Rehabilitation is a fundamental component of recovery after knee replacement surgery. This guide provides a structured overview of common exercises used during rehabilitation. It is intended for informational purposes only, and all exercises should be performed under the direct guidance of a physical therapist or surgeon.
The success of knee replacement surgery is significantly influenced by the postoperative rehabilitation process. Exercise helps restore range of motion, rebuild muscle strength, improve circulation to reduce swelling and clot risk, and ultimately regain functional independence. Rehabilitation typically follows a phased approach, advancing as healing progresses.
Early Postoperative Exercises (Initiated in the Hospital)
These initial exercises are often started within hours of surgery, with the assistance of a physical therapist. Their primary goal is to promote circulation and begin reactivating muscles.
- Ankle Pumps: While lying down, slowly push your ankle up and down by flexing and pointing your foot. This exercise should be done frequently throughout the day to help prevent blood clots by encouraging calf muscle contraction.
- Quadriceps Sets: Tighten the muscle on the top of your thigh by pushing the back of your knee down into the bed. Hold the contraction for 5-10 seconds before relaxing. This helps maintain muscle tone in the thigh.
- Gluteal Sets: Tighten the muscles in your buttocks, hold for 5-10 seconds, and then release. This stabilizes the hip and supports the knee.
Exercises for the Initial Weeks at Home
As recovery continues, the exercise program expands to include movements that improve knee bending and straightening. Consistency is important during this phase.
- Heel Slides: While lying on your back, slowly slide your heel toward your buttocks, bending the knee as far as is comfortable. Hold for a few seconds and then slide the heel back down. A strap or sheet looped around the foot can assist with the motion.
- Straight Leg Raises: With your non-surgical leg bent and the surgical leg straight, tighten the thigh muscle of the straight leg and lift it several inches off the bed. Hold for 5-10 seconds before slowly lowering it. This strengthens the quadriceps and hip flexors.
- Short Arc Quadriceps: Place a rolled towel or foam roller under your knee. Keeping your thigh on the surface, straighten your knee by lifting your foot until the leg is fully extended. Hold briefly, then lower slowly.
Intermediate to Advanced Strengthening Exercises
After several weeks, as pain decreases and stability improves, exercises often progress to include more weight-bearing and functional strength movements.
- Standing Hamstring Curls: While holding onto a stable surface for support, slowly bend your surgical knee, bringing your heel toward your buttocks. Hold briefly and then lower the foot back to the floor. This targets the muscles at the back of the thigh.
- Mini Squats: While holding onto a counter or table for support, feet shoulder-width apart, slowly bend your knees into a small squat, keeping your back straight. Lower only a few inches, ensuring your knees do not move forward past your toes. This builds overall leg strength.
- Stationary Cycling: A low-impact method to improve knee flexion and strength. The seat height should be set so that at the bottom of the pedal stroke, there is only a slight bend in the knee. Initially, pedaling backward may be easier before progressing to forward motion.
The Critical Role of a Structured Exercise Program in Rehabilitation
The title “A Patient’s Guide to Rehabilitation Exercises After Knee Replacement Surgery” underscores the essential partnership between the surgical procedure and the subsequent physical rehabilitation. Rehabilitation is not a passive process; it is an active, prescribed regimen of exercises designed to achieve specific physiological goals. These exercises are methodically introduced in phases, each with a distinct purpose: early movements focus on preventing complications and initiating muscle activation; intermediate exercises aim to restore fundamental range of motion and strength; and advanced activities promote endurance and a return to functional daily life. Adherence to this guided program is a primary factor in determining the long-term functional outcome and patient satisfaction following the surgery.
Safety is a paramount concern. Pain is a common guide; it is typical to feel muscle soreness, but sharp or severe pain in the knee or calf should be reported to a physical therapist or surgeon. Exercises should be performed on a stable surface, often with support nearby to prevent falls. Proper form is more important than the number of repetitions.
The frequency and duration of exercise are typically prescribed by the physical therapist. A common regimen might involve performing specific exercises 2-3 times per day in short sessions, rather than one long, strenuous session. This helps to maintain joint mobility without causing excessive inflammation.
In addition to prescribed exercises, daily walking is incorporated as a part of rehabilitation. Initially done with a walker or crutches, the duration and distance are gradually increased as tolerance improves. Walking helps to normalize gait patterns and improve overall endurance.
It is important to manage expectations regarding progress. Some days may show significant improvement, while others may involve setbacks with increased stiffness or swelling. Consistency over weeks and months is the key to a successful outcome. The complete rehabilitation process can continue for six months to a year, with gradual improvements throughout that period.
All rehabilitation protocols are individualized. The specific exercises, their order, and their intensity will be customized by a physical therapist based on the surgeon’s guidelines, the patient’s progress, and their specific goals. This guide provides a general overview, but the instructions from one’s own healthcare team should always take precedence.