These exercises can be performed in the rehabilitation room within a short period of time after surgery. There may be some discomfort at first, but these exercises can accelerate your recovery and gradually reduce your post-operative pain. 1. Quadriceps contraction exercises: 2. Straight leg raise exercises: 3. Ankle pump exercises: Regularly alternate contraction of the muscles in front and behind the calf to make reciprocal up and down movements of the foot. Perform the exercise 2 to 3 times per hour in the rehabilitation room for 2 to 3 minutes each time. Maintain this exercise until full recovery and the swelling of the calf has completely subsided. 4. Knee straightening exercise: Lie flat on the bed and place a roll of towel between the Achilles tendon and the bed surface, then the heel is lifted off the bed surface. Contract the thigh muscles and try to straighten the knee so that the back of the knee touches the bed. Continue for 5 to 10 seconds at a time. 6. Reclining supported knee flexion exercise: Lie flat on the bed and slide the heel on the bed toward the buttocks to maximize knee flexion. Each flexion to the maximum degree lasts 5 to 10 seconds, then straighten. Repeat the exercise until fatigue is felt. 7. Seated supported knee flexion exercise: Sit on the edge of the bed or stool with the thigh on the bed or stool, and place the foot of the healthy limb behind the heel of the affected limb for support. Slowly flex the knee to its maximum extent and hold for 5 to 10 seconds. 1 to 2 times per day. 8. Seated unsupported knee flexion exercise: Sit on the edge of the bed or stool with the thigh on the bed or stool and flex the knee to the maximum extent until the foot reaches the floor. After a short rest, place your foot on the floor and move your upper body forward to increase the knee flexion angle for 5 to 10 seconds, then fully straighten the knee. Twice daily. II. Early Activity You will need to walk short distances in the hospital and begin daily activities 3 days after surgery. Walking properly is most beneficial for knee recovery. Initially, you will need to walk with the help of a walker or crutches. Your doctor or physiotherapist will tell you how much weight you can carry. Stand upright, distribute your weight evenly on the walker or crutches, move your walker or crutches forward a short distance, and then move your operated lower leg forward, keeping it straight so that the heel can land first. As you move forward, your knee and ankle will be flexed and your entire foot will be fully on the ground. When you finish this step, your foot will be lifted off the ground and your hip and knee will be flexed so that you can begin the next step. The point of the walk is to land heel first, then the entire foot, and finally lift your toes off the ground. Try to move your stride as regularly and gently as possible, without being in a hurry. Adjust your walking stride and speed to return to normal. As your muscle strength and endurance increase, you can spend more time walking and you can gradually increase the degree of weight bearing on your lower extremities. You can walk with the help of a cane on the healthy side and gradually remove all support and walk independently. Usually by 2 to 3 weeks after surgery, when you can stand or walk for more than 10 minutes, your knee joint is strong enough to be supported without a cane or walker. At this point you can use a single crutch or cane to help you walk. The assistive device should be held by the patient’s opposite hand, and the affected limb should be weight-bearing, not all weight-bearing on the healthy limb. Movement up and down stairs requires joint strength and mobility. Initially, you will need to take one step at a time with your hand on the railing. When going upstairs, walk on the healthy side first and drive your body on the healthy side. When descending the stairs, walk on the affected side first and let the healthy side support the descent. Remember that the principle is “the healthy side goes up first and the affected side goes down first”. You may need help until you return to full mobility. Going upstairs is a particularly demanding activity in terms of strength and endurance. Do not attempt to go up higher than standard steps and use railings to help maintain balance. As your strength gradually increases and your flexibility gets better, you can alternate between left and right steps. Advanced Exercises and Activities Once you are able to complete a small distance or even a few steps independently, you can further increase your activity. Knee pain prior to surgery and post-operative knee swelling have left you with very little knee strength. Full recovery will take several months. The following exercises and activities will allow you to make a full recovery. Standing knee flexion exercises: Stand upright with the help of a walker or crutches, lift your thighs and flex your knee as hard as you can. Hold for 5-10 seconds. Then straighten the knee, starting with the heel on the ground. Repeat several times until you feel fatigue. Assisted knee flexion exercise: Lie on your back, fold a towel, place it at the ankle, flex the knee, and pull the towel upward with both hands to help flex the knee. Hold for 5-10 seconds. Repeat several times until you feel fatigue. Resistance knee strength exercises: You can add a little strength to your ankle by doing any of the above exercises. These resistance exercises are usually started 4-6 weeks after surgery. Use 1 to 2 pounds of strength at first, and you can continue to increase the resistance as your muscle strength returns. Bicycle exercises: Bicycle exercises are an excellent exercise for both strength and mobility recovery. Start out with the cushion positioned high and adjusted so that your knees can reach the pedals when they are nearly straight. Start by stepping backwards on the pedals. If you can pedal backwards in a complete circle, you can then pedal forward. Your strength will build in about 4 to 6 weeks, at which point you can increase the strength against the pedals. Practice 2 times a day for 10 to 15 minutes, gradually increasing to 3 to 2 times a day for 20 to 30 minutes each time. IV. Pain and swelling after exercise Swelling or pain in the knee joint occurs after exercise. Pain and swelling can be relieved by elevating the lower extremity and applying ice to the knee joint. Gradual exercises and participation in activities will slowly increase your strength and flexibility.