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Knee Replacement

Exercises Following Knee Replacement

Last updated on:
18/04/2012

Contributing Author: Guy Slowik FRCS

Exercising the knee and leg muscles following surgery is extremely important to the success of the total knee replacement.

Exercises aim to quickly regain increasing motion in the knee following surgery, prevent muscle loss, which is inevitable after surgery, rebuild the muscle strength and prevent stiffness of the new knee joint.

It is important therefore, to carefully follow the rehabilitation instructions given by the physical therapists and doctors.

Standard exercises that are used for early postoperative knee replacement include:

Quadriceps Setting

This is a good beginning exercise as it not only initiates the needed muscle contraction but also is helpful in increasing extension of the knee. It is optimal for both legs as both legs will be in a weakened state postoperatively. Try to do this exercise several times every hour. However, the amount of discomfort will determine how many each individual can perform.

While lying in bed with legs straight and together and arms at the side.

  • Tighten the quadriceps muscles while pushing the back of the knee downward into the bed.
  • Hold this muscle contraction for four to five seconds, relax for a short period of time and repeat 10-20 times for each leg.

Terminal Knee Extension

This exercise also helps promote muscle activity and increases knee extension. This exercise is to be repeated 10-20 times.

While lying in bed place a pillow or towel rolled up into a bolster under the operated knee to position the knee joint at approximately 40 degrees from full extension.

  • Tighten the quadriceps muscle and straighten the knee by lifting the heel off the bed.
  • Hold this muscle contraction for 5-10 seconds, then to slowly lower the heel to the bed.

Heel Slides (Knee Flexion)

This exercise will promote muscle activity of the hamstrings as well as help increase the amount of knee flexion. The physical therapist will record the amount of flexion and extension for a daily report on the patient's progress to be reviewed by the physician.

While lying in bed on the back, keep legs straight and together and arms at the side.

  • Slide the foot of the surgical limb toward the buttock to a point where a mild stretch is felt.
  • Hold this position to a count of ten then slowly returns to the starting position

Straight Leg Raising

This is another excellent exercise to promote strength to the quadriceps and the flexor muscles important in ambulating. Once the individual can perform 20 repetitions without any difficulty, gradual resistance at the ankle (such as the use of ankle weights) can be utilized to further strengthen the muscles. The amount of weight used should be increased in no more than one pound increments.

  • Bend the uninvolved leg by raising the knee and keeping the foot flat on the bed. (This will help decrease or avoid unwanted strain on the low back region).
  • While keeping the involved leg straight, raise the straightened leg about six to ten inches off the bed.
  • Hold this position for 5-10 seconds, then lower the leg slowly to the bed and repeat 10-20 times.

Pillow Squeeze

This is a good exercise to help strengthen the hip adductors or groin muscles.

  • Place a pillow between the knees (or slightly above the knee joint line if pressure at this area is uncomfortable).
  • Next squeeze the pillow and hold for a count of ten.
  • Relax for a short period of time and repeat this exercise 10-20 times
 
 

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.