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  • Writer's pictureTina Langdok - Professional Yoga Therapist

REFLECTIONS ON THE JOURNEY OF GOING BIONIC by Tina Langdok, Yoga Therapist and Mindfulness Teacher

Updated: Jun 2



The hike from the small area where we parked our 4-wheelers to the Mala Noche waterfall wound through the Costa Rican rain forest for about 2 miles. Even with hiking poles, I needed help navigating the muddy riverbeds. Every step was a lesson in humility, yet I persevered. Unable to resist the call of the cascade, I inched my way forward, hoping the torrent of water would soothe my wounded ego. In that moment of baptism, I finally accepted that it wasn’t my ego that was wounded. It was my knee!




It wasn’t only waterfall hikes that were compromised. Our Sunday hikes at the local State Park, had become shorter and slower. Mowing the lawn had become a lesson in concentration and focus, and the list of Yoga poses available to me was shrinking by the day. It was time to embrace the surgery that would allow me to return to the active lifestyle I crave and enjoy. It was time to go bionic!


As I sit here six months post-surgery, I realize how little I understood the journey of a total knee replacement. I was certainly attached to the outcome, but even after numerous appointments with surgeons and physical therapists, I wasn’t prepared for the ups and downs of integrating this titanium joint into my lifestyle.


As a Mindfulness Teacher and Yoga Therapist, I knew that both Meditation and Yoga would be essential elements for my healing, and I was right. My hope is that this blogpost helps others find their way more easily along the path to recovery with more information and inspiration in place.


The three essential elements of Mindfulness are Intention, Experience, and Non-Judgment. In this blogpost I will break down how these elements informed and animated my recovery.


INTENTION


The decision to get my left knee replaced was long in coming. I first injured my knee in 1975 after a long day swishing down the slopes of the Porcupine Mountains in Michigan's Upper Peninsula, warmed by a few too many sips of wine from a leather bota bag while skiing with college friends. Another fall while skiing with my sons at Big Sky, Montana made my knee much worse. I assumed it was simply a bad sprain. I rested, iced, and wrapped it, and in a few weeks, I was back on my yoga mat, strengthening and stretching.


I’ve never been much of an athlete. I ran a bit in my 30s, but mostly for fun and camaraderie with friends. I like to bike on trails and have always loved swimming. I stay in shape by practicing yoga daily to support my body, mind, and spirit. The left knee was always my weak link, but I could usually work around it with a few Sun Salutations, but lately I was losing ground.


About 17 years ago my knee refused to participate in Deviasana or Goddess Pose. I simply couldn’t flex my left knee in external rotation. I was disappointed, but there was still enough yoga that I could do, so I substituted and carried on. More recently, my wobbly knee started to affect key poses like Warrior II and Side Angle. Any pose with a 90-degree flexion had to be modified. So as a good yoga therapist, I modified with Triangle. Lots of Triangle….


In 2019, I trained to hike the high altitude Salkantay Trail en route to Machu Picchu. I knew it was going to be very difficult, so I modified again. I contacted a fitness trainer to strengthen my quads and gluts. I did as much cardio as possible and got up close and personal with my hiking poles. I’d have to say I was mostly in denial, which is tough when it’s a part of your own body that you’re denying!


The trek was challenging and with the steady gait of the tortoise and quite a few breaks to catch my breath, I made it to 15,200 feet and the summit. It was amazing. I felt proud of my accomplishment and have the photo to prove it!





Then we started going downhill. I thought my knee was going to break in half for most of the two days of descent, but I didn’t complain. Much. And my knee didn’t break. Neither did my spirit when my friend Susie and I were encouraged to ride pack horses for a while so we would get to camp before dark. Susie, being a good friend, stayed with me and rode her own horse alongside me, even though she could have hiked faster. I was the slowest turtle on the trail. Going faster wasn’t really an option.


Luckily, I have a very kind and wise partner, who was also the leader and organizer of the expedition. Chip constantly hiked back to check on me and then sprinted ahead, often with my pack on top of his own. It became obvious that I was overcompensating and out of modifications. When he suggested we separate from the main group for the last day to give my poor knee a rest, I was relieved. My mind was already enjoying the local hot springs at our last campsite in Santa Teresa, my heart had moved from denial toward acceptance, and my body – well, quite honestly my body was pretty pissed off at this point. Time to figure out what was going on with the knee and if there was a fix, get it fixed.


When an MRI revealed “a lot of pathology”, I decided to get a couple of opinions from orthopedic surgeons. Both doctors candidly announced that my only option was a total knee replacement. The damage was significant including no ACL, extensive cartilage and meniscus damage, and a very unstable PCL. The bones were misaligned and there was little to nothing supporting the knee or its damaged components. My knee was a mess.


There are hundreds of different kinds of knee replacement implants and materials vary according to the patient’s presentation and the doctor’s preference. Cemented vs cementless. Metal on plastic. Ceramic on plastic. Design options include posterior-stabilized and cruciate-retaining. One surgeon I met with used different prosthetics for women and men. It’s important to do your research and come into the initial appointment with questions and an open mind. I have numerous friends in the yoga world who are also Physical Therapists and they were very helpful in guiding me toward a surgeon that would understand my intention to continue to be active after surgery. Based on their suggestions and my consultations, I chose Dr. Michael Gordon in Milwaukee, WI. Dr. Gordon and his physician’s assistant Erik are very straightforward and practical. They encouraged that with hard work and lots of PT I would be able to resume most of my activities in about 6 months. When I asked Erik if I would be able to travel to Kenya at 10 weeks, he emphatically responded, “absolutely not!". The rule of thumb (or knee in this case) is 12 weeks before a major trip and in retrospect, Erik was absolutely right!


In my case, the PCL was severely damaged, so I needed the posterior-stabilized design. Dr. Gordon explained that this knee would be stiffer, so I’d need to work harder for flexibility. Ask questions, do your research, and once you choose a surgeon, move forward with confidence. Surgical follow-ups are a great way to measure progress and they gave me goals to work toward as I healed.


Because I was turning 65 in May, I waited until Medicare kicked in. It was a great decision. Between Medicare and my supplemental insurance, my balance due after the deductible was fulfilled was $0. My partner and I had committed to service work in Nicaragua in November and were already planning our annual humanitarian trip to Kenya in the spring. Based on those two trips and Erik’s strong advice not to travel before I was 12 weeks post-surgical, we set the surgery date at mid-December.


With the date set, I was now ready to move forward and start some physical therapy. A physical therapist is your greatest guide and advocate before and after knee replacement. I saw my surgeon every 6-8 weeks, but I saw my PT 2-3 times weekly. I had met Lauren a few months earlier when she signed up for the Mindfulness Based Stress Reduction (MBSR) course that I teach through my home studio, Trillium Studio MKE (www.trilliumstudiomke.com). I appreciated Lauren’s deep knowledge and connection to meditation and mindfulness. In our class discussions she often referenced ways that mindfulness coordinates with physical therapy to enhance outcomes. She also practices yoga.


After completing the MBSR course, I asked Lauren if I could be her patient and we set up an appointment to meet the next week at her clinic. Lauren Hogan has a DPT or clinical level doctorate in physical therapy and teaches at the University of Wisconsin-Milwaukee along with maintaining a thriving clinic practice at Body Mechanics in downtown Milwaukee. Our conversations about pain and healing enhanced my knowledge and understanding of the process of healing after total knee replacement through the doorway of physical therapy. Finding the “right” physical therapist before surgery is incredibly important. Some people prefer a more rigorous and practical approach while others need more compassion and kindness.


I would highly recommend some pre-surgery PT. Studies show that building strength before surgery can speed recovery after the fact. If you haven’t been active because of the knee, it’s even more important. In my case, I had overused my good leg to the point that my surgical leg was noticeably smaller and weaker. Lauren prescribed lots of quad lifts to get the muscle firing again. She also did some pre-surgery dry needling on my quad which can reduce post-surgical pain.


Yes, indeed. It was time to walk the talk of good self-care that I preach regularly. Teacher, heal thyself! Find a surgeon that you have confidence in and a Physical Therapist you can relate to as your guidepost during recovery. Trust that your partner will help you, love you, and take care of you at your most vulnerable. And have faith that your body, mind, and heart will support you as you look toward the next horizon.





The week before my surgery, I spent time each day in meditation and yoga sending gratitude to my knee for all its service, apologizing for the years of expecting more than it could physically provide, and getting my knee psyched for the next journey. Going bionic! Intention in place, I was ready to put this surgery in the rear-view mirror.


EXPERIENCE


Once I had accepted that total knee replacement was imminent, I embraced all the insight I could find by chatting with clients, acquaintances, and even strangers who had gone bionic. There is a strong sense of community that arises out of knowing others have been on the journey before you, survived and thrived. Their encouraging words were ringing in my ears before, during, and after surgery.


We arrived at the hospital at 6:00 a.m. and about two hours later I was wheeled into the operating room. I remember being amazed by the bright lights and rather large team assembled to catapult me into the next phase of my life. Then I woke up and it was over.


Lying in the hospital bed the morning after, I felt panic arising in my body and mind. “How am I ever going to be able to put pants on over this leg or find my way into a pair of shoes?” Everything seemed overwhelming and impossible. I couldn’t bend my knee at all, and the pain was different than anything I had experienced before. It wasn’t sharp, it was deep and aching and honestly more than I had imagined. I was barely able to stand on my own and could only walk using a walker. I was scared, exhausted, and overwhelmed. Thank goodness my partner stayed calm, cool, and collected. After PT and OT in the hospital, I was able to put on a loose pair of pants and a slip-on shoe, tips I received from a knee replacement vet. I’m usually a tight yoga pant person, but those first few weeks I was grateful for my baggy jogging pants.




I didn’t fit into the front seat of the car, so I rode side saddle in the back. Chip and I had already decided to stay at his place for the first few weeks as I live in an old Victorian home with lots of steps. His home is a tri-level with bedroom, living room, and two bathrooms on one floor. It was a big relief to get in the door and cozy up in my favorite chair with my leg elevated and my new knee being massaged by an ice machine.


Speaking of the ice machine, it was great and a lot of work. We went through numerous bags of ice those first couple of days. When I rented my ice machine the rep recommended freezing small water bottles we could rotate in and out as needed. This system worked better and lasted longer than bags of cubes. It was also less expensive. Chip also set up a charging station for my phone and other devices to help me stay organized and connected.




About day three, I was craving a warm shower, but couldn’t imagine how I’d be able stand that long or even fit inside of our shower. Chip came to the rescue with a 2-foot metal step ladder he placed in our shower stall. It was high enough that I didn’t have to bend my knee much to sit on the top step. We started with my leg outside the shower and the door open which was messy, but soon I was able to fit inside with the door closed. A long luxurious shower became a major highlight of each day.



Changing my point of view during the day was also essential. In Mindfulness we call these “habit releasers”. It’s easy to get comfortably uncomfortable in a favorite chair with the same blanket, same cup for tea, same view, and same frustrated, bored mood. Moving to another room is a great refresher and helps the mind detach from the grumpies and open to the moment with fresh eyes. I often felt resistance to my “new view” but changed rooms anyway. Acknowledging my frustration made it easier to accept it and work with it instead of pretending it wasn’t there or wishing it would go away.


Managing pain is an individual choice, and for me, the side effects of narcotics, mainly addiction and constipation, were major deterrents. I wasn’t eating or moving much those first few days so I did take senna (a gentle herbal laxative) along with my pain meds (oxycodone) for those first few days and was able to stay relatively regular over the short run. After Day 4 I found that two Tylenol during the day and Tylenol PM at night was enough but honestly, most of those first days and nights are a blur of pain, little sleep, and a very restless spirit. I didn’t feel like watching any of the TV shows I had downloaded onto my iPad. I couldn’t concentrate, and reading wasn’t relaxing or available. I felt like an irritable toddler who was refusing her nap, even though she knew she was exhausted! I tried doing a body scan to connect with my body positively through the door of awareness, but even that felt overwhelming. Then out of nowhere, from the deepest part of my exhausted and frustrated consciousness two Sanskrit words rose to the surface of my awareness: Yoga Nidra!


Yoga Nidra is often called psychic sleep. It is an active, guided meditation technique in which participants move awareness through body, mind, and spirit as a way of inducing physical, emotional, and mental relaxation while maintaining connection with the subconscious. The practice has been documented clinically in numerous research studies and was renamed NSDR or Non-Sleep Deep Rest by Andrew Huberman, PhD, a professor of Neurobiology at Stanford University’s School of Medicine. Call it what you want, it’s still Yoga Nidra. And for me, it helped!


I love the inherent randomness of Yoga Nidra. The practice consists of ten steps, each with a specific intention. It includes counting backwards in rhythm with the breath, visualizing objects in the mind’s eye, and feeling the energy of opposites. Some Yoga Nidras include a visualization or journey. In the Rotation of Consciousness (my personal favorite step) practitioners move awareness rapidly through the body by engaging with and releasing areas of the body systematically. Guidance emphasizes the hands, feet, and interior of the mouth because these areas have more sensory neurons than other parts of the body. Moving through center is key, along with shifting from right to left and broadening and narrowing attention. Unlike the Body Scan in which practitioners create more connection with the body through the doorway of sensation and presence, the intention in Yoga Nidra is connecting and releasing. Guidance and movement are constant and essential. The Rotation of Consciousness is usually where I drift off into “non-sleep deep rest” and clinical studies have shown that during the drift, the brain parachutes into deeply restorative and creative Theta waves that reflect the state between wakefulness and sleep and relate to the subconscious mind.


What worked for me after surgery was that Yoga Nidra isn’t about concentrating or doing anything in particular. Its randomness felt like a much-deserved break from managing pain and figuring out how to get to the bathroom. All I had to do was follow instructions and let go. Quite honestly, Yoga Nidra was the shiniest tool in the toolbox and the moments of drift allowed me to get breaks from my rather challenging reality. After Yoga Nidra, I felt a little kinder and more open to what was already happening and therefore more able to be present. I have recorded a Short Form Yoga Nidra on my profile on the Insight Timer App. Here’s the link if you’re interested in giving it a try:



Physical Therapy has changed a lot over the years. Gratefully the days of cranking on a new joint have morphed into kinder, more subtle practices. PT exercises encourage both strengthening the muscles around the knee as well as bending (flexing) and straightening (extending) to slow the development of scar tissue that can reduce range of motion in the long term. Lauren also included soft tissue massage that felt great on and around the implant. She worked above the joint into the hip and below into the calf and her knowledge of the intricate nature of the knee joint was incredibly important in my recovery. I’m not a big fan of pain (is anyone?) and yes, I would say that my physical therapy both at the office and at home was painful but accepting it as part of the journey made it easier to bear. Some patients take pain meds before PT. I often took Tylenol afterward and iced my knee.





I’d like to take a moment here to directly address the vulnerability of recovery. My partner and I have been together for 5 years. We’ve suffered through a nasty bout of H1N1 when traveling in Peru, endured a few bouts of the stomach flu together, and moved through the chaos of COVID in tandem, but those challenges were nothing like full knee replacement. We both thought that my recovery might be a sweet respite of time together. We would watch movies, read books, and share writing time. What we didn’t factor in was the reality that icing, managing pain, and daily activities like showering were a major ordeal. Add in breakfast, lunch, and dinner planning, plus trips to physical therapy and we had drifted through 14 days with no time for movies, books, or writing projects. Care and healing took up every minute of our day, and some of the night - since neither of us were sleeping well. The good news is we became even closer. I learned to trust in his care at my most vulnerable. He learned that seeing someone you love in pain is painful and that caring for someone you love fills you up in ways you’d never imagine. Every day I reminded myself that this surgery was designed to improve my quality of life – eventually. And each day we were grateful for that awareness.


Visits from good friends and family, and especially granddaughter time, was also very healing. About two weeks after surgery, I attended a performance of Bluey, Live! with my sons and my two granddaughters, which in hindsight was premature. I used my crutches to create a safe space for me amidst the sea of young Bluey fans, and while it was challenging, it was also great for my spirit. Brooke, our two year old, was sure she was "in" the show, standing on her seat for most of the performance! My oldest son, Ben and his daughter Emma spent the night with us, and I stayed up well past my bedtime chatting with Ben which warmed my mother heart. All good supports for my recovery.




About day five, the call of the yoga practice inspired me to get on my massage table so I could do some supine yoga therapy without having to get to the earth. The first time I stretched my inner legs in Supine Leg Extensions I nearly broke down crying! On day six, Chip was startled to see me grinning from ear to ear while perched on the massage table in Supported Bridge Pose with a yoga block under my pelvis. It felt great! My body was hungry for yoga and I found that many of the poses were available with a bit of ingenuity.


I knew knee down lunges were off the table for a while so I did them supine with extended bridge as my base. When Lauren, asked me to flip over onto my stomach to work the back of my knee, I nearly cried. I was prone! The next day I added Sphinx, Cobra, and some thoracic Cat/Cows to my repertoire. After my daily practice, I laid supine on the massage table with a bolster under my knees for Savasana. Sometimes I practiced Yoga Nidra, and other times I ended with some simple breathwork. First, I placed my hands in Anushasanam Mudra with my index fingers extended and the other three fingers curled into the palm with my thumb on top. This mudra or hand gesture moves energy through the extremities. Then, I brought awareness to the breath and visualized energy moving up and down through my legs and feet in rhythm with my breathing. It felt amazing to move breath through the new knee further integrating it into my whole body experience.


On day ten, I heard the call of Legs Up the Wall Pose and realized I could indeed reach the earth by bending my healthy knee and keeping my surgical leg gently extended. The feeling of bending and extending my leg while inverted was more available and comfortable. Resting afterward with my legs on the wall was the perfect time for some Pranayama or breath practices including Alternate Nostril Whole Body Breathing and Step Breathing.




Integrating physical therapy and yoga allowed the two to become one seamless flow of energy, focus, strength, and flexibility. When I was fatigued, I did a more restorative yoga practice between physical therapy exercises. When I had more energy, I included standing poses like Triangle and Side Angle. I was thrilled to add Goddess, Chair Pose, and all the Warriors into my repertoire and experimented with balancing poses like Tree early on. As a Yoga Therapist, I’ve always worked with clients after they were finished with physical therapy. As a patient, I learned that merging the two practices early in the rehab process is the best of both worlds. Instead of 10 quad lifts, I used the transition between Side Angle and Triangle as my quad reps, slowly flexing and extending my leg as I transitioned between the two poses 6-8 times.


Dr. Gordon assured me that kneeling on my new knee couldn’t hurt it, but it does feel weird. Very weird. Putting a blanket or a gardening pad under my knee helped as did grounding my back foot. I often refer to the back foot as the “kangaroo tail” of the posture. It can provide a lot of balance and support when engaged mindfully and made kneeling more comfortable. My psoas was tight from all the sitting (and icing) so a knee down lunge felt – great! I placed my hands on blocks as I lifted my sternum. Yum. It wasn’t long before I tried Camel Pose. Again, I made sure my feet were part of my foundation with toes pointed and tops of feet planted on the earth. I used my blocks to come to kneeling and wow! my quads were tiiiiggghhhht! I started in a modified Camel Pose and within a few days was able to move into a fuller expression of the pose that felt grrrrrreat! Eventually I turned my toes under which stretched into some new areas around the top of my knee and thigh. I still do Camel Pose every day.


The other pose I really missed was Figure 4 – the hip opener. Even with a strap, the classic supine Figure 4 didn’t work, because I didn’t have the flexibility in my knee to place my lower leg just above the kneecap on my thigh. I found that by keeping my supporting leg extended whether I was seated or supine, I could find a place to rest my lower leg just below the knee where the posture worked. Sort of. Lauren suggested we try dry needling my hip which gave me more rotation and some relief. Figure 4 continues to be a challenge for me, and a benchmark. At six months, it’s finally available to the point where I’m feeling it in my hip and not my knee and continues to stretch and challenge the flexibility in my new knee. Last time I saw Lauren I had gained 3 more degrees of flexion, so keep stretching, even after you’re released from your surgeon.


With Lauren’s encouragement, I got on my stationary bike early in my recovery. I raised the seat and perched myself as high as possible so I could reach the pedals with the smallest amount of flexion. Going backwards was easier than forwards (!) and after just a few backward rotations, I was able to spin forward at a comfortable speed for about 10 minutes. Each week I lowered the seat one level. After a couple sessions of careful peddling, I included my Peloton app and found that Emma Lovewell’s playlists made the time go faster and encouraged me to slide in a little cardio workout at the same time.


NON-JUDGMENT


After surgery, I noticed an increase in my fight-flight-freeze reaction - a sense of worry and anxiety that felt out of balance. The feeling was most prevalent with activities I hadn’t done for a while, like driving. As I got in the car on my own for the first time, I noticed a sense of trepidation brewing so I asked myself the mindful question, “What else is here along with this feeling of uneasiness?” I reassured myself with supportive thoughts like “You’re fine. You’re not taking painkillers and you’re ready to have more independence” while allowing myself to feel the good experience of driving myself to physical therapy, alongside the feeling of uneasiness. I turned off the radio and practiced good self-care by driving mindfully – feeling my hands on the steering wheel and seeing the traffic around me with calm attention. When I arrived at my destination, I felt a sense of relief and satisfaction and savored that feeling. It felt like another big step forward.


This weird sense of trepidation continued to show up – often in surprising ways. Part of it was fatigue. I wasn’t sleeping well at night due to the achiness in my knee. Connecting with friends and family is important for my spirit, but sometimes I over-scheduled myself. A highpoint of my week is spending half of each Monday with my granddaughter Brooke, and instead of watching her on my own, I went to my son's house and watched her with Ross while he took care of their newborn daughter, McKenzie (which meant I also got in a little cuddle time with the newest grandchild). I limited my work schedule to two clients each day and moved all weekly clients to every other week. Continuing to connect with meaningful work was a big support, as was connecting with family and friends. The challenge was not overdoing it.


I know that one of my patterns is appearing confident and strong, even when the opposite is true, so within a couple of weeks my friends assumed I was just fine. My kids assumed I was just fine. And so did my clients. My partner knew better. He saw me at the end of the day when my defenses were down. I was tired and afraid and overwrought when I had done too much.


As I prepared for a late afternoon meditation student, it finally made sense. I had been through a trauma. My body had been ripped apart and put back together, I had been vulnerable beyond my wildest fears, and my knee still ached and couldn’t bend to more than 110 degrees. I was trying to act as if everything was okay and, in some ways, it was. My surgery appeared to be successful. My appetite had improved, and the bouts of anxiety and fear were naturally subsiding. Sure. I made jokes about being impatient – but I hadn’t really been kind to myself. I was trying to act like everything was back to normal, but it wasn’t and wouldn’t be for a while. I could remind myself that it could be worse. I’m strong, relatively young for this operation – and every day I was bending more, biking longer, and getting stronger. What did I have to complain about?


The role of doctors and physical therapist is to push you to work hard enough to have the best result possible, but what I really needed was kindness - from myself to myself. This wasn’t a pity party. It was Self Compassion. Self Compassion isn’t feeling sorry for ourselves. Its noticing that recovery is challenging and acknowledging that the body has gone through a significant trauma. In the noticing, I felt a sigh of relief. It seemed to create some space around my anxiety that allowed me to breathe and be. When I sat down on the couch to ice my knee, I turned on my favorite episode of Friends or read a chapter in my current book club novel. Sometimes I did a body scan and other times curled up on the couch for a nap. It took some discipline to remember to be kind to myself on a daily basis. And it felt … good. The recognition of the trauma was the piece I had been avoiding. The key piece was now in place. At least for the moment.


The lessons continued to unfold. About six weeks into my healing, Chip went skiing with a friend in California so I jumped on the opportunity to go to Florida to see my friend Lynn. The trip came up quickly and I was nervous about flying on my own and leaving my comfortable routine. I knew the change in the weather from winter to summer would be good for my spirit, but it turned out to be good for my body and heart, too. And especially for my knee. Lynn’s husband, Don, had his knee replaced 5 months earlier, so we spent a fair amount of time sharing our experiences, both challenging and enlightening.


The first morning, my yoga and physical therapy practice by the pool was delightful! The songs of the birds and the warmth of the sun inspired me to practice longer and listen more deeply to my body and her edges. As I rolled up my mat, I wondered how it would feel to swim. My granddaughter Emma and I are both self-proclaimed mermaids. I love to swim and scuba and never pass up an opportunity to immerse myself in water. But swimming with this new knee felt... ominous ... and I wasn’t sure why. Hmmm. Here we go again. The first step was sitting on the side of the pool kicking my feet which felt great, but I couldn’t imagine actually swimming! I knew I’d need my knee to push off and kick to support me in the deep water. Treading didn’t feel like an available option nor did the frog kick of the breaststroke. But flutter kicking was fine from the safety of the edge. I waded along the perimeter of the pool testing the waters, but something was stopping me from full immersion.



Don and I had talked the night before about how the “new knee” didn’t really feel like a part of our body yet. We wondered about phantom sensations people feel when they have a prosthesis. What happens when that prosthesis is in the middle of your body? I’d spent a fair amount of time doing body scans to integrate my new knee into my current body experience. I also knew that on neuro-muscular level, I was still somewhat disconnected from it. My heart was beating with a fair bit of excitement when I finally broke through and allowed my passion for swimming to overcome the feeling of disconnection with my bionic knee. As soon as my feet left the ground, I knew I was going to be fine. My feet started fluttering and I flipped on my back. It was heaven. Weightless and floating again. My favorite sensations. After a lap on my back, I flipped over and started swimming the crawl. Twenty laps later, I was ecstatic. The micro-movements of kicking and turning were present – my legs felt buoyant and strong. And the new knee was performing just fine.


The same experience happened with some aspects of my yoga practice. Certain poses felt unavailable – like I couldn’t trust the strength of my new knee to support me or its flexibility to allow me access to a pose like knee down lunge. During a PT session, Lauren suggested I try a lunge with her assistance. She simply touched my quad as I lowered it down to the earth and ... voila! There I was, in Runners Lunge. Her touch helped me connect with the part of my body I was doubting. All this to reiterate the importance of not judging ourselves after a surgery like this. By acknowledging the trepidation, I was able to “let it be” or “let it go”, whichever felt more available. The support of a conversation with a friend about the weirdness of being bionic helped. So did the knowledge, experience, and encouragement of my amazing physical therapist.


In the pool, it was just the new knee and my inner mermaid wrestling our way through another first. By the end of the third month of recovery, I spent the afternoon in a pool, getting re-certified for scuba diving in time for our upcoming trip to Kenya. It was probably a bit early in the process, but it also felt like an amazing opportunity to reconnect with an activity I love. As I knelt buoyantly on the bottom of the pool to perform my skill tests, I felt proud. It was also a great way to use my brain and my body again. My final test was doing a giant stride into the pool with all my gear in place. With my right hand on my mask and regulator, I stepped out with my bionic leg from the side of the of pool and “splash” – there was that feeling of accomplishment again!


We left for Kenya at the 14-week mark, and I’m proud to report that I was able to participate in all activities. I didn’t do my PT every day, but whenever I was able to find a stationary bike or an exercise mat, I took advantage of it. Flexibility had its challenge points like boarding a bush plane and stepping into a dhow from a dock on the Indian Ocean, but I was transparent in my vulnerability by asking for extra help and support. I was always treated with kindness.


This was my third trip to Kenya. Two years ago I joined a non-profit board that supports the small village of Ewaso in Laikipia County. I work with their women's empowerment group called The Chui Mamas - selling their beaded jewelry and helping raise the status of women and girls in Maasai culture. To learn more, read my blogpost here: https://www.trilliumstudiomke.com/post/when-women-support-women-the-world-is-a-better-place-by-tina-langdok-professional-yoga-therapist




I’m now six months out and my flexibility and strength continue to improve. When Dr. Gordon released me, he announced with a smile that I was one of his most challenging patients. Who, Me? I still do yoga everyday with PT exercises integrated into my flow and am finally able to sit in “criss-cross applesauce” for my meditations. I sit with a block and a blanket under my pelvis and place another block under my bionic knee. It works and my para-spinals are getting stronger every day.


More and more I “forget” about my knee. As I swam laps last week, I realized that I was doing breaststroke without pain or stiffness. I was 20 laps in before I even noticed! I continue biking with Emma Lovewell on the Peloton with regularity and just braved the outdoors on the bike trail a few weeks ago. Each day seems a little easier – and I know more challenges await. I’ve traded flexibility for stability. I’m hiking faster and longer and looking forward to many hours of cannonball competitions and yoga with my granddaughters this summer.





I hope this reflection helps anyone on the journey. If you’re going through knee replacement or know some who is, I’d love to work with you bringing Yoga and Mindfulness into the process. You can contact me directly at tina@trilliumstudiomke.com for more information.


I also work with clients presenting with neurological challenges including MS, Parkinsons Disease, and ALS. Here's a link to a 12-minute film named Pizza & Prana that highlights my work with ALS patient, Dr. Scott Stieber. https://vimeo.com/454406868


Tina Langdok (PYT (500), E-RYT (200), AMT (200), MA-Spanish Lit) is an Internationally recognized and Accredited Mindfulness Teacher and Professional Yoga Therapist.


Tina has been practicing yoga and meditation for 45+ years and earned over 1000 hours of accreditation and training in Yoga, Yoga Therapy, Mudras, Pranayama, and Mindfulness. She has dedicated her professional life to the therapeutic potential of reflection, gentle movement, and energy based healing modalities to heal Body, Mind, and Heart. You can learn more about her work at www.trilliumstudiomke.com


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