This post contains affiliate links.
One of the first questions my homebound total knee patients ask me (an occupational therapist) when I see them a day or two after they have been discharged to home following total knee replacement surgery is: “How can I take a shower safely without getting the bandage wet?”
When Can I Shower After Knee Replacement Surgery?
A total knee replacement patient can shower the day after surgery if the surgical site is protected from becoming wet by using a water-resistant bandage or wrapping the knee with Saran Wrap and duct tape to keep the water out, and the showering station is safe from slips and falls.
Each surgeon has their own protocol and timeline; therefore, it is best to check with your surgeon on how soon you may take a shower.
Keeping the total knee surgical site bandage clean and dry is the patient’s number one focus until the bandage is removed.
According to a research paper in the US National Library of Medicine, infection is the biggest risk factor the patient faces, and keeping the bandage clean and dry is the best practice a total knee patient can do to prevent a devastating knee infection.
The majority of the patients I see come from a surgeon who has the lowest infection rate in California. He uses biological glue to close the surgical site, covering the surgical site with a Mepilex/Optifoam water-resistant bandage that is removed on the 7th day with the surgery day being counted as day one.
His patients do not require any secondary Saran Wrap techniques to prevent the bandage from becoming wet unless the water-resistant seal is broken, in which case the bandage is replaced, or protected from shower water using the Saran Wrap technique.
Most of these patients, once the bandage is removed, continue to shower without any protection between the water and their surgical site. They simply try to avoid getting any water on the surgical site as best they can, and immediately pat the surgical site dry after the shower and allow it to air-dry.
Patients that I see referred by other doctors, mostly doctors closing the surgical site with stitches or staples, may choose to cover the surgical site with the same bandage type or use sterile gauze pads covered with water-resistant tape.
Most of these bandages are left on the surgical site until the patient sees the surgeon for a follow-up visit about 3 or 4 weeks after the surgical date.
This time gap between 7th day bandage removal vs 3-4 week removal of the bandage I suspect is the presence of stitches and staples puncture holes that are not healed until after their removal.
Surgical sites closed with stitches or staples are the knees that I worry most about showering and getting the bandage wet.
These are the patients I would recommend taking the extra precaution of wrapping the total knee bandage with Saran Wrap.
There is a correct way and an incorrect way to apply the Saran Wrap extra protection layer:
- Start the Saran Wrap initial strip below the surgical site and wrap around the leg pulling the Saran Wrap tight against the leg.
- Wrap around the leg in an upward direction with the next layer overlapping the first layer by up to 50%.
- Continue up the leg until the leg is covered to above the surgical site.
- To prevent a “loose flap” at the top, wrap the last layer in a downward direction so the entire end of the Saran Wrap sticks to prior layers of Saran Wrap.
- If the seal at the top is inadequate, a wrap of adhesive tape at the top will pull it tight to the skin.
How Do You Shower After Knee Replacement Surgery?
The first concern regarding showering after total knee surgery is infection prevention by making sure the bandage stays clean and dry.
The second concern is making showering safe from slips and falls by modifying the showering station to help prevent falls.
You have a new knee!!! The pain, the limping, the limited range of motion, the inability to bend down, and even difficulty getting up off the floor have been eliminated, or so you think.
The reality is that your surgeon performed an outstanding job by removing your old, worn-out knee and replacing it with a state-of-the-art biometric component.
Being compliant at the hospital with the requirements to ambulate with a walker as well as navigate stairs gave you the green light to be discharged from the hospital to home.
“Oh, home sweet home. Everything will be magically better when I get home” are the words that drive us to move forward.
Once home, routine tasks become mountains. We encounter roadblocks at every turn as we try to figure out how to safely navigate what used to be a simple task.
Showering will be one of the more difficult activities of daily living to modify for safety.
Even though most of the questions were probably addressed while in the hospital, trying now to remember and recall all of the information presented while recovering from anesthesia, and being on pain medication, becomes momentous, and most of the information has been forgotten.
A booklet chalked full of good guidelines was issued, but trying to decipher it all is overwhelming (and pain medication can limit the patient’s attention span).
Moreover, where is that booklet among all of the items brought back home from the hospital?
One of the first things I hear from a new total knee replacement patient when I see them in their home a day or two after surgery is “When and how do I take a shower?”
How to shower after a Total Knee Replacement: (a step by step guide)
Set the showering supplies within reach:
- Decide if you are taking a shower to clean off your body and private areas or if you are also anticipating washing your hair.
- Set the Soap (liquid or bar), shampoo, conditioner, long handled sponge to wash the back and lower extremities, and wash cloth within easy reach.
- Set the shower hose in a location where you can reach it while sitting and standing in a shower. A shower hose mounted on a vertical slide bar is perfect.
- Place towels to dry after showering within easy reach so that you can either dry off after getting out of the shower while standing or sitting.
- Place and organize clothing you anticipate wearing after showering (underwear, slacks, shirt, sox) by the bed or chair within easy reach of where you will sit to dress.
If the patient has a choice, always choose to shower in a shower stall rather than showering in a tub.
A shower stall frequently has a non-skid tile floor and may not need a separate non-skid mat for the shower floor.
All showers within a tub should use a non-skid mat. Not only are the tub floors slick, they also are not flat and level. A towel placed on the floor of the tub will reduce the slipperiness of the tub, but a non-skid mat would be much safer.
Transferring into and out of a shower stall:
If possible, always enter the shower before turning on the water.
Running water is not only distracting but makes the shower floor more slippery.
Place an absorbent floor mat on the floor just outside the shower to step on when exiting the shower.
Showering might require some manual assistance from a caregiver to complete the task, but even if no assistance is required, always have someone within hearing distance when showering.
The mixture of decreased balance, pain meds, and soapy water is always a dangerous situation.
A shower chair and a shower hose are a great help in cleaning below the waist.
Entering the shower stall:
- Approach the shower entry using the walker and positioning the body sideward to the shower entry with the unoperated extremity closest to the shower lip.
- Move the walker clockwise or counterclockwise until the back of the walker is facing the shower entry.
- Keeping one hand on the walker and the other hand inside the shower on the wall or grab bar, lift the unoperated foot up and over the lip of the shower stall and place it flat and firm on the shower floor.
- Bring the other hand inside the shower placing it on the shower wall or grab bar and bring the operated foot into the shower.
- Turn on the water and shower.
Exiting the shower stall:
- After turning off the water, dry the upper body while still in the shower. Exiting the shower stall with dry hands is much safer than with wet hands.
- Position the body in the shower stall with the operated extremity facing the shower exit.
- Wipe down the shower wall where the hands will be placed with a dry towel.
- Place hands on the dry shower wall or grab bar and step side-ward out of the shower leading with the operated extremity, stepping onto the previously placed absorbent floor mat.
- Move one hand onto the previously placed walker while the other hand stays on the dry wall or grab bar.
- Bring the unoperated extremity’s foot out onto the floor mat.
- Turn in the walker to the correct forward position placing both hands on the walker.
- Move to a location where drying the lower half of the body can be dried off in a seated position.
Transferring into and out of a tub shower:
Tub showers are much more difficult to enter and exit than a shower stall because:
- The side of a tub is much higher than the lip of a shower stall and the patient may not yet have enough knee flexion to be able to get the operated extremity into a tub shower.
- Tub shower floors are very slippery and are curved rather than flat making them much more of a fall risk. Always use a non-skid mat when showering in a tub shower.
Entering a tub shower:
- Approach the tub shower entry using the walker and positioning the body sideward to the tub entry with the unoperated extremity closest to the tub side.
- Move the walker clockwise or counterclockwise until the back of the walker is facing the tub side.
- Keeping one hand on the walker and the other hand inside the shower on the wall or grab bar, lift the unoperated foot up and over the tub side and place it flat and firm on the tub floor.
- Bring the other hand inside the shower placing it on the shower wall or grab bar and bring the operated foot into the tub.
- Turn on the water and shower.
Exiting the tub shower:
- After turning off the water, dry the upper body while still in the tub. Exiting the tub shower stall with dry hands is much safer than with wet hands.
- Position the body in the tub shower with the operated extremity facing the tub exit.
- Wipe down the shower wall where the hands will be placed with a dry towel.
- Place hands on the dry shower wall or grab bar and step sideward out of the tub leading with the operated extremity, stepping onto the previously placed absorbable floor mat.
- Move one hand onto the previously placed walker while the other hand stays on the dry wall or grab bar.
- Bring the unoperated extremity’s foot out onto the floor mat.
- Turn in the walker to the correct forward position placing both hands on the walker.
- Move to a location where drying the lower half of the body can be dried off in a seated position.
A shower chair is highly recommended if showering in a tub, the tub’s floor is just too slick and uneven.
If the patient cannot get the operated extremity into the tub shower because there is not enough flexion in the new knee to allow the patient to get it up and over the tub’s edge, then a shower bench that is designed to sit ½ in the tub and ½ out of the tub will solve that problem.
Where is the best placement of grab bars in the tub/shower?
For placing grab bars in your bathtub or bathtub-shower combination, use these guidelines:
- A vertical entrance/exit grab bar is best placed on the wall opposite the faucet.
- Mount a horizontal grab bar on the sidewall between 33 and 36 inches above the floor. It should be as long as possible.
- The faucet wall requires a vertical grab bar situated close to the faucet controls.
See grab bar code regulations…..
Final Thoughts:
- Never soak the bandage of a new knee replacement, such as taking a bath.
- Avoid direct shower spray onto the surgical bandage.
- Wrap the bandage with Saran Wrap if there is any question about its water resistance.
- Pat the bandage dry after showering. Rubbing the bandage with a towel may break the water-resistant barrier.
- Set up the showering area and dressing area with all necessary items before beginning the shower.
- Be sure to use a non-skid mat in a tub shower.
- Serious consideration should be given regarding the installation of grab bars before the surgical date.
Tip 1: Apply Cold Therapy Before Going To Bed.
All of my total knee surgery patients are using either Ice Packs or Cold Therapy Machines (Amazon affiliate links) multiple times daily to help control pain levels. Applying cold therapy for 40 minutes just before going to bed will reduce your pain while sleeping
See my article: Ice After Total Knee Replacement: A PT’s Complete Guide.
Read my other articles about Total Knee Replacement
Enjoy Showering Safely
Paying It Forward
Perhaps you are approaching or already retired and wondering how you could earn extra money in retirement.
One option would be to do as I am doing.
Read my article How To Generate Retirement Income: Cash In On Your Knowledge.
Age In Place School is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. We also participate in other affiliate programs which compensate us for referring traffic.
