The surgery went well. You are walking, the physio is happy, and the car has been in the driveway for weeks. You want your independence back.

This article explains who decides when you can drive, what driving asks of your legs, and when an occupational therapist (OT) check may help.

Who decides when I can drive again?

Your surgeon, or your treating doctor, decides. We do not. The national standard, Assessing Fitness to Drive, says people with significant pain or reduced mobility from an injury or surgery should be advised not to drive during treatment. It leaves the timing of the return to driving with the treating doctor. It also says returning to driving after this kind of short-term problem “is not a licensing issue.”

That means Transport and Main Roads (TMR) is not usually involved in the timing. Your surgeon is.

Do not rely on a number of weeks from the internet, including from us. Recovery varies. Your surgeon knows your surgery, your pain and your medicines.

What does driving ask of your legs?

More than most people expect. The national standard says your lower limbs need “sufficient range of movement, sensation, coordination and power” to operate the foot controls. Getting in and out of the car also needs “a degree of strength and flexibility”. Sitting for a longer drive needs posture and endurance.

In an automatic car, your right foot does the braking and the accelerating. You move it quickly from one pedal to the other. If it is the right hip or knee that was replaced, that movement needs to be quick and comfortable before you rely on it.

If you drive a manual car, the clutch uses your left leg. A left-sided replacement then matters more.

A simple check is to sit in the car with the engine off. Can you swing your leg in without pain? Can you move your foot from the accelerator to the brake smoothly and quickly? Can you sit for as long as your usual trip? This does not replace your surgeon’s clearance. It is a way to notice problems before you are in traffic.

How does pain affect driving?

Pain does not only affect movement. The national standard notes that pain can affect attention, concentration and emotional responses, which are all part of driving.

Pain medicines can cause drowsiness or slow your thinking in some people. We do not advise on medicines. Ask your surgeon or pharmacist whether yours may affect driving. We cover the wider picture in Driving with Arthritis or Stiff Joints in Queensland.

Do I need to tell Transport and Main Roads?

Queensland drivers must give TMR a medical certificate when they have a permanent or long-term condition that affects driving. Recovery from joint replacement is usually short-term, so many people do not need to report it. Ask your doctor, because your situation may differ.

If you still have limits after the usual recovery, or you have another condition as well, your doctor may suggest a medical certificate. Read Reporting a Medical Condition to Queensland Transport for how that works.

When is an OT driving assessment worth considering?

Most people do not need one after a joint replacement. Your surgeon clears you, you feel comfortable, and you drive.

An assessment may help when:

• Your recovery is slower than expected, and you or your family are unsure about your driving.

• You have ongoing pain, stiffness or weakness in the leg.

• You have another condition as well, such as arthritis or a past stroke.

• Your doctor has suggested a practical check.

• You need to know if a change to the car, such as an automatic or a left foot accelerator, would help.

We come to your home. The off-road part covers your strength, joint movement, reaction time, vision and thinking skills. The on-road part is about an hour in a driving instructor’s car, fitted with dual controls. We sit in the back and observe how you manage the pedals, steering, mirrors and head checks. You can read more in What to Expect on the Day.

What can help if the leg is still limited?

The national standard gives examples of licence conditions for lower limb problems. They include an automatic car for a left leg problem and a left foot accelerator for loss of right leg function. For more serious loss of leg function, hand controls are an example. Extended pedals suit shorter legs.

These are examples, not a menu you choose from. TMR decides on conditions after your doctor’s certificate. We recommend what we think is safe, based on what we see. If a modification is needed, Vehicle Modifications for Drivers in Queensland explains the process.

When you may not need an assessment

If your surgeon has cleared you and you can move your foot between the pedals quickly and without pain, you probably do not need one. Same if you have no other health conditions affecting driving and no one is worried about your driving.

Ready to book an OT driving assessment on the Gold Coast? Steer Driving is a mobile assessment service covering the Gold Coast and surrounding areas. Whether you already have a referral or you’re just getting started, get in touch and we’ll guide you through the next steps.

This article was written by Elise, an AHPRA-registered Occupational Therapist and driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice.