I. Early period
Straight splint fixation period (4-6 weeks after surgery)
Purpose: to promote circulation, reduce pain, swelling; early muscle strength exercises to avoid excessive muscle atrophy.
In the early stage, there should not be too much walking, and walking should not be used as an exercise method. Otherwise, it is very easy to trigger joint swelling and fluid accumulation, which will affect functional recovery and tissue healing.
(i) After the postoperative anesthesia subsides
1. Move the toes (or the ankle joint if the cast is not fixed) – Move the toes with force, slowly and as widely as possible. (It is important to promote circulation, reduce swelling and prevent deep vein thrombosis)
2, quadriceps (anterior thigh muscle group) isometric exercises – that is, thigh muscles gently tense and relax. Do as much as possible without increasing pain.
3, N cord muscle (posterior thigh muscle group) isometric exercise – the affected leg force down the padded pillow, so that the posterior thigh muscle tense and relax.
(ii) 2 days after the operation, after the drainage is removed
1.Can walk on the ground with the help of crutches, but only to go to the toilet but necessary daily activities.
2.Start side leg raising exercise (absolutely no straight leg raising!) Absolutely no straight leg lift!
3.Posterior leg lift exercise: prone position, posterior leg lift until the foot is 5 cm from the bed.
(C) 1 week after surgery
Start joint mobility exercises as determined by the surgeon.
1.Begin flexion exercises.
The thigh muscles must be completely relaxed during the exercises! Otherwise, it will have a negative effect on the healing of the fracture. Apply ice for about 20 minutes immediately after the flexion exercises. If you usually have a feeling of obvious heat and swelling in the joint, you can ice it again 2-3 times/day.
2.Start stretching exercises (seated suspension).
Make the affected leg leave the bed completely and relax the muscles to make the knee joint extend naturally.
II. Mid-term
Period of strengthening mobility and muscle strength exercises
Purpose: To start and strengthen mobility exercises to avoid and release joint adhesions and contractures. Strengthen muscle strength exercises to improve joint control and stability; gradually improve gait.
In this period, the muscle strength level is low and the bone tissue connection is still fragile. Therefore, static exercises (keeping a certain posture still to practice strength) or small load endurance exercises are mainly used.
(II) 4-6 weeks after surgery
1.Start straight leg lift exercise – straight leg lift after knee extension until heel is 15M from the bed, keep it until exhaustion.
2.Start “leg hook exercise” in prone position.
3.With the increase of muscle strength, you can start “leg hooking” exercises in the standing position.
III. Later period
Recovery period: (after the fracture has basically reached bony healing)
Purpose: To strengthen the joint mobility until it is as flexible as the healthy side. Strengthen the muscle strength and improve the stability of the joint. Resume daily life
and gradually regain motor ability.
*With the improvement of muscle strength level, absolute strength exercises will be the main focus in the middle term.
1. Strengthen the joint mobility until it is basically the same as the healthy side.
2.Start squatting or sliding exercises against the wall.
3.Start pedaling exercises
5.Strive to achieve normal gait walking.
6.Fixed bicycle exercises, no load to light load.
7.After the muscle strength is increased, the knee exercises can be started on the affected side in a 45° half squat flexion and extension.
During this period, the fracture healing is not strong enough, so the exercises should be gradual, not forced or blindly adventurous. It is important to strengthen the muscles to ensure the stability and safety of the knee joint in sports.
Recovery period: (after the fracture has healed completely)
Purpose: Full return to sports or strenuous activities. To strengthen the muscle strength and stability of the joint during running and jumping.
1.Passive flexion to the same angle as the healthy side.
2.Progressively try full squat under protection
3.Strengthen muscle strength
4.Start knee circling exercises
5.Start jumping up and down exercises
6.Start lateral jumping exercises
7 .Start swimming, jumping rope and jogging.