Rehabilitation exercises after knee replacement are important for functional recovery of the joint. Regular exercises are needed to restore joint mobility and muscle strength and gradually return to normal activity. In the early stages of rehabilitation, your orthopedic surgeon or rehabilitator will practice two to three times a day for 20 to 30 minutes each time, plus two to three times a day for 30 minutes each time you walk. Your doctor may recommend these exercises below. The following rehabilitation guidelines can help you better understand the rehabilitation program. 1. Short-term postoperative exercises These exercises below should be done as early as possible after surgery. These can be done in the recovery room shortly after surgery and may be uncomfortable at first, but they will speed up your recovery and gradually reduce your post-operative pain. Quadriceps exercises – Increase the strength of your thigh muscles. Straighten your knee joint as much as possible for 5 to 10 seconds at a time. Repeat this 10 times in 2 minutes, then rest for a minute and keep repeating until you feel your thigh muscles are tired. Straight Leg Raise Exercise C Lie flat on your back, contract your thigh muscles, keep your knee fully extended on the bed, then lift your lower leg a few inches from the bed, hold for 10 seconds, then slowly lower it. Repeat this action until you feel thigh muscle fatigue. You can also practice lifting your legs while sitting. Contract your thigh muscles as much as you can so that your knee is fully extended and your entire lower extremity is lifted off the bed without support, and repeat the exercise. Adhere to this exercise until quadriceps strength is fully restored. Ankle Pump Exercise C Regularly alternate contraction of the muscles in the front and back of the lower leg to reciprocate up and down movement of the foot. Perform this exercise 2 to 3 times per hour in the rehabilitation room for 2 to 3 minutes each time. Continue this exercise until full recovery and the swelling in the lower leg has completely subsided. Knee Extension Exercise C Lie flat on your back and place a roll of towels between the Achilles tendon and the bed surface, lifting the heel 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. Continue this exercise until you feel fatigue. Supported Knee Flexion Exercise in Reclining Position C Lie flat on the bed and slide your heel over the bed toward your buttocks to maximize knee flexion. Each flexion to maximum lasts 5 to 10 seconds, then straighten. Repeat the exercise until you feel fatigue. Continue this exercise until knee flexion is fully restored. Seated Supported Knee Flexion Exercise C Sit on the edge of a 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. Repeat the exercise until you feel fatigue. Continue this exercise until knee flexion is fully restored. Seated unsupported knee flexion – Sitting on the edge of a bed or stool with your thighs on the bed or stool, flex the knee to its 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. Repeat until you feel fatigue. Continue this exercise until knee flexion is fully restored. 2. Early activities You will need to walk short distances in the hospital and begin daily activities within a short period of time after surgery. These early activities will aid your recovery and help restore strength and mobility to the knee. Moving up and down stairs C Moving up and down requires strength and mobility of the joint. Initially, you will need to walk up one step at a time with your hands on the railing. On the way up, 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 higher than the standard step (7 inches) and use the railing to help maintain balance. As your strength gradually increases and your flexibility gets better, you can alternate between left and right steps gradually. 3. 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 level. 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 C 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 C In supine position, fold a towel and place it at the ankle joint, 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. 4. Pain and swelling after exercise C You may experience swelling or pain in the knee joint after exercise. You can relieve pain and swelling by elevating the lower extremity and icing the knee joint. Gradual exercises and participation in activities will slowly increase your strength and flexibility. If you have any doubts, consult your doctor or rehabilitator immediately.