Rehabilitation after knee replacement Exercises for the knee
Rehabilitation after knee replacement - Exercises for the knee
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Knee replacement is quite different from hip replacement. Walking about and doing normal life is enough
to rehabilitate a hip, but a knee needs a different approach. A knee replacement needs a steady, persistent
approach to exercise, day after day.
To get the best out of your new knee, you need to work!
Exercising the main muscle groups around the knee is very important both before and after having a total
knee replacement.
Exercise regularly, for instance for 10 minutes 6-8 times a day. Do not spend all of your time exercising or
your knee may become inflamed, swollen and painful. It needs a mixture of rest and regular exercise,
which will be to some extent uncomfortable. Taking your painkillers is important here as it will allow you
to exercise and get your knee going.
What are you aiming for?
It is important to be exactly clear what you are trying to achieve, so you can tailor your exercises and
rehabilitation towards this:
A straight knee
OA knees are often stiff and lose some of their ability to straighten completely as the person
holds them slightly bent for comfort. The knee is less stressed in a slightly bent position so we
choose this when our knee hurts. If we keep this position up for long enough, the bend becomes
permanent and the knee is stiff. The surgeon can correct some of this fixed position in the
operation but there may be more work to do to get the knee completely straight after the
operation.
A strong knee
The main knee muscle on the front of the thigh keeps your knee stable when you put your
weight on it. It pushes you up stairs and out of a chair and allows you to sit down in a controlled
manner. Your muscle must be strong enough to fully straighten your knee under load, right to
the end of the movement. This gives you good knee control for walking.
A good bend
Your knee is designed to bend to at least 120 degrees and it is useful to have a good range of
bending movement. Knees bend to 70 degrees in normal walking and 110 degrees is necessary
to go up and down stairs normally. You can manage with much less bend but it is inconvenient.
These exercises are for the initial period immediately after the operation and many more exercises could be
appropriate later.
The exercise for a straight knee
Passive knee stretches
Sit or lie with your leg out in front of you. Put the heel up on a block or pillow so that the knee hangs in
mid air. Let the knee stretch for a short time, building up to five minutes or so, or less if it is too painful.
This exercise stretches out the tight structures behind the knee which are stopping it going completely
straight.
Exercises for knee strength
Static quadriceps exercise
This exercise can be done when others cannot, such as when you are out or visiting, standing or just after
operation. It activates the large quadriceps muscles at the front of the thigh and helps the knee remain
stable when it is close to being completely straight.
To perform: Have the knee straight, tense up the front muscles of the thigh as if you are trying to
straighten the knee and lift the heel. Hold for a few seconds then relax. Try not to tense up the buttock
muscles or to try too hard. Sometimes doing the exercise with both legs at the same time will give the
affected knee the right idea. This is the exercise to do in the early time after your operation.
Inner range quadriceps
Sit with your knee bent over a rolled up towel, high enough to be able to lift the heel off the ground.
Tighten up the knee muscles and lift your heel off the ground. Keep your knee firmly down on the roll.
Hold for a few seconds, trying to get the heel as high as you can, relax and repeat. People with patellar
(kneecap) problems may need to avoid this exercise if it causes pain.
I think this is by far the best exercise to do for the strength of your quadriceps, as when you do it, only the
correct muscles can be working. If you find it difficult, increase the size of the roll. The bigger the roll the
easier the exercise is, so start with a big roll and gradually reduce.
Straight leg raise
Sit or lie with the leg out straight. Tighten the thigh muscles, straighten the knee and lift the whole leg six
inches (15cm) up off the bed or floor. Hold for three seconds then lower slowly.
DO NOT do this if you have a total hip replacement on the same side.
I must confess to not liking this exercise at all, as it stresses the hip muscles more than the quadriceps and
is very difficult to do with the weight of the leg.
Exercises for knee bending
Knee bends on the bed
You can use a board for this exercise, and at home you can use a tray. Keep the heel down on the board
and slide the foot towards you, bending the knee. Hold it at the full bend for three seconds then release.
Knee bends in the chair
Sit in a chair with your foot on the ground. Slide the foot firmly towards you and then release. Hold for
three seconds each time in the fully bent position. Do not allow your hips to move, just the foot.Further information and bookings to see physiotherapists nationwide are at The Physiotherapy Site
© Jonathan Blood Smyth
HPC Registered Physiotherapist
www.thephysiotherapysite.co.uk
August 2008
The information is designed primarily for use by people immediately after knee
replacement. However, the information contained in this document is NOT a substitute for
the advice of a physiotherapist or doctor and should not be used as such. We provide this
information for educational and informational purposes only. In no way should it be
considered as offering medical advice. If you feel you are ill or have a medical problem
you must consult your doctor or physiotherapist.
Source of article:http://www.thephysiotherapysite.co.uk