Exercises for Total Knee Replacement

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Having total knee replacement surgery can be a tremendous shock to the body. The cutting and removal of large pieces of bone and the placement of a prosthetic device into the joint is traumatic to say the least. While in most cases, the result is a much-improved quality of life after recovery, the path to getting there can be a challenge. This article will give you some tips on exercises you will do to recover from a total knee replacement surgery.

Immediately Post-Op

  • Believe it or not, your exercises will begin within a few hours of waking from your surgery. More than likely you will be on a constant motion machine when you come out of recovery, to keep the joint from stiffening while it recovers from the shock of bone removal. Your physical therapist will come in within the first 12 hours and have you stand on the leg. You will walk, with assistance and with the use of a walker or crutches.

    You will then be given exercises to do in bed. These usually consist of quad sets, which can be done sitting or lying down. This involves tightening the ring of muscles that surround your kneecap and pushing your knee down toward the floor. Yes, it will HURT, and no, you will NOT want to do it. But you will have to. Start with five repetitions and work up to 10. By the end of the third day, you will need to be at 20 repetitions. These quad sets will be a vital exercise that you do daily from the first day of surgery through the remainder of your recovery.

The First 2 Months

  • The first 2 months of recovery will be the hardest. Pain during your physical therapy will be an issue that you will have to work through. Take your pain medication, take a deep breath and be prepared to do what it takes. Under the skilled guidance of a professional physical therapist, you will begin with range-of-motion exercises. These will be simple movements, such as heel slides. Using a towel or a large exercise band, you will loop one end around your foot, while your leg is flat against the floor or table. Then, using the band to assist you, you will slide your heel toward your rear end. This forces the knee to bend and makes the muscles, tendons and tissues stretch, breaking down scar tissue and keeping the joint moving.

    Leg lifts will also be a crucial part of this stage. Tips on how to do these are in articles referenced below. Leg lifts re-engage the quad muscles and strengthen them, which is a key part to regaining proper stability in the knee joint.

    Once general strength has returned, ankle weights will be added to increase resistance and build muscle. These are the most critical exercises you will do for the first 8 weeks.

Months 3 to 6

  • Once you have regained most of your range of motion, and your quad muscles are engaging well, you will begin many other exercises to build leg strength and core strength. These include balancing exercises, such as standing on the new knee, then slowly lifting the good leg off the floor until all the weight is on the sore leg. You will hold this, then slowly lower into a small squat, feeling your quad muscle quiver. You will stand on balance boards and balance foam, using the muscles in your new knee to maintain balance.

    There will be weight machine exercises: leg curls, leg extensions and leg presses. There will be resistance band exercises, where you use the bands to press against, to walk against and to pull against. Many of these exercises are noted in the below referenced articles. All this must take place under the supervision of a professional physical therapist.

6 Months and On

  • If you have worked hard and are on track, you should be released from physical therapy at around 6 months post-op. Exercises for your new knee will not stop but will become a lifelong process. Walking, which is the best possible exercise for anyone who has had a total knee replacement, should be done each day. Another great exercise is swimming. This takes pressure off the leg yet exercises the muscles. Elliptical machines are another great alternative for knee replacement patients, since the motion is smooth and the stress is taken off the joint. Incorporating one or more of these exercises into your daily routine is a must to keep your knee healthy and moving.

References

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