Some people wear their knees out sooner than others. It can from genetics, injuries, overuse or just because.

In the past, I have seen too many people who had unsuccessful joint replacement surgery. However, it wasn’t because the surgeon didn’t do a good job. It was because the person did not do the exercises prescribed before and after the surgery. And those exercises do not have an end date. You gotta keep moving. If we don’t use it, we lose it.

If someone is overweight, they need to lose a certain amount of weight before the surgery can happen. Some people are not happy about it, but I understand your surgeon. First of all, your body (and joints) are going to feel so much better with weight loss. If you want to experiment, carry around 5 pounds in each hand all day long. That’s only 10 pounds extra, but I know you will be feeling it. Also, the commitment to lose the weight needed gets you prepared for the road after your surgery. Your physical therapy and your exercise plan you need to continue is forever. If you can’t commit to much-needed weight loss, are you able to commit to your pre- and post-operation exercises? Find a great trainer who can help you through the process after you are done with PT or help with a weight loss/exercise plan pre op.

We have so many great trainers in our county and of course at our YMCAs. We can steer you in the right direction and that might be a recumbent bike and pool exercises. If you continue the exercises your doctor and PT give you to do at home (and you actually do them), you will be fine.

Typically, when your surgery was not a success, you need to see if you were doing the required exercises. At our Novant Rowan Medical Center, they put you, after a replacement, in a great program called “joint camp” where they work very specifically on things you need to do to make your surgery successful. But you must continue the specific exercises your medical team provided and instructed for you to do. If you don’t, within a pretty short amount of time you feel your range of motion in your knee joint disappear, and your knee gets stiff.

We have to take ownership of our own health. Your medical team gives you homework to make a surgery, such as a joint replacement, successful and you have to continue the exercises to get the full benefits. Of course, there are times when you have done everything and it was not the outcome you expected. But in my experience, the majority of the time, the much-needed therapy was not done as instructed. It’s not just the time at the PT, they give you homework for a reason to continue your rehab for the best outcome. I have never had a knee replacement but have dealt with enough people to know that it hurts when they start the exercises. Typically, it will be painful in the beginning. Your doctor and physical therapist will teach you to differentiate between pains that are supposed to be there, and pain that happens when you are pushing too hard. Most of the time, it’s a different pain than before the replacement. Within time and the correct therapy/exercise plan, you will be as good as new with your “bionic” knee or joint. If you need help to lose weight before they can do your surgery, find a reputable trainer to help you on that journey.

Ester H. Marsh is director of healthy living at the J.F. Hurley Family YMCA.