Strengthening program: Knee exercises before total knee replacement surgery
You may have discovered that you've been less active because of your knee joint
discomfort. When muscles aren't used, they become weak and don't perform well
in supporting and moving your body.
Having your knee replacement surgery will correct the joint problem, but you
will need a regular exercise program to strengthen your muscles and properly
support your new joint.
Beginning an exercise program before your surgery can greatly enhance your
recovery period. Follow your doctor's orders before your surgery.
Because everyone responds to exercise differently, you need to be the judge
of how much exercise you can do each day. If an exercise causes an increase
in joint discomfort, stop doing that exercise.
You should try to exercise one to two times a day, every day, before surgery.
Do five repetitions of each exercise. If you are comfortable with the exercise,
increase the repetitions by five each week until you reach 20 repetitions (week
one: 5 to 10 repetitions, week two: 10 to 15 repetitions and week three: 15
to 20 repetitions).
For the most comfort, do the exercises lying down. Your bed is an excellent
place to do your exercises.
Ankle pumps and circles
Bend both your ankles up, pulling your toes toward you, then bend both
your ankles down, pointing your toes away from you. In addition, rotate
your foot clockwise and counterclockwise, keeping your toes pointed toward
Thigh squeezes (quadriceps sets)
Tighten the muscles in front
of your thigh by pushing the back of your knee down into the bed. Hold
for 5 seconds and relax.
Heel slides (hip and knee flexion)
Bend your hip and knee by sliding your heel up toward your buttocks while
keeping your heel on the bed. Slide your heel back down to the starting
position. Keep your kneecap pointed up toward the ceiling during the exercise.
You may want to use a cookie sheet under your heel to help it slide easier.
Leg slides (abduction/adduction)
Slide your involved leg out to the side, keeping your kneecap pointed
up toward the ceiling. Slide your leg back to the starting position. You
may want to use a cookie sheet under your heel to help it slide easier.
Lying kicks (short arc quadriceps)
Lie on your back with a 3-pound coffee can or rolled blanket under your
involved knee. Straighten your involved knee. Hold for 5 seconds. Slowly
lower your leg down and relax. The back of your knee should stay in contact
with the can/blanket throughout the exercise.
Straight leg raises
Bend your uninvolved leg with foot flat on the bed. Raise your involved
leg up (about 12 inches), keeping your knee straight. Hold for 5 seconds.
Slowly lower your leg down and relax.
Bed mobility exercise
Lie flat on your back. Come up on both elbows. Straighten arms out behind
you and come to a sitting position. Lower yourself down onto your elbows
again, then down to lying flat.
Knee bending (sitting knee flexion)
Sit on a chair. Bend your knee back as much as you can. Hold for ________
seconds. Return to the starting position and relax. Repeat 5 times.
Sitting kicks (long arc quads)
Sit in a sturdy chair. Straighten your knee as much as possible. Hold
for 5 seconds. Slowly lower your leg down and relax.
Chair push up
Sit on a sturdy chair with arms. Grasp the arms of the chair. Push down
on the chair arms, straightening your elbows so that you raise your buttocks
off the seat of the chair. Hold for 5 seconds. Lower yourself slowly back
into the chair. If your arms are weak at first, use your legs to help
raise your buttocks off the chair.
Optional: Hamstring sets (heel digs)
Bend your involved knee a little and tighten the muscle on the back of
your thigh by digging your heel into the bed. Hold for 5 seconds.
Optional: Buttocks squeezes (gluteal sets)
Tighten your buttocks muscles by squeezing the muscles together. Hold
for 5 seconds.
Before surgery exercise progam schedule (requires Adobe Reader)
Mobility techniques to practice before total knee replacement surgery
Before surgery breathing (respiratory) exercises
Your health care team
Total knee replacement
Source: Allina Patient Education, Total Knee Replacement, third edition, ortho-ahc-90140
First published: 10/01/2000
Last updated: 12/01/2006
Reviewed by: Allina Patient Education experts