The first step toward recovery after a total knee replacement is exercise. The process extends beyond physical therapy, with daily exercise to regain range of motion, flexibility, balance and strength. Continue with the prescribed program after discharge from your surgeon and physical therapist and progress with your exercises periodically when you adapt to the new workload. Exercise progression facilitates your return to activities of daily living, such as self-care, housework and shopping. Progress safely with repetitions and frequency to avoid injury and aggravating your knee.
Repetitions
The primary goals following a knee replacement are improving range of motion, strength and endurance. Perform one to three sets of eight to 12 repetitions. The repetitions develop strength and increase muscle size over time. Neuromuscular adaptations occur during the first four to six weeks as your nervous system learns the patterns necessary to have your muscles correctly perform the exercises with control. Endurance helps you do activities repeatedly without abnormal fatigue, pain and more swelling.
Frequency
For at least the first 12 weeks, do your exercises daily. During this stage, you do not require a day of rest between workouts like mainstream fitness program, but take one if you experience complications such as, recurrent swelling or more pain. Once you reach your previous exercise load, reduce your frequency to three times per week while keeping the same number of sets and repetitions. Similar to traditional exercise, Pilates exercise frequency is a minimum of three times a week. Enlist the help of a certified instructor to modify exercises, repetitions and sets in accordance with post-operative precautions.
Exercise Progression
Add exercise repetitions and resistance safely and appropriately to avoid injury or complications. Start with one to three sets of eight repetitions., and increase your repetitions to 10 when you can perform eight easily. When you can do 10, increase to 12. When you can perform three sets of 12 repetitions with minimal to no fatigue, increase resistance starting at 5 percent but by no more than 10 percent at a time. -- if you can lift 50 lbs. on the leg press, increase to 52.5 to start but no more than 55. The National Strength and Conditioning Association exercise guidelines advise increasing the resistance to the next weight increment on exercise equipment for large lower extremity muscle groups. Either way, go slowly and watch for signs of stress and strain.
Call for Help
Contact your physician if you experience persistent swelling, pain or difficulty with normal activities that do not subside with rest, ice or basic first aid, or if you notice a decrease in your range of motion, strength, balance or mobility. Swelling often contributes to continued weakness or a regression in strength. Otherwise, continue with a regular program to keep progressing and return to your favorite activities one step at a time.
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