before and after total knee replacement.

Music Licensing Statement: Music used in this episode is licensed for use through Descript. All rights to the track are secured via Descript’s music library.

References

Orange GM, Hince DA, Travers MJ, Stanton TR, Jones M. Physical Function Following Total Knee Arthroplasty for Osteoarthritis: A Longitudinal Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1–15.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in Outcomes and Number of Visits Following Care Guideline Implementation: Part 2 of an Analysis of 12 355 Patients After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151–160.

Gränicher B, Lüthi F, Bastiaenen CHG, et al. Prehabilitation Improves Knee Functioning Before and Within the First Year After Total Knee Arthroplasty. J Rehabil Med. 2022;54(1):1–9.

White DK, Hinman RS, Liles S, et al. A Telehealth Physical Therapy Intervention to Increase Physical Activity in Adults With Knee OA: The Delaware PEAK Randomized Controlled Trial. J Orthop Sports Phys Ther. 2025;55(5):377–390.

Fortin PR, Clarke AE, Joseph L, et al. Outcomes of Total Knee Replacement in Patients With Osteoarthritis. Arthritis Rheum. 1999;42(8):1722–1732.

Skou ST, Roos EM, Laursen MB, et al. Supervised Exercise and Patient Education Improve Outcomes After Total Knee Arthroplasty. Arthritis Care Res (Hoboken). 2012;64(3):469–477.

In Episode 19 of the Total Knee Success Podcast, Michelle explains why physical therapy remains one of the most important steps after knee replacement. Drawing on high-level studies through 2025, she explores early motion, teamwork with therapists, gait training, functional movement, NMES, and emerging telehealth programs. Listeners learn how collaborative, evidence-based therapy prevents stiffness, builds strength, and restores confidence. Resources available at TotalKneeSuccess.com. As an Amazon Associate, I earn from qualifying purchases.

Episode Resources For a full list of recommended products, complete reference details, and additional information discussed in this episode, visit: https://TotalKneeSuccess.com/episode19-skipping-PT?

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your surgeon, physical therapist, or other qualified health provider with any questions about your specific condition or care. Never disregard professional advice or delay seeking it because of something you heard on this podcast. This podcast is not affiliated with Michelle’s clinic or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. This means that if you click on a product link in my show notes or at TotalKneeSuccess.com and make a purchase, I may receive a small commission at no extra cost to you. These commissions help support the podcast and allow me to keep creating free, evidence-based content. I only share products commonly recommended for knee-replacement healing and that patients have found helpful.

Evidence-Based Content Statement All information shared in this episode is based on current research and professional consensus guidelines available at the time of recording. The studies referenced are peer-reviewed and selected to ensure accuracy, clarity, and relevance for listeners navigating life before and after total knee replacement.

Music Licensing Statement Music used in this episode is licensed for use through Descript. All rights to the track are secured via Descript’s music library.

References

Jette DU, Hunter SJ, et al. Clinical practice guideline: Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-1631.

Capin JJ, Minick KI, et al. Variation in outcomes and number of visits following care guideline implementation after TKA. J Orthop Sports Phys Ther. 2023;53(3):151-163.

Graber JL, Stevens-Lapsley JE, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty: A Delphi study. J Orthop Sports Phys Ther. 2023;53(9):566-578.

White DK, Hinman RS, Liles S, et al. A telehealth physical therapy intervention to increase physical activity in adults with knee OA: The Delaware PEAK RCT. J Orthop Sports Phys Ther. 2025;55(5):377-390.

Bove AM, Slover JD, et al. Rural Access to Physical Therapy for Osteoarthritis Rehabilitation (RAPTOR): A pilot feasibility study. Arthritis Care Res. 2025;77(2):215-226.

Nunes GS, de Moraes WSLA, et al. Are changes in dynamic knee movement control related to pain or function? A systematic review and meta-analysis. J Orthop Sports Phys Ther. 2023;53(7):388-401.

In Episode 30 of the Total Knee Success Podcast, Michelle explores why sleep often feels so disrupted after knee replacement and why this experience is both common and expected during early healing. She explains how swelling, pain sensitivity, and nervous system changes influence sleep, and walks listeners through back sleeping, side sleeping, and recliner use with a focus on comfort, safety, and flexibility rather than rigid rules. Michelle also addresses common misconceptions about sleep positions, reassures listeners that restless nights do not mean healing is failing, and emphasizes practical ways to support rest by managing swelling, pain, and expectations. By the end of the episode, listeners gain reassurance, clarity, and permission to prioritize supported rest over perfect sleep as their body heals.

More information at totalkneesuccess.com

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer This podcast is for informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, physical therapist, or other qualified healthcare provider with any questions you may have regarding a medical condition or healing process. Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast.

Amazon Affiliate Disclaimer Some links shared may be affiliate links. As an Amazon Associate, we may earn a small commission from qualifying purchases at no additional cost to you.

Evidence-Based Content Statement This episode integrates peer-reviewed research, clinical expertise, and current rehabilitation principles related to healing after total knee replacement.

Music Licensing Statement Music used in this podcast is licensed for use under applicable agreements.

References Wylde V, Beswick AD, Dennis J, Gooberman-Hill R. Post-operative patient-reported outcomes after total knee replacement: a systematic review of sleep, pain, and function. Bone Joint J. 2018;100-B(6):700-707.

Naylor JM, McBurney H, Ko V, Harmer AR. Outcome measures in the early postoperative phase after total knee replacement: poor sleep and fatigue are common despite functional gains. Phys Ther. 2014;94(5):673-685.

Jette DU, Hunter SJ, Burkett L, et al. Physical Therapist Management of Total Knee Arthroplasty. Phys Ther. 2020;100(9):1603-1631.

Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468(1):57-63.

Orange GM, Murphy MC, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15.

Singh JA, Lewallen DG. Predictors of activity limitation and pain outcomes after total knee arthroplasty. J Arthroplasty. 2013;28(6):e1-e5.

Katz JN, Wright EA, Guadagnoli E, et al. Differences between men and women undergoing major orthopedic surgery for chronic pain: sleep, pain, and functional recovery. Arthritis Rheum. 2011;63(10):3064-3070.

Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative healing: pain, sleep, and fatigue. Lancet. 2003;362(9399):1921-1928.

In Episode 29 of the Total Knee Success Podcast, Michelle walks through the most common mistakes people make before knee replacement surgery—including resting too much, waiting for pain to improve before moving, underestimating the role of strength and endurance, and going into surgery with unrealistic expectations. You’ll learn why smart, intentional preparation matters, how prehabilitation can support a smoother early recovery, and what to focus on in the final weeks before surgery. This episode is designed to help you feel more informed, more confident, and better prepared as you head toward knee replacement.

More information at totalkneesuccess.com

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer

The Total Knee Success Podcast is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Always seek the guidance of your surgeon, physical therapist, or qualified healthcare provider with any questions about your health. Never ignore or delay seeking professional advice because of something you hear on this podcast. This show is not affiliated with Michelle’s clinical or teaching roles.

Amazon Affiliate Disclaimer

As an Amazon Associate, I earn from qualifying purchases. If you choose to purchase through a referenced link, I may receive a small commission at no additional cost to you. These commissions support the continued creation of free educational resources.

Evidence-Based Content Statement

All information presented in this episode reflects current peer-reviewed research and professional guidelines available at the time of recording.

Music Licensing Statement

Music used in this episode is licensed through Descript.

References

1. Gränicher U, Delaune V, Giesinger JM, et al. Effects of prehabilitation before total knee arthroplasty on function and recovery: A systematic review and meta-analysis. J Arthroplasty. 2022;37(8):S389-S399.
2. Bricca A, Juhl CB, Steultjens M, Wirth W, Roos EM. Impact of exercise therapy on knee joint structure in people with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Osteoarthritis Cartilage. 2019;27(7):999-1011.
3. Orange ST, Northgraves MJ, Marshall P, Madden LA, Vince RV. Expectations, experiences, and recovery following total knee arthroplasty: A longitudinal cohort study. Phys Ther. 2020;100(10):1804-1814.
4. Minick KI, Kahle N, Smith B, et al. Patient education and structured rehabilitation pathways following total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(4):1-10.
5. Capin JJ, Khandha A, Zarzycki R, et al. Progressive rehabilitation and self-management after total knee arthroplasty: Associations with functional outcomes. Phys Ther. 2022;102(5):pzac028.
6. Arhos EK, Trudelle-Jackson E, Brown M, et al. Quadriceps activation failure after total knee arthroplasty: Implications for rehabilitation. J Orthop Sports Phys Ther. 2021;51(8):391-398.
7. Na Y, Shi Y, Han C, et al. Diabetes mellitus and outcomes after total knee arthroplasty: A systematic review and meta-analysis. J Knee Surg. 2020;33(5):495-504.

In Episode 28 of the Total Knee Success Podcast, Michelle explains how much walking is appropriate in the first two weeks after total knee replacement and why the early focus should be on short, frequent, controlled bouts of walking rather than distance. She discusses surgeon-recommended limits including five-minute and ten-minute hourly walks, specific step caps, and the importance of respecting tissue tolerance. The episode emphasizes that early activity does not predict long-term outcomes and that recovery is strengthened by patience, pacing, and alignment with surgeon and therapist recommendations.

More information at totalkneesuccess.com

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Always seek the guidance of your surgeon, physical therapist, or qualified healthcare provider with any questions about your health. Never ignore or delay seeking professional advice because of something you hear on this podcast. This show is not affiliated with Michelle’s clinical or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. If you choose to purchase through a referenced link, I may receive a small commission at no additional cost to you. These commissions support the continued creation of free educational resources.

Evidence-Based Content Statement All information presented in this episode reflects current peer-reviewed research and professional guidelines available at the time of recording.

Music Licensing Statement Music used in this episode is licensed through Descript.

References

Dandis A, et al. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty, based on longitudinal trajectories of walking speed. J Orthop Sports Phys Ther. 2021;51(7):362-374.

Duong V, Dennis S, Ferreira ML, et al. Predictors of adherence to a step count intervention following total knee replacement: an exploratory cohort study. J Orthop Sports Phys Ther. 2022;52(9):620-629.

Orange GM, Jones M, Stanton TR, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-19.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation: part 1 of an analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-150.

Bricca A, et al. Exercise therapy “wears down” my knee joint: myth or reality? J Orthop Sports Phys Ther. 2025;55(7):463-479.

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725.

Goff AJ, Donaldson A, Silva DD, et al. Physical therapists prioritize providing education about exercise therapy and dispelling misconceptions about radiology for people with knee osteoarthritis: a concept mapping study. J Orthop Sports Phys Ther. 2022;52(9):607-619.

In Episode 27 of the Total Knee Success Podcast, Michelle guides you through exactly what to focus on in the final two weeks before your knee replacement so you can walk into surgery feeling steady and prepared. She explains why this isn’t the time to push your strength, how to set up your home for an easier first week, and why simple organization can make those early days feel calmer. Michelle also shares insights from the latest research and from real patients who’ve been through it, all to help you feel confident heading into surgery. She closes with a preview of next week’s episode on how much walking is actually appropriate right after knee replacement. More information at totalkneesuccess.com

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Always seek the guidance of your surgeon, physical therapist, or qualified healthcare provider with any questions about your health. Never ignore or delay seeking professional advice because of something you hear on this podcast. This show is not affiliated with Michelle’s clinical or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. If you choose to purchase through a referenced link, I may receive a small commission at no additional cost to you. These commissions support the continued creation of free educational resources.

Evidence-Based Content Statement All information presented in this episode reflects current peer-reviewed research and professional guidelines available at the time of recording.

Music Licensing Statement Music used in this episode is licensed through Descript.

References

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty. J Orthop Sports Phys Ther. 2022;52(11):709–725.

Goff AJ, Donaldson A, Silva DO, Crossley KM, Barton CJ. Physical therapists prioritize providing education about exercise therapy for people with knee osteoarthritis. J Orthop Sports Phys Ther. 2022;52(9):607–618.

Na A, Coronado RA, Blanck CR, et al. Diabetes mellitus blunts the functional and quality-of-life benefits of total knee arthroplasty. J Orthop Sports Phys Ther. 2021;51(6):269–280.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53:143–150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in outcomes and number of visits following care guideline implementation: Part 2. J Orthop Sports Phys Ther. 2023;53:151–162.

Duong V, Dennis S, Ferreira ML, et al. Predictors of adherence to a step-count intervention following total knee replacement. J Orthop Sports Phys Ther. 2022;52:620–630.

Nunes GS, Mello R, da Cunha Ribeiro RP, et al. Are changes in dynamic knee movement control related to changes in pain or function in people with knee osteoarthritis. J Orthop Sports Phys Ther. 2023;53:1–10.

Graber JJ, DeBenedictis B, Stevens-Lapsley JE, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53:1–10.

In Episode 26 of the Total Knee Success Podcast, Michelle explains why the “other” knee—the one that didn’t have surgery—often feels tired or achy after total knee replacement. She discusses how arthritis in the opposite knee impacts balance and fall risk and brings in new research on function, movement control, strength, and prehabilitation. Listeners learn practical ways to support both knees using strength, pacing, and better movement habits.

Learn more at totalkneesuccess.com

Medical Disclaimer

The Total Knee Success Podcast is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. Always seek the guidance of your surgeon, physical therapist, or another qualified medical provider with any questions you may have about your health. Never ignore or delay seeking professional advice because of something you have heard on this podcast. This show is not affiliated with Michelle’s clinical or teaching roles.

Amazon Affiliate Disclaimer

As an Amazon Associate, I earn from qualifying purchases. If you choose to purchase through a referenced link, I may receive a small commission at no additional cost to you. These commissions support the continued creation of free educational resources. Only items commonly recommended in orthopedic rehabilitation are shared.

Evidence-Based Content Statement

All information presented in this episode reflects current peer-reviewed evidence and professional guidelines available at the time of recording.

Music Licensing Statement

Music used in this episode is licensed through Descript.

References

Si H, et al. Prevalence of falls and the association with knee osteoarthritis in the contralateral knee in patients with unilateral TKA: prospective cohort (N=376). Unpublished summary document.

Chan AC, et al. Sensitivity of balance assessments after total knee arthroplasty: BESTest and Mini-BESTest detect more change than Berg. Arch Phys Med Rehabil. 2018.

Orange S, et al. Physical function following total knee arthroplasty: a longitudinal systematic review. 2025.

Nunes GS, et al. Dynamic knee movement control and its relationship to changes in pain and function. 2023.

Gränicher L, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty. 2022.

Minick K, et al. Improved outcomes following care guideline implementation. 2023.

Capin J, et al. Variation in outcomes and visits following care guideline implementation. 2023.

In Episode 25 of the Total Knee Success Podcast, Michelle explores how wearable technology can support recovery after total knee replacement. She discusses step counters, smartphone apps, QR-code exercise programs, and motion-tracking sensors, and explains how these tools bring clarity to a process that can feel unpredictable. Michelle shares how wearables help people stay consistent, notice progress that isn’t always easy to feel day to day, and give therapists meaningful insight between visits. She also talks about why some surgeons limit steps early on, what research shows about step-count habits after surgery, and how real-time feedback from sensors can improve gait, confidence, and overall movement quality.

Medical Disclaimer

The Total Knee Success Podcast is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. Always seek the guidance of your surgeon, physical therapist, or another qualified medical provider with any questions you may have about your health. Never ignore or delay seeking professional advice because of something you have heard on this podcast. This show is not affiliated with Michelle’s clinical or teaching roles.

Amazon Affiliate Disclaimer

As an Amazon Associate, I earn from qualifying purchases. If you choose to purchase through a referenced link, I may receive a small commission at no additional cost to you. These commissions support the continued creation of free educational resources. Only items commonly recommended in orthopedic rehabilitation are shared.

Evidence-Based Content Statement

All information presented in this episode reflects current peer-reviewed evidence and professional guidelines available at the time of recording.

Music Licensing Statement

Music used in this episode is licensed through Descript.

References

Gordon D, et al. Wearable devices to monitor patient outcomes after total knee arthroplasty: a systematic review. Arch Orthop Trauma Surg. 2025;145:155–166.

King MG, et al. Wearable sensors to guide remote rehabilitation following knee arthroplasty surgery: a systematic review. BMC Musculoskelet Disord. 2023;24:785.

Feng Y, et al. Wearable gait devices following knee replacement: a systematic review. Gait Posture. 2023;103:35–44.

Schaffer NE, et al. Accuracy of wearable motion sensors for monitoring knee range of motion after TKA: pilot study. Sensors (Basel). 2022;22(12):4567.

Duong V, et al. Predictors of adherence to a step count intervention following total knee replacement. J Orthop Sports Phys Ther. 2022;52(9):620–630.

Roche MW, et al. Early clinical use of smart knee implants with embedded sensors: motion and step count tracking in TKA patients. J Arthroplasty. 2022;37(6):1090–1097.

Kelmers E, et al. Smart knee implants: an overview of current technology. Sensors (Basel). 2022;9(4):93.

Bahadori S, Immins T, Wainwright TW. Wearable motion tracking systems used in rehabilitation following hip and knee replacement: a review. J Orthop Res. 2018.

Constantinescu D, et al. The role of commercially available smartphone apps and wearable activity monitors in lower-limb arthroplasty rehabilitation: review. EFORT Open Rev. 2022;7(7):547–556.

Östlind E, Sant’Anna A, Eek F, et al. Physical activity patterns and adherence to using a wearable activity tracker among individuals with hip and/or knee osteoarthritis. BMC Musculoskelet Disord. 2021;22:450.

White DK, Hinman RS, Liles S, et al. A telehealth physical therapy intervention to increase physical activity in adults with knee osteoarthritis. J Orthop Sports Phys Ther. 2025.

In Episode 24 of the Total Knee Success Podcast, Michelle explains how the standard Timed Up and Go and the Dynamic Gait Index help clarify why walking may still feel hesitant or slower after total knee replacement. The episode breaks down what these tests measure, how therapists interpret the results, and how they relate to real-world walking challenges.

https://totalkneesuccess.com/walking-hesitation-after-knee-replacement-tests/

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. Always seek the guidance of your surgeon, physical therapist, or another qualified medical provider with any questions you may have about your health. Never ignore or delay seeking professional advice because of something you have heard on this podcast. This show is not affiliated with Michelle’s clinical or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. If you choose to purchase through a referenced link, I may receive a small commission at no additional cost to you. These commissions support the continued creation of free educational resources. Only items commonly recommended in orthopedic rehabilitation are shared.

Evidence-Based Content Statement All information presented in this episode reflects current peer-reviewed evidence and professional guidelines available at the time of recording.

Music Licensing Statement Music used in this episode is licensed through Descript.

References

Orange GM, Hince DA, Travers MJ, et al. Physical Function Following Total Knee Arthroplasty for Osteoarthritis: A Longitudinal Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1–XX.

Na A, Oppermann LM, Jupiter DC, et al. Diabetes Mellitus Blunts the Symptoms, Physical Function, and Health-Related Quality of Life Benefits of Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2021;51(6):269–280.

Duong V, Dennis S, Ferreira ML, et al. Predictors of Adherence to a Step Count Intervention Following Total Knee Replacement. J Orthop Sports Phys Ther. 2022;52(9):620–630.

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation Improves Knee Functioning Before and Within the First Year After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2022;52(11):709–725.

Minick KI, Hunter SJ, Capin JJ, et al. Improved Outcomes Following Care Guideline Implementation. J Orthop Sports Phys Ther. 2023;53(3):143–150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in Outcomes and Number of Visits Following Care Guideline Implementation. J Orthop Sports Phys Ther. 2023;53(3):151–160.

Dandis M, et al. Latent Class Analysis to Predict Outcomes of Early High-Intensity Physical Therapy After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2021;51(7):362–371.

Goff AJ, Donaldson A, de Oliveira Silva D, et al. Education Priorities of Physical Therapists for People With Knee Osteoarthritis. J Orthop Sports Phys Ther. 2022;52(9):607–619.

Bricca A, Roos EM, et al. Exercise Therapy “Wears Down” My Knee Joint: Myth or Reality? J Orthop Sports Phys Ther. 2025;55(7):463–476.

In Episode 23 of the Total Knee Success Podcast, Michelle explains how the Berg Balance Scale and the Mini-BESTest describe balance and mobility after total knee replacement. She reviews what each test measures, why many therapists still use the Berg, and why the Mini-BESTest often provides a clearer picture of dynamic balance and walking confidence.

Medical Disclaimer The Total Knee Success Podcast is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Always seek the guidance of your surgeon, physical therapist, or qualified healthcare provider with any questions about your health. Never ignore or delay seeking professional advice because of something you hear on this podcast. This show is not affiliated with Michelle’s clinical or teaching roles.

Amazon Affiliate Disclaimer As an Amazon Associate, I earn from qualifying purchases. If you choose to purchase through a referenced link, I may receive a small commission at no additional cost to you. These commissions support the continued creation of free educational resources.

Visit totalkneesuccess.com for more information.

https://totalkneesuccess.com/still-wobbly-after-knee-replacement-balance-tests/

Evidence-Based Content Statement All information presented in this episode reflects current peer-reviewed research and professional guidelines available at the time of recording.

Music Licensing Statement Music used in this episode is licensed through Descript.

References

Orange GM, Hince DA, Travers MJ, et al. Physical Function Following Total Knee Arthroplasty for Osteoarthritis: A Longitudinal Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1–XX.

Na A, Oppermann LM, Jupiter DC, et al. Diabetes Mellitus Blunts the Symptoms, Physical Function, and Health-Related Quality of Life Benefits of Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2021;51(6):269–280.

Duong V, Dennis S, Ferreira ML, et al. Predictors of Adherence to a Step Count Intervention Following Total Knee Replacement. J Orthop Sports Phys Ther. 2022;52(9):620–630.

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation Improves Knee Functioning Before and Within the First Year After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2022;52(11):709–725.

Minick KI, Hunter SJ, Capin JJ, et al. Improved Outcomes Following Care Guideline Implementation. J Orthop Sports Phys Ther. 2023;53(3):143–150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in Outcomes and Number of Visits Following Care Guideline Implementation. J Orthop Sports Phys Ther. 2023;53(3):151–160.

Dandis M, et al. Latent Class Analysis to Predict Outcomes of Early High-Intensity Physical Therapy After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2021;51(7):362–371.

Goff AJ, Donaldson A, de Oliveira Silva D, et al. Education Priorities of Physical Therapists for People With Knee Osteoarthritis. J Orthop Sports Phys Ther. 2022;52(9):607–619.

Bricca A, Roos EM, et al. Exercise Therapy “Wears Down” My Knee Joint: Myth or Reality? J Orthop Sports Phys Ther. 2025;55(7):463–476.

In Episode 46 of the Total Knee Success podcast, Michelle explains how to stay engaged after knee replacement when progress feels slower and less obvious. She discusses why mid-phase slowdowns are normal and why consistency, rather than constant testing or perfection, supports continued improvement. Michelle introduces ten research-informed activity options often used between three and six months after surgery and encourages listeners to use these as a starting point for thoughtful conversations with their physical therapist about where to focus next.

NMES unit commonly used for quad muscle contraction

A second estim unit to check out

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Gränicher P, Mulder L, Lenssen T, Scherr J, Swanenburg J. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: A systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709–725.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation: Part 1 of an analysis of 12 355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143–150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in outcomes and number of visits following care guideline implementation: Part 2 of an analysis of 12 355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151–159.

Duong V, Dennis S, Ferreira ML, et al. Predictors of adherence to a step count intervention following total knee replacement: An exploratory cohort study. J Orthop Sports Phys Ther. 2022;52(9):620–629.

Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: A longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1–16.

Na A, Coronado RA, Fitzgerald GK, et al. Diabetes mellitus blunts the symptoms, physical function, and health-related quality of life benefits of total knee arthroplasty: A systematic review with meta-analysis. J Orthop Sports Phys Ther. 2021;51(6):269–280.

In Episode 45 of the Total Knee Success podcast, Michelle explains why progress after total knee replacement often slows after the early postoperative phase and why that change does not mean recovery has stalled. The episode explores how deeper strength, endurance, and neuromuscular adaptations take longer to develop and are harder to see week to week. Michelle reviews research on recovery trajectories, adherence, and activity consistency after TKA, helping listeners understand why early gains do not predict long-term outcomes. The episode closes with guidance on when to seek individualized input from a physical therapist or surgeon and how to stay engaged without chasing perfection.

NMES unit commonly used for quad muscle contraction

A second estim unit to check out

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Duong V, et al. Predictors of adherence to a step-count intervention following total knee replacement: an exploratory study. Phys Ther. 2022.

Minick KI, et al. Improved outcomes following a care guideline implementation after total knee arthroplasty: analysis of 12,355 patients. J Orthop Sports Phys Ther. 2023.

Orange ST, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review. Osteoarthritis Cartilage. 2025.

Gränicher F, et al. Prehabilitation improves knee function before and after total knee arthroplasty. Clin Rehabil. 2022.

Graber J, et al. Expert consensus for outpatient rehabilitation visits after total knee arthroplasty. J Orthop Sports Phys Ther. 2023.

Capin JJ, et al. Variation in outcomes and rehabilitation utilization following care guideline implementation after total knee arthroplasty. J Orthop Sports Phys Ther. 2023.

Dandis K, et al. Predictors of outcomes after early high-intensity physical therapy following total knee arthroplasty. Phys Ther. 2021.

Goff AJ, et al. Physical therapists’ perspectives on education and exercise after knee arthroplasty. Phys Ther. 2022.

In Episode 36 of the Total Knee Success Podcast, Michelle begins a two-part, evidence-based conversation focused entirely on preparation before knee replacement surgery. This episode explores the foundational drivers that shape recovery, including strength, muscle activation, walking capacity, and consistency, while clearing common myths about exercise and range of motion. Episode 36 sets the stage for Part 2 by clarifying what truly deserves attention before surgery.

Get notified when the Knee Replacement Game Plan is released. More information at totalkneesuccess.com. What will you do in the two weeks before surgery? Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Gränicher P, Mulder L, Lenssen T, Scherr J, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725. doi:10.2519/jospt.2022.11160

Capin JJ, Minick KI, Stevens-Lapsley JE, Snow GL, Woodfield D, Dibblee P, Brennan GP, Hunter SJ. Variation in outcomes and number of visits following care guideline implementation after total knee arthroplasty: part 2 of an analysis of 12 355 patients. J Orthop Sports Phys Ther. 2023;53(3):151-158. doi:10.2519/jospt.2023.11475

Minick KI, Hunter SJ, Capin JJ, Stevens-Lapsley JE, Snow GL, Woodfield D, Dibblee P, Brennan GP. Improved outcomes following a care guideline implementation after total knee arthroplasty: part 1 of an analysis of 12 355 patients. J Orthop Sports Phys Ther. 2023;53(3):143-150. doi:10.2519/jospt.2023.11474

Arhos E, Ito K, Schmitt LC, Stevens-Lapsley JE. Who’s afraid of electrical stimulation? Let’s revisit the application of neuromuscular electrical stimulation at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-108. doi:10.2519/jospt.2023.12044

Bricca A, Juhl CB, Steultjens M, et al. Exercise therapy “wears down” my knee joint: myth or reality? J Orthop Sports Phys Ther. 2025;55(7):463-471. doi:10.2519/jospt.2025.12188

Duong V, Dennis S, Ferreira ML, et al. Predictors of adherence to a step count intervention following total knee replacement: an exploratory cohort study. J Orthop Sports Phys Ther. 2022;52(9):620-629. doi:10.2519/jospt.2022.10987

In Episode 35 of the Total Knee Success Podcast, Michelle explores how to think about the timing of knee replacement without focusing solely on the calendar. This episode walks listeners through the trade-offs between waiting and moving forward, explains how strength, balance, and physical capacity influence recovery, and helps people reflect on whether waiting is preserving function or gradually making recovery harder. Listeners are encouraged to use this information alongside conversations with their surgeon to make informed, individualized decisions.

Get notified when the Knee Replacement Game Plan is released

More information at totalkneesuccess.com.

What will you do in the two weeks before surgery? Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1–14.

Canfield M, Savoy L, Cote MP, Halawi MJ. Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window. Arthroplasty Today. 2020;6:62–67.

Fortin PR, Penrod JR, Clarke AE, et al. Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee. Arthritis Rheum. 2002;46(12):3327–3330.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation: part 1 of an analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143–150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in outcomes and number of visits following care guideline implementation: part 2 of an analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151–160.

Bricca A, Juhl CB, Steultjens M, et al. Exercise therapy “wears down” my knee joint: myth or reality? J Orthop Sports Phys Ther. 2025;55(7):463–470.

Chan ACM, Ouyang XH, Jehu DAM, Chung RCK, Pang MYC. Recovery of balance function among individuals with total knee arthroplasty: comparison of responsiveness among four balance tests. Gait Posture. 2018;59:267–271.

In Episode 34 of the Total Knee Success Podcast, Michelle examines robotic-assisted total knee arthroplasty through the lens of current research. She explains what robotic assistance actually does during surgery, where it improves technical precision, and why those advantages don’t automatically translate into faster recovery or better long-term outcomes for every patient. She also discusses newer MAKO-specific evidence suggesting modest functional benefits at certain timepoints, while emphasizing the importance of surgeon experience, individualized decision-making, and a strong recovery plan.

Get notified when the Knee Replacement Game Plan is released. What will you do in the two weeks before surgery? Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Sodhi K, Eaton-Brown J, Kumar PR, Adebayo O, Searle HKC, Metcalfe AJ, Davis ET, Khatri C. Robotic-assisted total knee arthroplasty with MAKO is associated with improved functional outcomes: a systematic review and meta-analysis. Bone Jt Open. 2025;6(11):1382–1393. doi:10.1302/2633-1462.611.BJO-2025-0180.R1

Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty. Bone Joint J. 2018;100-B(7):930–937.

Kayani B, Konan S, Huq SS, Tahmassebi J, Haddad FS. Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1132–1141.

Marchand RC, Sodhi N, Anis HK, et al. One-year patient outcomes for robotic-arm-assisted versus manual total knee arthroplasty. J Knee Surg. 2019;32(11):1063–1068.

Onggo JR, Onggo JD, De Steiger R, Hau R. Robotic-assisted total knee arthroplasty is associated with improved mechanical alignment but similar clinical outcomes compared with conventional total knee arthroplasty: a meta-analysis. Orthop Traumatol Surg Res. 2020;106(7):1313–1323.

Chen X, Li J, Cao F, Wang J, Huang Z. Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc. 2022;30(9):2917–2929.

Zhang J, Ndou WS, Ng N, et al. Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient-reported outcomes: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022;30(8):2677–2695.

In Episode 33 of the Total Knee Success Podcast, Michelle explains what partial knee replacement really is, how it differs from total knee replacement, and why it’s often confused with minimally invasive surgery. Drawing on large national joint registries from the United Kingdom and Australia, she discusses who may be an appropriate candidate, the trade-offs patients need to understand, and why revision rates are higher for partial knee replacement. The episode helps listeners approach this decision with clarity, realistic expectations, and a focus on long-term success.

Get notified when the Knee Replacement Game Plan is released More information at totalkneesuccess.com

What will you do in the two weeks before surgery? You need a clear checklist for the final 14 days before knee replacement — so you know exactly what to prepare, what to expect, and how to set yourself up for a smoother first week after surgery. Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Theus-Steinmann C, Lustig S, Calliess T. Update Indikation Teilprothese: Neue Aspekte (Evolving indications for partial knee replacement: new aspects). Orthopädie (Heidelberg). 2024;53(4):238-245. doi:10.1007/s00132-024-04484-9.

Goodfellow JW, O’Connor JJ, Murray DW. A critique of revision rate as an outcome measure: reinterpretation of knee joint registry data. J Bone Joint Surg Br. 2010;92(12):1628-1631.

Liddle AD, Judge A, Pandit H, Murray DW. Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients. Bone Joint J. 2014;96-B(11):1493-1500.

Burn E, Liddle AD, Hamilton TW, et al. Cost-effectiveness of unicompartmental compared with total knee replacement: population-based matched cohort study. BMJ. 2019;364:l352. doi:10.1136/bmj.l352.

Liddle AD, Pandit H, Judge A, Murray DW. Effect of surgical caseload on revision rate following unicompartmental knee replacement. J Bone Joint Surg Am. 2016;98(1):1-8.

National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. 20th Annual Report. NJR Centre; 2023.

Australian Orthopaedic Association National Joint Replacement Registry. Hip, Knee & Shoulder Arthroplasty: 2023 Annual Report. AOA; 2023.

Zuiderbaan HA, van der List JP, Khamaisy S, et al. Unicompartmental knee arthroplasty versus total knee arthroplasty: which type of artificial joint do patients forget? Knee Surg Sports Traumatol Arthrosc. 2017;25(3):681-686.

In Episode 44 of the Total Knee Success podcast, Michelle explains why being “cleared” after knee replacement does not mean recovery is complete. She explores the difference between medical clearance and true functional readiness, including strength, load tolerance, and neuromuscular recovery. The episode helps listeners understand why swelling, stiffness, or fatigue can persist despite surgical success and how to respond without fear. Listeners are guided to view clearance as permission to progress thoughtfully rather than pressure to perform.

NMES unit commonly used for quad muscle contraction

A second estim unit to check out

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References: Vossen JA, et al. Long-term recovery of knee extensor strength after total knee arthroplasty. J Arthroplasty. 2025.

Sun Y, et al. Neuromuscular electrical stimulation after joint replacement surgery: a systematic review and meta-analysis. Clin Rehabil. 2025.

Arhos A, Ito Y, Stevens-Lapsley J, et al. Who’s afraid of electrical stimulation? Let’s revisit the application of neuromuscular electrical stimulation at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-110.

Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-20.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation: part 1 of an analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-152.

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725.

Graber J, Stevens-Lapsley J, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty: a Delphi study. J Orthop Sports Phys Ther. 2023;53(9):566-576.

In Episode 43 of the Total Knee Success podcast, Michelle explains the real healing timeline after knee replacement by walking through how skin, muscle, tendons, ligaments, and bone heal at different rates. She clarifies why the knee can look healed on the outside while deeper tissues are still adapting, and how this mismatch influences stiffness, swelling, and strength. The episode helps listeners understand how different tissues heal over time and what they can reasonably expect as recovery progresses.

NMES unit commonly used for quad muscle contraction

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-14.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-150.

Capin JJ, Hunter SJ, Minick KI, et al. Variation in outcomes and number of visits following care guideline implementation after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151-160.

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725.

Graber J, Stevens-Lapsley J, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty: a Delphi study. J Orthop Sports Phys Ther. 2023;53(9):566-578.

Dandis D, et al. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty. J Orthop Sports Phys Ther. 2021;51(7):362-371.

Na A, Coronado RA, et al. Diabetes mellitus blunts the symptoms, physical function, and health-related quality-of-life benefits of total knee arthroplasty. J Orthop Sports Phys Ther. 2021;51(6):269-280.

Aldhahwani BM, et al. Sociodemographic differences in short-term physical function outcomes after hip and knee arthroplasty. JOSPT Open. 2025;3(3):254-266.

Werner BC, Carr JB, Browne JA. Risk factors, outcomes, and timing of manipulation under anesthesia after total knee arthroplasty. J Bone Joint Surg Am. 2015;97(24):1956-1961.

In Episode 42 of the Total Knee Success podcast, Michelle explains how to decide when to progress walking after knee replacement without guessing or reacting out of fear. The episode focuses on practical signals such as recovery patterns, fatigue, walking speed trends, endurance, confidence, and assistive device use. Listeners learn how to interpret these signals to make informed progression decisions, shifting from uncertainty to clarity and building confidence in their recovery choices.

Check out this Self Standing Pivot Walking Cane or this Rollator Walker on Amazon

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References: Minick KI, Hunter SJ, Capin JJ, Stevens-Lapsley JE, Snow G, et al. Improved outcomes following a care guideline implementation: part 1 of an analysis of 12 355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-152. doi:10.2519/jospt.2022.11436.

Capin JJ, Kittelson AJ, Stevens-Lapsley JE, et al. Variation in outcomes and number of visits following care guideline implementation after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(4):1-12. doi:10.2519/jospt.2022.11437.

Dandis MT, Stevens-Lapsley JE, Kittelson AJ, et al. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty based on longitudinal trajectories of walking speed. J Orthop Sports Phys Ther. 2021;51(7):362-371. doi:10.2519/jospt.2021.10345.

Orange GM, Murphy MC, Wand BM, Sharma S, Kim S, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-16. doi:10.2519/jospt.2024.12123.

Graber J, Stevens-Lapsley JE, Snyder-Mackler L, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(5):1-11. doi:10.2519/jospt.2023.11541.

In episode 41 of the Total Knee Success podcast, Michelle explains why walking speed often feels slower than expected after knee replacement and why this does not signal failure or poor effort. She describes walking speed as a functional vital sign, explains what common walking speeds in meters per second tend to reflect during recovery, and reviews research showing that improvement unfolds gradually and along different trajectories. The episode explores how strength, balance, pain, and confidence influence pace, and offers practical guidance on how to interpret walking speed as useful feedback. Listeners are guided from uncertainty to clarity, learning how walking speed can inform smarter recovery decisions rather than drive fear or self-comparison.

NMES unit commonly used for quad muscle contraction

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References:

Gränicher P, Mulder L, Lenssen T, Scherr J, Mulder L, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725. doi:10.2519/jospt.2022.11160.

Minick KI, Hunter SJ, Capin JJ, Stevens-Lapsley JE, Snow G, et al. Improved outcomes following a care guideline implementation: part 1 of an analysis of 12 355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-152. doi:10.2519/jospt.2022.11436.

Orange GM, Murphy MC, Wand BM, Sharma S, Kim S, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-16. doi:10.2519/jospt.2024.12123.

Dandis MT, Stevens-Lapsley JE, Kittelson AJ, et al. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty based on longitudinal trajectories of walking speed. J Orthop Sports Phys Ther. 2021;51(7):362-371. doi:10.2519/jospt.2021.10345.

Arhos EK, Stevens-Lapsley JE, Balter JE, et al. Who’s afraid of electrical stimulation? Revisiting the application of neuromuscular electrical stimulation at the knee. J Orthop Sports Phys Ther. 2024;54(2):1-12. doi:10.2519/jospt.2023.12041.

In Episode 40, Michelle takes a deep dive into neuromuscular electrical stimulation and its role in restoring quadriceps strength after total knee replacement. She explains why quadriceps weakness persists after surgery, how NMES works to improve muscle activation when the nervous system is still protective, and why visible, high-intensity contractions are essential for results. The episode clarifies how NMES differs from TENS and other forms of electrical stimulation, reviews what the research shows about earlier and more consistent use, and discusses practical setup considerations including pad size, placement, skin preparation, and safety precautions. Michelle also explores why NMES sometimes appears to “fail” in clinical settings, how dosing and frequency influence outcomes, and when guided home use may be appropriate as part of a broader strengthening plan.

NMES unit commonly used for quad muscle contraction

A second estim unit to check out

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Arhos EK, Ito N, Silbernagel KG, et al. Who’s afraid of electrical stimulation? Let’s revisit the application of NMES at the knee. Journal of Orthopaedic & Sports Physical Therapy. 2024;54(2):101–109.

Stevens-Lapsley JE, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty. Physical Therapy. 2012;92(2):210–226.

Nussbaum EL, Houghton P, Anthony J, et al. Neuromuscular electrical stimulation for treatment of muscle impairment: critical review and recommendations for clinical practice. Physiotherapy Canada. 2017;69(5):1–76.

Graber J, Jette DU, McDonough CM, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty. Physical Therapy. 2023;103(4):pzac185.

Gränicher C, de Bie RA, Staal JB, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty. Archives of Physical Medicine and Rehabilitation. 2022;103(7):1357–1366.

American Physical Therapy Association. Clinical practice guideline for physical therapy management of total knee arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 2020;50(9):CPG1–CPG81.

In Episode 39 of the Total Knee Success Podcast, we explore why quadriceps weakness is one of the most overlooked drivers of difficulty after knee replacement. Many patients notice slower progress with walking, stairs, and confidence even when they are consistent with their exercises, and this episode explains why that happens. We break down how quad inhibition develops after surgery, how it changes movement patterns and trust in the surgical leg, and why simply pushing harder with strengthening often falls short. Listeners will gain clarity on what may truly be holding their recovery back and why this challenge is common rather than a personal failure.

Click here to get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com. What will you do two weeks before surgery? Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Arhos EK, Ito Y, Schmitt LC, et al. Who’s afraid of electrical stimulation? Let’s revisit the application of NMES at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-109.

Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15.

Minick KI, Hunter SJ, Capin JJ, et al. Improved outcomes following a care guideline implementation after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in outcomes and number of visits following care guideline implementation after total knee arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151-159.

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725.

Na A, Coronado RA, et al. Diabetes mellitus blunts the symptoms, physical function, and health-related quality of life benefits of total knee arthroplasty. J Orthop Sports Phys Ther. 2021;51(6):269-280.

Dandis J, et al. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty. J Orthop Sports Phys Ther. 2021;51(7):362-371.

White DK, Hinman RS, et al. A telehealth physical therapy intervention to increase physical activity in adults with knee osteoarthritis: the Delaware PEAK randomized controlled trial. J Orthop Sports Phys Ther. 2025;55(5):377-388.

Episode 38 explores why knee arthritis makes everyday life feel harder than expected by examining effort, fatigue, loss of efficiency, and changes in confidence beyond pain. It sets the foundation for Episodes 39 and 40, which focus on quadriceps weakness and neuromuscular electrical stimulation as tools for restoring function.

Click here to get an email when The Knee Replacement Game Plan is released.

More information at totalkneesuccess.com. What will you do in the two weeks before surgery? Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Schmitt LC, Rudolph KS. Altered gait characteristics in individuals with knee osteoarthritis and self-reported knee instability. J Orthop Sports Phys Ther. 2015;45(5):351-359. doi:10.2519/jospt.2015.5540.

Hart HF, Crossley KM, Culvenor AG, Khan MCM, West TJ, Kennedy JB, Couch JL, Whittaker JL. Knee confidence, fear of movement, and psychological readiness for sport in individuals with knee conditions: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2024;54(4):234-247. doi:10.2519/jospt.2024.12070.

Arhos E, Ito K, Snyder-Mackler K, Stevens-Lapsley JE. Who’s afraid of electrical stimulation? Let’s revisit the application of neuromuscular electrical stimulation at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-110.

Gränicher F, Wieser K, Aeschlimann A, et al. Prehabilitation improves knee functioning before and within the first year after total knee arthroplasty. Arch Orthop Trauma Surg. 2022;142(8):1737-1748.

Dandis RB, Stevens-Lapsley JE, Marmon AR, et al. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty. Phys Ther. 2021;101(7):pzab055.

Goff AJ, Donaldson A, de Oliveira Silva D, Crossley KM, Barton CJ. Physical therapists prioritize providing education about exercise therapy and dispelling misconceptions about radiology for people with knee osteoarthritis: a concept mapping study. J Orthop Sports Phys Ther. 2022;52(9):607-616.

Bricca A, Juhl CB, Steultjens M, Roos EM. Exercise therapy wears down my knee joint: myth or reality? J Orthop Sports Phys Ther. 2025;55(7):463-470.

In Episode 37 of the Total Knee Success Podcast, Michelle continues a two-part, evidence-based series focused on preparation before knee replacement surgery. This episode explains which commonly emphasized factors carry less influence than people often fear, including imaging, weight, and equipment, while highlighting less obvious influences such as expectations, access to care, and health context Episode 37 complements Episode 36 by helping listeners let go of noise and focus on steadier readiness before surgery.

More information at totalkneesuccess.com. What will you do in the two weeks before surgery? Click on this link: totalkneesuccess.kit.com/free2weeklaunch

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008;9:116. doi:10.1186/1471-2474-9-116

Boyce L, Prasad A, Barrett M, Dawson-Bowling S, Achan P, Millington S, Hanna SA. The influence of obesity on outcome after total knee arthroplasty: a systematic review. EFORT Open Rev. 2019;4(8):478–485. doi:10.1302/2058-5241.4.180056

Goff AJ, Donaldson A, de Oliveira Silva D, Crossley KM, Barton CJ. Physical therapists prioritize providing education about exercise therapy and to dispel misconceptions about radiology for people with knee osteoarthritis: a concept mapping study. J Orthop Sports Phys Ther. 2022;52(9):607–618. doi:10.2519/jospt.2022.10808

Aldhahwani BM, Piva SR, Robinson KA, et al. Sociodemographic differences in short-term physical function outcomes after hip and knee arthroplasty in the United States: a scoping review. JOSPT Open. 2025;3(3):254–267. doi:10.2519/josptopen.2025.0156

White DK, Hinman RS, Liles S, et al. A telehealth physical therapy intervention to increase physical activity in adults with knee osteoarthritis: the Delaware PEAK randomized controlled trial. J Orthop Sports Phys Ther. 2025;55(5):377–388. doi:10.2519/jospt.2025.12102

Bove AM, Zavacky EN, Zeleznik H, Bise CG, Patterson CG, Parmanto B, Fitzgerald GK. Rural access to physical therapy for osteoarthritis rehabilitation (RAPTOR): a pilot feasibility study. JOSPT Open. 2025. Advance online publication. doi:10.2519/josptopen.2025.0167

Dupuis F, Perreault K, Roy JS, et al. Group physical therapy programs for military members with musculoskeletal disorders: a pragmatic randomized controlled trial. J Orthop Sports Phys Ther. 2024;54(6):417–428. doi:10.2519/jospt.2024.11891

In Episode 50 of the Total Knee Success podcast, Michelle explains how walking speed and endurance predict independence after total knee replacement. She outlines how to measure 10‑meter walking speed, discusses the 2‑ and 6‑minute walk tests for endurance, and connects gait performance to strength, balance, and long-term function.

NMES unit commonly used for quad muscle contraction

A second estim unit to check out

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Arhos EK, Ito N, Snyder-Mackler L, et al. Who’s afraid of electrical stimulation? Let’s revisit the application of NMES at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-110.

Dandis NA, Stevens-Lapsley JE, Mizner RL. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty, based on longitudinal trajectories of walking speed. J Orthop Sports Phys Ther. 2021;51(7):362-370.

Duong V, Dennis S, Ferreira ML, et al. Predictors of adherence to a step count intervention following total knee replacement: An exploratory cohort study. J Orthop Sports Phys Ther. 2022;52(9):620-629.

Na A, Coronado RA, et al. Diabetes mellitus blunts the symptoms, physical function, and health-related quality of life benefits of total knee arthroplasty: A systematic review with meta-analysis. J Orthop Sports Phys Ther. 2021;51(6):269-280.

Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: A longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15.

White DK, Hinman RS, Liles S, et al. A telehealth physical therapy intervention to increase physical activity in adults with knee OA: The Delaware PEAK randomized controlled trial. J Orthop Sports Phys Ther. 2025;55(5):377-389.

Bricca A, et al. Exercise therapy “wears down” my knee joint: Myth or reality? J Orthop Sports Phys Ther. 2025;55(7):463-468.

Chan ACM, Ouyang XH, Jehu DAM, Chung RCK, Pang MYC. Recovery of balance function among individuals with total knee arthroplasty: Comparison of responsiveness among four balance tests. Gait Posture. 2018;59:267-271.

In Episode 49 of the Total Knee Success Podcast, Michelle explains the objective strength benchmarks that define meaningful recovery after total knee replacement. She breaks down quadriceps strength symmetry, sit-to-stand performance, stair descent control, and single-leg stability thresholds that predict long-term independence. Listeners learn why pain reduction alone does not define recovery and how measurable strength data creates clarity and direction. This episode lays the foundation for understanding how strength translates into walking performance in the next episode.

NMES unit commonly used for quad muscle contraction

A second estim unit to check out

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Arhos EK, et al. Who’s Afraid of Electrical Stimulation? Let’s Revisit the Application of NMES at the Knee. J Orthop Sports Phys Ther. 2024;54(2):101-111.

Gränicher P, Mulder L, Lenssen T, et al. Prehabilitation Improves Knee Functioning Before and Within the First Year After Total Knee Arthroplasty: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2022;52(11):709-725.

Minick KI, Hunter SJ, Capin JJ, et al. Improved Outcomes Following a Care Guideline Implementation: Part 1 of an Analysis of 12 355 Patients After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-150.

Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in Outcomes and Number of Visits Following Care Guideline Implementation: Part 2 of an Analysis of 12 355 Patients After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151-160.

Orange GM, Hince DA, Jones M, et al. Physical Function Following Total Knee Arthroplasty for Osteoarthritis: A Longitudinal Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15.

Na A, et al. Diabetes Mellitus Blunts the Symptoms, Physical Function, and Health-Related Quality-of-Life Benefits of Total Knee Arthroplasty: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2021;51(6):269-280.

Dandis J, et al. Latent Class Analysis to Predict Outcomes of Early High-Intensity Physical Therapy After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2021;51(7):362-372.

In Episode 48 of the Total Knee Success podcast, Michelle explains what truly defines a successful recovery after total knee replacement beyond range of motion and timelines. She discusses strength, functional performance, walking endurance, balance, and meaningful improvement as more accurate markers of progress. Listeners learn how to evaluate their own recovery in practical, real-life terms and gain clarity about whether they are truly on track.

NMES unit commonly used for quad muscle contraction

Get email when The Knee Replacement Game Plan is released.

Visit totalkneesuccess.com.

Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan.

Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you.

Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation.

Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript.

References

Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: A longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15.

Arhos EK, Ito N, Stevens-Lapsley JE, et al. Who’s afraid of electrical stimulation? Let’s revisit the application of NMES at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-110.

Roush JR, et al. Preliminary evaluation of the clinimetrics of a modified Lower Extremity Functional Scale in older adults after total knee arthroplasty. JOSPT Open. 2024;2(3):240-250.

Dandis R, et al. Latent class analysis to predict outcomes of early high-intensity physical therapy after total knee arthroplasty, based on longitudinal trajectories of walking speed. J Orthop Sports Phys Ther. 2021;51(7):362-370.

Na A, et al. Diabetes mellitus blunts the symptoms, physical function, and health-related quality of life benefits of total knee arthroplasty: A systematic review with meta-analysis. J Orthop Sports Phys Ther. 2021;51(6):269-280.

Aldhahwani BM, et al. Sociodemographic differences in short-term physical function outcomes after hip and knee arthroplasty in the United States: A scoping review. JOSPT Open. 2025;3(3):254-268.

Nunes GS, et al. Are changes in dynamic knee movement control related to changes in pain or function in people with knee disorders? A systematic review and meta-analysis. J Orthop Sports Phys Ther. 2023;53(7):388-401.

White DK, et al. A telehealth physical therapy intervention to increase physical activity in adults with knee OA: The Delaware PEAK randomized controlled trial. J Orthop Sports Phys Ther. 2025;55(5):377-388.

TKA Structured Research Guide. Balance and falls evidence summary. Updated 2025.