Post-operative rehabilitation program for knee replacement
1 to 2 days after surgery.
This period is aimed at promoting blood circulation, preventing thrombosis and preventing tissue adhesions.
The patient should remain seated for at least one and a half hours in the morning and one and a half hours in the afternoon. Try to do some flexion and extension exercises as far as possible, the main purpose is to prevent the joint from being stationary for a long time and developing intra-articular adhesions. After the drainage tube is removed, the patient can sit on the edge of the bed and let the affected limb droop as naturally as possible. However, there is no angle requirement.
Quadriceps exercises: Tense your thigh muscles and straighten the knee joint as much as possible and hold for 5-10 seconds. Do this 10 times in two minutes, rest for 1 minute and do the same exercise again until you feel some fatigue in your thigh muscles
Straight leg raise: Straighten and tense your knee joint in bed, lift it slightly and hold it for 5-10 seconds, then lower it slowly until you feel some fatigue in your thigh muscles. You can also do this exercise in a seated position.
Flexion and extension of the ankle: Rhythmically flex and extend your ankle back and forth for 15 minutes at a time. Three to four times a day.
Rotate your ankle: Rotate your ankle from the inside out; repeat for five minutes three to four times a day.
Knee straightening exercises: Place a small pad under your heel to keep your heel out of contact with the bed. Tighten your thigh muscles and straighten your knee for 5-10 seconds until you feel some fatigue in your thigh muscles.
3-14 days after surgery.
The focus during this period is on restoring knee mobility to at least 0° to 90°; secondly, muscle strength restoration exercises.
Knee flexion and extension in bed: Keep your foot sliding on the bed to flex the knee as much as possible. Hold in maximum flexion for 5-10 seconds, then straighten the knee. Repeat several times until you feel some fatigue or your knee is fully flexed.
Seated knee flexion and extension exercise 1: Sit on the side of the bed or chair with your lower leg hanging down. With the base of the healthy foot on the instep of the operated side, slowly flex the knee as far as possible, holding it in maximum flexion for 5-10 seconds. Repeat until you feel some fatigue or until you are able to fully flex your knee.
Seated knee flexion and extension exercise 2: Sit on the side of a bed or chair with your lower leg hanging down. Slowly flex your knee as far as possible until your foot rests on the floor. Then lean your upper body forward to increase the angle of knee flexion and hold for 5-10 seconds. Fully straighten the knee.
Repeat until you feel some fatigue or your knee is fully flexed.
It is important that you get off the floor as soon as possible after surgery to help your recovery, but you should follow your doctor’s instructions on when to do so.
Standing knee flexion exercises: Stand smoothly with a walker or crutches, bend your hip and knee as much as possible, then hold for 5-10 seconds and straighten your knee. Repeat the exercise until you feel some fatigue.
Walking: The correct way of walking will facilitate your recovery. You will have to walk with a walker or crutches, and your surgeon or physical therapist will tell you when to put weight on. Start by standing still and placing your body weight on the walker or crutches, move the walker or crutches forward, take a step with the affected limb taking care to straighten your knee so that your heel hits the ground first, bend your knee and ankle forward so that your whole foot lands smoothly on the floor, and then take the next step with your forefoot on the ground bending your knee and ankle.
Note: Use your heel to land first, then your entire foot to land smoothly, and finally take the next step with your forefoot.
2-6 weeks post-op (i.e., post-discharge rehabilitation program).
The main goal of this period is to build muscle strength and maintain the knee mobility that has been gained.
1. Time rehabilitation takes time and you should make the rehabilitation program your schedule. Start with 3-5 reps of each exercise, then gradually increase the frequency of each exercise at twice the rate until you can do 15 reps at a time. If you feel difficult to perform a certain exercise, do not force to carry out, you can try to perform the exercise again after a week.
2. Breathing Pay attention to your breathing rhythm! You should keep breathing evenly, do not hold your breath. You can try this exercise to see how it feels, when you squat – exhale, when you stand – inhale. You can also breathe in when squatting and breathe out when standing. Find a method that works best for you. Whenever you finish one exercise and before you start the next one, take 3 deep breaths in this way.
3, away from pain in the process of all exercises, you should feel relaxed and happy and should not feel pain. You should give up the sports you do not feel good. If you feel knee pain, apply a local cold pack with ice. Elevate your legs as often as possible. Don’t get frustrated, you can rest quietly, even for several days. When you start again, start with simple exercises and gradually increase the intensity.
4.Reclining exercises
Exercise one, the whole body tense. Both shoulder joints to your front down direction to reach hard, calves or heels pressed firmly on the couch, just like you do when walking, alternately sliding in the direction of the front and back. If you want to speed up a little, you can slowly speed up the movement, while continuing to tense the body, do deep breathing.
Exercise two, the whole body tense. Toes facing up, heel down on the other side of the foot back. Now straighten the knee and lift the lower limb on the following side, tense the entire lower limb and hold for 7 seconds. Then slowly lower it. Make sure to practice each limb for at least 30 seconds, taking three deep breaths in between. Repeat the action to practice the other side of the limb.
5.Sitting exercises
Exercise one, the whole body tense. Slowly lift your heels at the same time until your toes hit the ground, then put them back until your heels hit the ground. Feel the floor under your feet?
Yes! You can gradually increase the speed.
Exercise two, the whole body tense. Alternate the above movements, with one foot on the toe and one foot on the heel, alternating.
You are doing a great job!
Exercise three, the whole body tense. Pull both feet in turn in the direction of the hips. Let the whole foot slide on the ground. You must press the floor and have the feeling of tense muscles.
Exercise four, the whole body tense. Extend one leg forward. Hook your toes and let your leg straighten out completely. Pull back the leg so that the palm of the foot is completely on the ground. Do the same for the other leg. Exercise five, full-body tensing. If you feel relaxed about exercise four, then now practice extending one leg out and off the ground for some distance. Hold for 7 seconds and slowly lower the leg so that the heel lands on the ground. Then land on the balls of your feet and slowly pull your leg back. Do the same action, practice the other leg
Exercise 6: Tense your whole body.
Now please combine exercise three and exercise four. Pull one leg as far as possible in the direction of the buttocks, and the other leg as far forward as possible. Hold for 7 seconds each time you do the last movement.
Exercise 7: You’re doing great! Now hold one leg with both hands and gently, with moderate force, slowly massage the calf from the bottom up. Relax the muscles at the back of the calf. Don’t forget the other leg! Now do you feel more comfortable with your legs? If you feel comfortable, you can do this exercise a few more times a day!
6.Standing exercise
You can stand with your back against the wall. Spread your legs apart, the same width as your pelvis. The heels are seven centimeters from the wall. The buttocks (tailbone), shoulder joints and the backs of the hands are pressed against the wall. If you cannot safely stand alone, you should use a cane. You can also lean your back against a table, writing desk or other object so that you can use support to avoid falling if necessary.
Keep your whole body tense, chest up, shoulders back, and keep your upper legs against the wall. Keep your hips close to the wall, your abdomen relaxed, the soles of your feet close to the floor, your knees slightly bent, and your toes facing out. Keep this tense state for seven seconds, then slowly release.
Exercise 1: Tense your whole body. Alternately lift the heels and toes of both feet and keep the knees and hips straight. When you are sure enough of safety, you can transfer the weight from one leg to the other and gradually accelerate the frequency.
Exercise 2: Tense your whole body. Squat down as far as you can, keeping your heels off the ground. Hold this position for 7 seconds, then slowly stand up. If you find it very difficult to flex your knees when you do it, don’t squat too low when you practice. Whatever is comfortable for you.
Rehabilitation Training Precautions
1. Avoid falling.
2. Avoid excessive weight bearing and avoid repeated flexion and extension of the knee joint under weight.
3. Avoid strenuous competitive sports.
4. Maintain body weight to avoid osteoporosis.
5. Avoid strenuous jumps, sharp turns and stops.