I. Early stage (the day of surgery ~ 2 weeks after surgery)
Rehabilitation purpose: to reduce pain and swelling; early muscle strength exercises to avoid muscle atrophy; early mobility exercises to avoid adhesions.
Rehabilitation precautions.
1, because the early muscle strength level is low and the tissue has a more obvious inflammatory response, so the endurance training should be based on small loads. Choose a light load (complete 30 times the amount of fatigue of the action that the load), 30 times / group, 2 ~ 4 groups of continuous exercise, rest 30 seconds between groups, until fatigue.
2. Do not walk too much in the early stage, and do not use walking as an exercise method, otherwise it is very easy to cause joint swelling and fluid accumulation, which will affect the functional recovery and tissue healing.
Exercise plan.
1.On the day of surgery
Ankle pump exercise After the anesthesia subsides, start to move the toes and ankle joint. The method is hard, slow, full range flexion and extension of the ankle joint, 5 minutes/group, multiple groups/hour.
Quadriceps isometric exercises Muscle tensing and relaxation exercises for the anterior thigh, more often without increasing pain.
N cord muscle isometric exercises Put a pillow under the knee of the affected limb, make the posterior thigh muscle tense and relax to press down the pillow with force, do more without increasing the pain.
After 24 hours after surgery, you can walk on crutches, but only to go to the bathroom and other necessary activities.
2.Day 1 after surgery
Continue the above exercises.
Straight leg raise exercise Knee straight, straight leg raise until heel is 15cm from bed, hold for 5 seconds. 30 times/group, 3~4 groups/day.
Side leg raise exercise Same requirements and times as above.
Back leg raise exercise Prone position, straight leg raise with knee joint extended until toe is 5cm from the bed, hold for 5 seconds, same requirements and reps as above.
Weight-bearing balance exercise Under protection, separate the feet and move the center of gravity alternately from side to side within the range of slight pain, 5 minutes/time, 2 times/day. Then separate the feet back and forth and move the center of gravity.
If the pain and swelling are not obvious, you can use single crutches or no crutches, but do not encourage more walking.
3.The 3rd day after surgery
Continue the above exercises.
Start flexion exercises to reach the largest possible angle with slight pain.
4.Day 4 after surgery
Continue the above exercises.
Single leg standing balance exercise 5 minutes/time, 2~3 times/day.
Prone leg hook exercise Use sandbag as load, perform within 0°~45° flexion and extension of knee joint, 30 times/group, 2~4 groups/day. Apply ice immediately after the exercise if the joint is swollen and painful.
Active knee flexion should reach 90°.
5.Day 5~7 after surgery
Continue the above exercises.
Weight-bearing knee flexion/extension Exercises Active knee flexion/extension in the range of 0°~45° in the standing position with full weight-bearing, 30 times/group, 2~3 groups/day. Apply ice immediately after the exercise if the joint is swollen and painful.
6.The second week after surgery
Squatting against the wall with your back against the wall, feet shoulder-width apart, toes and knees facing forward, slowly squatting exercises. Gradually increase the squatting angle as the knee muscle strength increases, but do not exceed 90°, 2 minutes/time, 5 seconds interval, 5~10 times/group, 2~3 groups/day.
Standing leg hook exercise In standing position, actively flex the knee joint of the affected limb to the maximum pain-free angle for 10~15 seconds, 30 times/group, 4 groups/day.
II. Initial period (2 weeks to 1 month after surgery)
Rehabilitation purpose: continue to strengthen joint mobility and muscle strength; improve joint control and joint stability; start to resume daily activities.
Rehabilitation precautions.
1, this period to improve the absolute strength of the exercise is the main, choose a medium load (that is, the completion of 20 movements that fatigue load), 20 times / group, 2 ~ 4 groups of continuous exercises, rest 60 seconds between groups, until fatigue.
2, should pay attention to control the amount of exercise, to avoid joint swelling, fluid accumulation. If the joints feel swollen and hot after the exercise, apply ice in time.
Exercise plan.
1.2 weeks after surgery
Active flexion of the knee joint to 120°~130°.
Strengthen muscle strength exercises, one straight leg raise exercise up to 6 minutes.
Walk with a normal gait as much as possible.
Muscle strength exercises for all muscle groups around the knee joint.
2. 3 weeks after surgery
Active flexion of the knee joint to 140°.
Intensive muscle strength exercises.
Anterior-posterior and lateral striding exercises Gradually transition from lateral striding to anterior-posterior striding exercises, and gradually increase the load.
III. Mid-term (1~2 months after surgery)
Rehabilitation purpose: strengthen joint mobility to the same level as the healthy side; strengthen muscle strength; improve joint stability; restore the ability to perform all activities of daily life; be able to participate in light sports.
Exercise plan.
1.4~5 weeks after surgery
Active flexion of the knee joint to 150°, i.e., full range of the same as the healthy leg, and basically pain-free.
Single leg half squat exercise on the affected side at 45° 5 minutes/time, 4 times/day.
Fixed bicycle exercise 30 minutes/time, 2 times/day.
2.6~8 weeks after surgery
Can complete daily activities, such as walking up and down stairs, riding a bicycle, walking more than 5000 meters without joint swelling and pain.
Kneeling exercises, pedaling exercises.
Swimming, rope skipping and jogging are possible.
IV. Late stage (2~3 months)
Rehabilitation purpose: full recovery of all activities of daily life; strengthening muscle strength and joint stability; gradual return to sports; improving maximum strength.
Rehabilitation precautions.
Large load should be used (i.e., the amount of load to complete 12 movements that feel fatigue), 8~12 times/group, 2~4 groups of continuous exercises, with 90 seconds rest between groups until fatigue.
Exercise plan.
Continue the above exercises.
Knee wrapping exercises.
Forward and backward and left and right lateral bouncy bed straddle jump exercises.
Athletes can start practicing the basic movements in special sports.
Knee brace can be worn for protection during strenuous exercise.
V. Recovery period (after 3 months post-op)
Rehabilitation purpose: full recovery of sports or strenuous sports; gradual resumption of special training; strengthening of muscle strength and stability of the joint during strenuous activities; muscle strength of the affected side up to 85% or more of the healthy side, no pain and obvious swelling during sports.