Knee Surgery: A Practical Guide for Scaling

When done properly, a good scaling or modification option should seamlessly bring an athlete into the fold of a group class and improve their fitness. While basic modifications such as using bands for pull-ups or swapping a row for a run do this naturally, scaling for specific injuries or physical limitations require more thoughtful efforts.

In “Working Wounded,” injury is described as “an ineluctable fact of life.” It’s reasonable to think that every athlete will, at some point, need to work around an injury or physical limitation — whether it be a shoulder tweak from a rec league softball game or a surgery to repair a knee injury from a ski accident. Conventional thought puts an injured athlete’s fitness on a steady decline during the recovery period while in CrossFit we look to improve an individual’s overall fitness while they recover the injured body part.

“Whereas treatment and rehabilitation receive considerable attention and focus in discussing injury, compensatory strategies for maintaining or improving fitness while recovering from injury are generally given short shrift.” —”Working Wounded”

While scaling and modification options are seemingly endless, knowing which options are available to athletes given certain circumstances is how a coach can more readily offer substitutions on the fly in class.

For example, knowing different ways to scale a pull-up is one skill. The next step is to know which of those options is a good fit for someone who just had knee surgery.

Ways To Scale a Pull-up:

• Use bands
• Ring rows
• Strict pull-ups
• Seated pull-ups
• Bent-over rows

For an athlete who has just had knee surgery, is in a brace, and is using crutches, trainers need to take the risk of falling into consideration. In this case, using bands is not an ideal scaling option. Bar rows and seated pull-ups, however, are great options.

For coaches, applying scaling and modification options and offering rep and volume options for athletes recovering from an injury is a skill that must be mastered and nurtured as they develop and master their craft.

In the attached one-sheet, we provide a resource for trainers to modify movements for an athlete who has just undergone knee surgery. Additionally, you can find a guide for scaling and modifying movements for pregnant athletes HERE. Print these sheets and keep them handy at your affiliate to reference as needed.

Pull-up examples from the one-sheet: