I. Initial period (0-1 week after surgery).
1. Day of surgery.
After anesthesia subsides, start moving the toes and ankle joints.
(1) Ankle pump – forceful, slow, full range flexion and extension of the ankle joint, 5 minutes/group, 1 group/hour.
(2) Quadriceps isometric exercises – i.e. thigh muscle tensing and relaxation. Should be done as much as possible without increasing pain.
(3) N cord muscle isometric exercise – the affected leg force down the padded pillow, so that the back of the thigh muscle tense and relaxed. The requirements are the same as above. All exercises should be done as often as possible without increasing pain!
(4) After 24 hours after surgery, you can walk on the ground with the help of crutches, but only to go to the toilet and other necessary activities.
2.Day 1 after surgery.
(1)Continue the above exercises.
(2) Change the ankle pump to anti-gravity exercises.
(3)Start straight leg raise – straight leg raise after knee extension to heel 15M from bed, hold for 5 seconds. 30 times/group, 3-4 groups/day.
(4) Start side leg raise exercise. Same requirements and reps as above.
(5) Start back leg raise exercise, prone, straight leg raise after knee extension to 5M from the bed at the toe, hold for 5 seconds. The requirements and the number of times as above.
(6) Weight bearing and balance: separate the feet under protection and move the center of gravity alternately from side to side within the range of slight pain. 5 min/time, 2 times/day; separate the feet back and forth and move the center of gravity. If the pain and swelling is not obvious, you can support the single crutch, or do not use the crutch to go down, but do not encourage more walking.
3, the third day after surgery (1) continue the above exercises.
(2) Start flexion exercises, see remarks for method. Take the slight pain as the degree, and reach the largest possible angle.
4.Day 4 after surgery.
(1)Continue the above exercises.
(2)Start single leg standing balance exercise. 5 minutes/time, 2-3 times/day.
(3) Start prone “leg hook exercise”, 30 times/group, 2-4 groups/day.
(4) Active knee flexion up to 90 degrees.
5. Postoperative day 5.
(1) Continue and strengthen the above exercises.
(2) Start active extension and flexion exercises in the range of 0-45 degrees with weight in standing position. 30 times/group, 2-3 groups/day, ice for swelling and pain after the exercises.
6.Postoperative week 1.
(1) Active flexion greater than 90°.
(2) Can stand on one foot, can walk short distances without crutches.
(3) start squatting exercises against the wall. Squatting exercises: back against the wall, feet shoulder-width apart, toes and knees are forward, not “inside and outside the eight”, with the power to gradually increase the angle of squatting (less than 90 °), 2 minutes / time, interval of 5 seconds, 5-10 consecutive / group. 2-3 groups / day.
(4) Begin standing “hook leg” exercises resistance flexion to the maximum angle of pain-free hold 10-15 seconds. 30 times / group, 4 groups / day.
Early stage: (2 weeks to 1 month after surgery).
Purpose: To strengthen mobility and muscle strength exercises: improve joint control and stability; start to resume daily activities.
With the improvement of muscle strength level, exercises to improve absolute strength are the main focus in this period. Choose a medium load (the amount of load to complete 20 movements that is fatigue), 20 times / group, 2-4 groups of continuous exercises, rest 60 seconds between groups, until fatigue.
Care should be taken to control the amount of exercise to avoid joint swelling and fluid accumulation. If the joints feel swollen and hot after the exercise, ice should be applied in time!
1.2nd week after surgery.
(1) Active flexion to 120-130°.
(2) Intensive muscle strength exercises. (One straight leg lift up to 6 minutes) (3) If there is no obvious swelling or pain in the joint, then you should walk with a normal gait as much as possible.
(4) Begin to instruct the knee joint extension position thigh leather band resistance muscle strength exercises exercise load, angle, number of times and time, according to their own conditions. Generally 30 times/group, 2-4 groups/day.
2.The 3rd week after surgery.
(1) Passive flexion to 140°.
(2)Intensive muscle strength exercises.
(3) Start anterior-posterior and lateral straddle exercises (see Figure 6-5-7) gradually transition and gradually increase the load. 30 reps/group, 4 groups/day.
III. Mid-term: (1 month-2 months after surgery).
Objective: To strengthen joint mobility training to the same level as the healthy side; to strengthen muscle strength training and improve joint stability; to restore the ability of all activities of daily life and light exercise.
1.Postoperative week 5.
(1) Active flexion up to 150° (full range, same as the healthy leg), and basically pain-free.
(2)Start single leg 45 degree position half squat exercise on the affected side. 5 minutes/time, 4 times/day.
(3) Start fixed bicycle exercise. 30min/time, 2 times/day.
2. Postoperative weeks 6-8.
(1)The active flexion and extension angle reaches the same as the healthy side, and there is no pain.
(2) Can complete daily activities, such as going up and down stairs, riding a bicycle, walking more than 5000 meters without swelling and pain in the joint.
(3) Begin kneeling exercises.
(4)Start pedaling exercises.
(5) Start swimming, rope skipping and jogging.
IV. Late stage: (2 months-3 months after surgery).
Purpose: To fully resume all activities of daily life. Strengthen muscle strength and joint stability. Gradually resume exercise. Increase the maximum strength, choose a large load of 70% 1RM (complete 12 movements that is the amount of fatigue load), 8-12 times / group, 2-4 groups of continuous exercises, rest 90 seconds between groups, until fatigue.
1.Start the knee ring exercise.
2.Start jumping up and down exercises.
3.Start lateral straddle jump exercises.
4.Mobilize and start the basic movements of the special exercises. If necessary, wear knee pads for protection.
V. Recovery exercise period: (3 months after surgery).
Purpose: Full return to sports or strenuous activities.
1. Gradually resume strenuous activities, or special training.
2. Strengthen muscle strength and joint stability in running and jumping.
3, muscle strength test, the affected muscle strength up to 85% of the healthy side or more, no pain during exercise, no obvious swelling, then can fully resume sports.