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Home exercise program

  • Your leg muscles may feel weak after surgery because you did not use them much with your knee problems. Surgery corrected the knee problem. Your home exercise program will include activities to help reduce swelling and increase your knee motion and strength. This will help you move easier and get back to doing the activities you enjoy.

    Your success with rehabilitation largely depends on your commitment to follow the home exercise program on these web pages and as developed by your therapists.

    You can track how often you do your exercises on the home exercise program tracking sheet.

    Swelling

    It is important to try to keep your swelling down after surgery. You will be able to do this by:

    • lying flat with your leg at the level of your heart
    • putting a cold pack on your knee
    • actively pumping your muscles through ankle pumps
    • balancing activity with rest
    • Go to activities that will help with swelling.

    Range of motion

    It is important to work on your knee motion (bending and straightening) after knee replacement surgery. This will help you walk without a limp and get up and down easier from a chair, toilet or bed.

    You will be able to do this by:

    Strengthening activities

    It is important to work on regaining strength after knee surgery. This will help you get back to doing the things you enjoy.

    You will be able to do this by doing leg strengthening exercises as instructed by your physical therapist.

    Go to activities that will help with strengthening.

    Walking

    It is important to walk often throughout the day. This will help you get back to walking outside and in the community.

    You will be able to do this by:

    • walking around your home using a front-wheel walker, crutches or a cane (assistive walking device) your therapist instructed you to use
    • walking with the "heel-toe" pattern that your therapist taught you (to help keep you from walking with a limp)
    • gradually increasing the distance you walk

    Get additional instructions on how often to walk.

    Follow any additional instructions given to you by your health care provider or therapist.

    Swelling

    Do these activities to help reduce the amount of swelling and improve circulation after surgery.
    How often: At least 3 times a day

    You will have swelling in your leg and foot after surgery. Your swelling may increase after you leave the hospital. This is common and should gradually go away. It is important to try to keep your swelling down. The activities below will help you with managing swelling and pain.

    Rest and elevate illustration

    Lie on your back and elevate your leg using pillows when icing and doing ankle pumps.

    Rest and elevate

    • Lie down with your surgical leg at or above the level of your heart for at least 20 minutes.
    • You may place two to three pillows lengthwise beneath your surgical leg if you have an increase in swelling. Call your surgeon if you are concerned about the amount of swelling you have or if your swelling does not improve.

    Ice

    • While you are resting and elevating, place cold packs around your knee for 15 to 20 minutes at a time.
    • Place a clean, dry towel or pillowcase between your skin and the cold pack.

    Ankle pumpsMuscle pumping exercises

    Do the following exercises 10 times each while you are lying down resting.

    • Ankle pumps and circles
      Pump your feet up and down by pulling your feet up toward you, then pushing your feet down away from you. In addition, rotate your feet clockwise and counterclockwise. Ankle pumps should also be done 10 times every hour while you are awake.

    Activity

    • It is important to gradually increase your out-of-home activity during the first few weeks after surgery. If you do too much activity, your knee may become more swollen and painful.

    Important: When your knee is swollen, it will be hard to bend it. Once the swelling goes down, it will be easier to bend and straighten your knee. You will also have less pain.

    Range of motion

    Do these stretches to increase your knee motion.
    How often: 3 times a day

    Knee straightening stretch (sitting knee extension)

    Knee straightening stretch (sitting knee extension)

    Sit on a sturdy chair with your lower leg on an equal height chair or solid surface in front of you. Relax your muscles to let your knee straighten. You should feel a gentle stretch on the back of your knee. You can do thigh squeezes to increase the stretch. Do this stretch for 5 to 10 minutes.

    Knee straightening stretch on bed

    You can also do this stretch lying on your bed with a rolled up blanket or towel under your ankle.

    Knee bending

    Knee bending stretch (sitting knee flexion)

    Step 1: Sit toward the front of a sturdy chair. Bend your knee by slowly sliding your foot back-and-forth, resting briefly as needed. Try to move your foot back farther each time as you are able. You can use your hands to help. Do this for a few minutes as a warmup. You may want to use a plastic bag under your foot to help it slide easier.

    Knee bending stretch step 2

    Step 2: Slowly bend your knee back until you feel a gentle stretch. Scoot your body forward on the chair to increase the stretch as you are able. Your heel may lift from the floor but do not lift your hip. Hold for 20 to 30 seconds. Return to the starting position and relax. Repeat 3 times.

    The stretching should be more slow and gentle than fast and forceful. Try to keep your muscle relaxed throughout the exercise.

    Strengthening

    Do these exercises to strengthen your muscles.
    How often: 2 times a day

    Do 10 repetitions of each exercise. If you are comfortable with the exercises, gradually increase the number of repetitions until you reach 20 repetitions.

    Do your exercises lying down for the most comfort. Your bed is an excellent place to do your exercises.

    Ankle pumps

    Ankle pumps and circles

    Pump your feet up and down by pulling your feet up toward you, then pushing your feet down away from you. Next, rotate your feet clockwise and counterclockwise.

    Thigh squeezes (quadriceps sets)

    Thigh squeeze

    Tighten the muscles on the top 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 surgical hip and knee by sliding your heel up toward your buttocks while keeping your heel on the bed. Heel slidesSlide your heel back down to the starting position and relax. Keep your kneecap pointed up toward the ceiling during the exercise. You may want to use a plastic bag under your heel to help it slide easier.

    Leg slides (abduction/adduction)

    Leg slides

    Slide your surgical 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 plastic bag under your heel to help it slide easier.

    Lying kicks (short arc quadriceps)

    Lie on your back with a rolled-up blanket or towel (at least 6 inches in diameter) under the knee of your surgical leg. Lying kicksStraighten your surgical leg. Work up to holding for 5 seconds. Slowly lower your leg down and relax. The back of your knee should stay in contact with the blanket or towel during the exercise.

    Straight leg raises

    Leg raises

    Bend your non-surgical leg with your foot flat on the bed. Tighten the muscles on the top of your thigh, stiffening your knee. Raise your surgical leg up (about 12 inches), keeping your knee straight. Work up to holding for 5 seconds. Slowly lower your leg down and relax.

    Sitting kicks (long arc quadriceps)

    Sitting kicks

    Sit on a sturdy chair or on the side of your bed. Straighten your knee. Work up to holding for 5 seconds. Slowly lower your leg down and relax.

    Walking

    How often: 5 times a day

    Besides your exercise program, you must leave time for walking. It helps build your strength and endurance.

    • Walk around your home five times a day. Trips to the bathroom or kitchen are not enough.
    • Gradually increase the distance you walk. Work up to walking outside and in the community.

    Keep in mind that each person is different and has different pre-surgery levels of fitness. Talk with your physical therapist about walking if you have additional medical conditions.