Immediate postoperative rehabilitation – 3 weeks postoperative
1) Ankle pump exercises. Start from the first day after surgery. The method is as follows: with both lower extremities straightened in bed, the patient should first relax both ankles naturally and then do dorsiflexion, which must reach the maximum when dorsiflexing. Then do plantarflexion from the maximum dorsiflexion state, and plantarflexion should also reach the maximum, each action lasts for 5 seconds, and so on repeatedly. Liu Bingli, Department of Joint Diseases, Tangshan Second Hospital
2) Do contraction and relaxation exercises for the quadriceps muscle: From the first day after surgery, perform a moderate amount of contraction and relaxation exercises for the quadriceps muscle every day.
The method is: the patient lies on the bed, the legs are naturally straight, repeatedly contract the thigh muscles of both lower limbs for 5 seconds, and then relax for 2 seconds. The number of contraction and relaxation is 3 sets per day, 50 times per set, 150 times in total. If the exercise is performed simultaneously on both legs, the contraction force of the quadriceps muscle on the affected side can be increased by 30%.
The exercise will increase the contraction of the quadriceps on the affected side by 30%.
3) For 3 weeks after surgery, knee flexion and extension activities are not required. You can push the patella from side to side to prevent adhesions.
3 weeks – 4 weeks after surgery
1) The first knee flexion exercise to 45-60 degrees can be performed after 3 weeks. Rest with the knee brace fixed in the straight position.
2) Partial weight-bearing with crutches, toe to toe walking (continue until 6 weeks post-op before full weight-bearing).
3) Muscle strength training of the healthy limbs and both upper limbs.
4) During lower limb exercises and bed placement, the posture and position of the lower leg should be observed so as not to put it in an excessive anterior-posterior displacement.
Postoperative rehabilitation from 4 weeks to 8 weeks
1) Continue the above exercises.
2) Flexion of the knee to 90 degrees at 4 weeks postoperatively. Non-weight bearing knee flexion and extension (e.g. using a gymnastic ball) is beneficial to reduce swelling (not too many times per day). Knee extension at 0-90 degrees is permissible.
3) Knee flexion to 110 degrees at 5 weeks postoperatively.
4) 6 weeks after surgery, knee mobility should be between 0-120 degrees.
Muscle strength training at this time.
Knee presses (i.e. heel down on the bed) in the range of 10-60 degrees are allowed in order to practice the strength of the posterior thigh group muscles) of the N cord muscle.
In the case of weight-bearing exercises: be careful when adding weight to the lower extremities: the knee should be relaxed and good stability of the knee joint should be maintained. However, complete weight-bearing should be avoided until 6 weeks postoperatively, and even if the patient is pain-free, it is best to weight-bear only one-third of the body weight.
Shear forces on the knee should be avoided for 8 weeks after surgery.
8 weeks – 3 months postoperatively
1) Continue and strengthen the above exercises.
2) Daily knee exercises of 0 – 120 degrees should be maintained for 8 weeks after surgery. Flexion of the knee can be practiced up to 125 degrees to start normal walking with full G-abduction weight-bearing.
3) Knee mobility should be reduced by at most 10 – 20 degrees at 10 – 12 weeks postoperatively (i.e. 3 months postoperatively).
4) Note: At this stage, you must strengthen the muscle exercises of the lower limbs, otherwise you will have symptoms such as playing soft legs. Golden chicken independence, or standing horse stance can strengthen the muscles of the lower limb muscle strength.
3 months-6 months after surgery (removal of brace exercise)
1) The same as the rehabilitation training for 6 weeks-3 months after surgery, with more emphasis on strength and endurance training.
2) Muscle strength training: such as standing horse stance, golden chicken independence, half squatting and standing exercises for one leg
3) Reactive exercises: acceleration exercises, deceleration exercises and change of direction exercises can be performed to restore the original coordinated movement ability.
4) Proprioceptive exercises: lateral movements, backward running, balance board exercises, golden chicken independence.
For non-athletes: Rehabilitation is mostly completed 4-6 months after surgery, but can also continue with a 2-3 week adaptation to various activities. It takes about one year for muscle strength, innervation and coordination sections to return to basic normal.
Note: This rehabilitation program is only applicable to patients with joint ligament injuries. Please review the program promptly if other unexpected circumstances arise in the rehabilitation.