I’ve had many patients ask about yoga over the years, and as yoga becomes more popular there seems to be greater interest. They are typically patients who have practiced yoga prior to having surgery. Many people think yoga is off limits after joint replacement. However, with medical clearance and the right modifications, yoga can have great benefits postoperatively.
What are the overall health benefits of practicing yoga?
Yoga can help you become more aware of your body, including your muscles and joints.
Benefits of yoga after surgery include flexibility, muscle strengthening, relaxation, stress and pain relief, and even improvement in digestion.
Besides strengthening the muscles around the new joint, an important benefit from yoga is improvement in overall posture. Joint pain prior to surgery may cause patients to limp, resulting in poor posture. Yoga can help improve posture with stretches and by increasing awareness of body alignment and one’s new joint.
In addition, some patients are not prepared for the mental stresses their recovery might entail. Even though the surgery is many times elective, it’s still a major life event. Yoga can help with stress relief, insomnia and postoperative pain.
What special considerations must be taken into account when practicing yoga after joint replacement surgery?
Like any major exercise routine after surgery, it is imperative to get medical clearance from one’s orthopedic surgeon. Patients must be aware of any specific precautions to take based on their medical history, type of surgery, the surgical technique used, and type of implant. Their new joint will often have limitations, and modifications will be necessary for a safe yoga practice. A prosthetic joint implant is designed to perform activities of daily living; it’s not exactly made for advanced yoga poses. In addition, the stress of the surgery on surrounding tissues may make them more vulnerable to injury or instability. We recommend staying within certain range of motion parameters and always avoiding any position that causes pain.
Is there a form of yoga that is best to practice after joint replacement?
Immediately after surgery, upper body chair yoga poses are a safe option to stretch and strengthen the arms after a hip or knee replacement. Early on in the recovery, a restorative yoga class may be beneficial. Restorative yoga classes are typically slow and gentle, use a lot of props, and focus on relaxation. Restorative poses with props would be a great option for total shoulder replacement patients to get into a relaxing pose for some rest. Once you receive the go-ahead from your surgeon, any style of yoga, including Vinyasa or Bikram yoga, is possible as long as the proper modifications are made to your practice.
How and when do you know if you’re ready to practice yoga after joint replacement surgery?
You must have your surgeon’s clearance before starting yoga or any other exercise program. However, certain aspects of yoga, such as meditation, can be incorporated as early as the day after surgery. Meditation and pranayama (breathing techniques) can help in the recovery process.
Is it important to get your doctor’s clearance, even if a significant amount of time has passed since your joint replacement and you’re feeling good?
Yes, definitely. Your surgeon may have specific precautions for you to take, depending on your medical history, type of surgery, type of implant, etc.
How long should you wait before practicing yoga after a joint replacement?
Discuss this with your surgeon. Most recommend waiting anywhere from three months to one year, again taking into account your medical history, type of surgery and other factors.
How do you find a good program/instructor? What should you look for?
Do your research. Ask around and get references from friends and family. Find out from your local yoga studio if they would recommend a certain teacher with experience and knowledge of anatomy. You may notice an instructor helping other students with modifications and asking about injuries prior to class, and this is a good sign. Your teacher should make you feel comfortable and be approachable enough for you to ask questions.
How important is it to let the yoga instructor know you had joint replacement surgery?
Always let your yoga instructor know that you have had a joint replacement prior to starting the class. He or she can help you correct your alignment to stay safe and provide help with props. Some instructors offer hands-on assistance, and they will need to know not to push you, as this could cause injury.
Never assume that the teacher is knowledgeable about joint replacement surgery. Before you start your yoga practice, you should know your own limits and the precautions you need to take. Never force yourself into a pose or allow a teacher to do so. Do not do anything that’s painful or feels wrong.
When doing yoga after joint replacement, are there any signs you should stop? How important is it to listen to your body?
Yoga teaches us self-awareness of our bodies, including our muscles and joints. When practicing yoga after surgery, it is even more important that you listen to your body’s cues to maintain proper alignment and protect your joint replacement. Avoid anything that causes pain or does not feel right. Never try to work through pain to force yourself into a pose.
The Content in this blog post is not intended to be a substitute for your physician’s medical advice. Always seek the advice of your health provider with any questions you may have regarding your health, joint replacement surgery, and yoga or exercise program.
Christine Mironenko, MSN, AGNP-BC, is an orthopedic nurse practitioner in the Postoperative Care Program at Hospital for Special Surgery. She has been practicing Vinyasa yoga for 12 years.