If you've had knee replacement surgery, a regular exercise regimen is the best way to nurse your knee back to health and get you moving like you used to. Regular exercising helps restore mobility in the knee and over time you can build back the strength that you lost through the healing process. As with any surgery, exercise should only be done under the supervision of the doctor or an approved therapist.
Three Stages of Rehabilitation
Because full function of the knee is why you had knee replacement surgery in the first place, and is also the goal of the surgeon, you must take the necessary time and steps in order to rehabilitate the area appropriately. With a knee replacement, exercise generally falls into three areas: early post-operative exercises, early activities, and advanced exercises. As time goes on, and you move through the stages, your knee will become stronger and more flexible.
Early Post-Operative Exercises
Early post-operative exercises can be done as soon as you feel up to them--many of them while you are still in the recovery room. Although these are very basic, make sure your surgeon is OK with starting your regimen this early. One such early post-operative exercise is called a quad set. A quad set involves tightening the thigh muscle, the large muscle right above the knee. You'll want to try and straighten the knee when you do this. Hold it for 5 to 10 seconds or until it becomes uncomfortable. The second exercise, called straight leg raises involves, once again, tightening the thigh muscle and straightening the knee. Lift the leg a couple inches off the floor or, most likely, the bed. Hold the position for 5 to 10 seconds and then rest. Repeat the exercise until the thigh muscle is moderately sore.
Early Activities
There are several things you can do shortly after your operation. Many of these can also be done while still in recovery at the hospital and they are the basis of how you are going to build back the strength and flexibility required to return to normal activity. As with all exercises, make sure that you have the doctor's OK. Walking is one of the first, and most useful, exercises that you'll be able to do. You will most likely have to start with crutches. Ask your surgeon about the amount of weight that you can put on the limb when you start walking. When first walking, be careful not to rush your steps. Find a nice, slow, rhythmic pace. Walking up and down stairs is another good way to return strength and flexibility. There's an important order to stairs. You'll want to use your good leg when you go up, use your bad leg when you go down. Use the stair railing if available or have someone support you as you go from step to step. Continued regular exercise using both the early post-operative exercises and the early activities will set you up for more advanced exercises.
Advanced Exercises
You can do a variety of exercises once the knee begins healing. This doesn't mean you should forgo the previous exercises. A well-rounded regimen of exercise should always include walking and strengthening of the muscles in the leg as you go along. One of the best low-impact forms of knee exercise involves resistance bands. These are long, colored strips of rubber about 6 inches thick. Placed under the middle of the foot, they can add resistance to workouts. Knee-bends are a more basic form of stretching. To do one, stand on your feet and simply lift your thigh up, bending at the knee until you feel discomfort. Hold the bent knee for 5 to 10 seconds and then slowly release. Do as many sets as time and comfort allows. Ride a stationary bike. This is a good way to start before actually hitting the road. Decrease the tension so that you can comfortably pedal with the leg extended. Start by pedaling backward. Once comfortable you can start pedaling forward. Increase the tension and increase the distance so that the knee is more bent as you go along.
Pain and Swelling
After surgery and once you've begun exercising the knee, you are, undoubtedly, going to deal with pain and inflammation of the area. Pain can be good in that it means you are rebuilding muscle. It is also natural. To alleviate the pain and swelling, elevate the leg and apply an ice wrap to the area. Do this for anywhere from 10 to 20 minutes at a time. If the pain and swelling persists, give your knee a break until the pain has subsided.
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