Joint Replacement, Surgery, Physical Therapy, Dr. Kelly Starrett, Laird Hamilton And Gabby Reece Dive Deep Into The Pros & Cons | Gabby Reece Show

Key Takeaways

  • Surgery is a step, not the end goal
  • Speak with the best people you have access to, understand the different methods and procedures, and make the most informed decision you can for yourself – no one knows your body and what you are feeling better than you
  • The decision to get surgery should be beyond pain – maybe you experience: loss of force, loss of mobility and range of motion, inability to do the things you used to, limitations in complementary joints and muscles
  • The work you put in before surgery pays off in recovery
  • Post-surgery pain is real but you have to embrace it and push through to recover
  • Ask yourself: “What does success look like for you?” – Dr. Kelly Starrett – then work backwards to understand what needs to get done
  • Set a plan and take agency over what you can control: dial in nutrition and hydration, move, ice, connect with a support system
  • Surgery and recovery are mentally taxing: understand everyone’s role (surgeon, physical therapist, your role), quell anxiety by setting a plan, stay connected to any fitness and exercise community you had before, find a rehabilitation specialist to guide you through the process


Dr. Kelly Starrett, DPT (@thereadystate) is a coach, physical therapist, author, and speaker. He is a renowned expert when it comes to mobility, movement, and human performance and the founder of The Ready State. Podcast: TRS The Ready State

Laird Hamilton (@LairdLife) is a world-renowned big-wave surfer turned entrepreneur. He is known as the best American big wave surfer and innovator in action water sports.

On this episode of Gabby Reece Show, Gabby, Dr. Kelly Starrett, and Laird Hamilton discuss their experiences with joint replacement surgery, how to decide whether that’s the appropriate route, and the physical and mental preparations for forgery and recovery.  

Host: Gabby Reece (@GabbyReece)

Things To Consider Pre-Joint Replacement Surgery

  • Surgery is a great solution when we know the injury is mechanical and it’s the only option left
  • Needing a knee replacement isn’t just for people who have pain: you could have swelling, limited range of motion, inability to do the things you used to, pain or limited mobility in complementary joints and muscles, loss of force  
  • We’re designed for survival and will navigate around discomfort as long as possible
  • Pain is the low bar: if we wait until pain drives decisions, it’s a less effective way to understand our body and brain because it doesn’t cure what our function is
  • Waiting until you have atrophy is going to prolong recovery
  • Fear of what could happen usually stops us from going through the process to get surgery
  • We have ways of self-soothing to mask the pain but we need to decide our goal is to maintain as much function as we can
  • Disability: when we can no longer maintain our role in society
  • We traditionally think of surgery for people who are not trying to get back in the game – we associate surgery with older people who just want to get out of pain
  • The work you put in before surgery pays off in the recovery process – be fit, eat well, build a durable life

The Realness Of Pain And Its Role In Healing  

  • The lymphatic system is responsible for how you handle swelling and based on muscle contraction and movement system
  • “Pain is a request for change.” – Dr. Kelly Starrett
  • The pain is real: it’s ok to use pain medications in extreme scenarios but that shouldn’t be the only method of recovery – move the affected joints, eat nutritiously, be active in the process
  • “We’ve really done people a disservice in how we talk to them about what is their responsibility after surgery to continue as much movement as possible.” – Dr. Kelly Starrett
  • There’s no such thing as a fast healer – we’re all human and have limits to healing
  • We need to have behaviors that encourage healing at the rate our bodies want to heal – we need to maximize what’s possible at our age
  • Have a strategy and plan pre- and post- surgery  

Tools Used By Dr. Kelly Starrett To Heal From Knee Replacement

  • “Most of the guidelines for recovery are predicated to people who are detrained.” – Dr. Kelly Starrett
  • H-Wave device: non-fatiguing muscle device used which puts electricity into muscles which cause gentle muscle contraction and trigger movement without literal motion
  • H-wave reduces pain and increases movement without opiates
  • Hot pack on groin and belly
  • Wound vac: unload wound and drain some blood
  • Normatec boots to encourage lymphatic drainage
  • Early movements will set you up for success
  • Supplements: Turmeric, Collagen
  • Dietary tools: hydration, maintain macronutrients particularly protein, increased fruit intake for micronutrients
  • Progress isn’t linear: don’t make a decision about progress for several months down the road

Laird Hamilton Experience With Hip Surgery

  • There are usually a variety of options, methods, and techniques for surgical procedures – meet with the best people you have access to and take ownership to make a decision based on your body
  • Understand material and options: “You are your own greatest doctor” – Laird Hamilton
  • Get information from great people but you know how you feel better than anyone else
  • Exhaust other options: try stem cell, physical therapy
  • Laird Hamilton had surgery without going under general anesthesia (used twilight) to try to speed up recovery as quickly as possible
  • Suppressing pain delays healing: the more pain you can endure, the faster you will heal
  • You should move while injured to minimize swelling and blood pooling which lead to scar tissue
  • Sleep and comfort may be secondary to the acute process of healing
  • Embrace the pain of healing
  • Set a plan and breakdown into steps – partly as a distraction so you are not focused solely on the pain and limitations imposed

General Tips For Healing

  • Ask yourself: “What does success look like for you?” – Dr. Kelly Starrett – then work backwards to understand what needs to get done
  • The surgery is not the end goal, it’s a step
  • Frame the conversation around who is responsible for each component of the process: the surgeon is responsible for the procedure; the physical therapist sees you 30-minutes; you are responsible for the whole rest of the recovery time and process
  • The system is not failing you, it’s set up for you to come out without infection and adverse effects of surgery
  • Have agency around what you are going through: bring in your own nutritious food, put together best practices to serve yourself post-surgery, and control as much as you can
  • Find a rehabilitation specialist to guide you

Fear & Managing The Psychology Of Surgery

  • Your support structure and social network is as important as what you do to move
  • “You will feel like you don’t have any control over this.” – Dr. Kelly Starrett
  • Most of us define ourselves through our physical practice
  • Take ownership over the things you can control: heat pack, elevation of joint, movement, nutrition, hydration  
  • Stay plugged into a training environment and fitness community
  • Acknowledge that this can induce an existential threat: you are making a conscious decision to be vulnerable
  • Remember, your brain is always trying to protect you: understand that it will take 12-18 months for the brain to be comfortable with you putting yourself in the position that compromised your joint in the first place

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