Knee Replacement Exercises

Knee discomfort is a frequent issue for many people, but if it worsens and starts interfering with your daily life, or if it’s accompanied by swelling, sensitivity, or inflammation, it’s crucial to seek medical help.

Located in New York City and Long Island, we have access to six hospitals and state-of-the-art facilities for advanced knee surgeries and orthopedic care. Booking a consultation with an orthopedic surgeon is easy either online or by phone.

Learn about the different causes and treatments for knee pain, and recognize when surgery is the best option.

Overview

Knee replacement surgery is a common procedure for individuals suffering from severe knee pain and limited mobility due to conditions like osteoarthritis or injury. While the surgery can significantly improve quality of life, proper rehabilitation is crucial for maximizing its benefits and ensuring a successful recovery. One essential aspect of rehabilitation is performing knee replacement exercises tailored to strengthen the muscles around the knee, improve flexibility, and enhance overall function.

In this comprehensive guide, we will delve into the importance of knee replacement exercises, their benefits, and specific exercises you can incorporate into your rehabilitation routine. We’ll also discuss the scientific research supporting the effectiveness of these exercises in promoting recovery and long-term joint health.

Understanding Knee Replacement Surgery

Before delving into exercises, let’s briefly understand knee replacement surgery. During knee replacement, damaged or diseased parts of the knee joint are replaced with artificial components made of metal and plastic. This procedure aims to relieve pain, restore function, and improve mobility for individuals with severe knee conditions.

However, the success of knee replacement surgery relies not only on the surgical procedure itself but also on the post-operative rehabilitation process. Rehabilitation typically begins soon after surgery and involves various interventions, including exercises, physical therapy, and lifestyle modifications.

Importance of Knee Replacement Exercises:

Knee replacement exercises play a pivotal role in the recovery process by addressing several key objectives:

Strengthening Muscles: Strengthening the muscles around the knee joint is essential for providing stability and support. Weak muscles can contribute to instability and increase the risk of injury or complications.

Improving Flexibility: Maintaining or improving flexibility in the knee joint and surrounding muscles is crucial for restoring range of motion and preventing stiffness.

Enhancing Function: Through targeted exercises, individuals can improve their ability to perform daily activities such as walking, climbing stairs, and bending the knee.

Minimizing Pain: Certain exercises can help alleviate pain by reducing inflammation, improving circulation, and promoting the release of endorphins, the body’s natural pain-relieving hormones.

Preventing Complications: Regular exercise can reduce the risk of complications such as muscle atrophy, joint stiffness, and blood clots, which are common after knee replacement surgery.

Exercise and physical therapy after total knee replacement is associated with early return to activity and decrease in post operative pain and stiffness. Knee replacement surgery is a common surgery and the most successful surgery in medicine.

Knee replacement implants on an average last more than 20 years and more. Exercise and physical therapy forms an important part of post operative rehabilitation.

During the surgery, the arthritic ends of the knee joint are replaced with prosthetic metal alloy and plastic parts. The surgery involves cutting of the tissues and the bone to fix the prosthetic parts. A bone cement is used to fix the prosthetic parts at the ends of the thigh bone, shin bone and the undersurface of the patella.

X-ray showing a total knee replacement.

As the muscles and tissues are separated and cut to perform the surgery, a range of motion exercises started after surgery help prevent stiffness. Regular exercise is recommended for at least 30 minutes, repeated 3-4 times a day along with regular walking.

Immediately following the surgery, the patients are advised to do ankle pumps. Ankle pumps involve pushing the ankle down and up while lying straight on the bed. The calf muscles contract when performing ankle pumps. The contraction of calf muscles not only improves circulation but also prevents serious complications like deep vein thrombosis.

Deep vein thrombosis is the formation of blood clots in the veins of the leg that may travel up to the lungs to cause pulmonary embolism. Deep vein thrombosis may occur in response to a major surgery like knee replacement. Exercise and early ambulation helps to improve the circulation that plays a role in preventing deep vein thrombosis.

While lying straight on the bed, the patients are advised to contract their thigh muscles, the thigh muscles (quadriceps) contract helps to straighten the knee. To aid in exercise, the patients are advised to try to touch the back of their knees to the bed and hold it in the position for some time. The exercise is repeated alternatively on each leg and done multiple times a day.

Intraoperative image showing prosthetic component.

Straight leg raise exercise may be performed while lying straight or in sitting position. While lying straight, the patients are advised to try to move their leg straight up in the air, lifting a couple of inches off the bed. The straight leg is held up in the position till the thigh muscles are fatigued. The exercise is repeated on the other leg and multiple repetitions are done throughout the day.

Straight leg raise when performed in a sitting position, involves raising the leg to straighten the knee and holding it in position. Similar to lying down technique, the exercise is repeated multiple times.

Knee bending exercises may be done while lying on the bed or in a sitting position. While lying down on the bed, the patient is advised to slowly bend their knee with their sole of the foot touching the bed. The patients are advised to bend their knee as far as possible and hold in that position for some time and slowly bring it back. The exercise is repeated with an attempt to bend further each time.

The knee bends may be performed using a rubber band for support. The knee band may similarly be performed unsupported or supported while sitting in a chair. In supported knee bends the other leg is used to aid in bending the knee.

Majority of the patients may be able to walk the same day of the surgery or the day after. The patients are advised to walk using a walker as an ambulatory aid. The patients are advised to first be comfortable standing. Once comfortable, the patients are advised to advance their walker forward and move with their operative leg first.

The patients are advised to keep the operated leg straight and move forward with their heel touching the ground first. The amount of weight bearing will depend upon the type of knee replacement.

Once the patients are comfortable walking and standing for long, the patients may be allowed to use a cane for ambulation. Climbing and descending stairs are an important part of daily activity. The patients are advised to climb the stairs one step at a time.

During climbing the stairs, the non operated knee is placed first, while during descending the stairs, the operated knee is placed first. The use of handrail is recommended at all times during navigating the stairs.

Advanced exercises such as resisted knee bends and straightening exercises are initiated under supervision of a physical therapist. The advanced exercises help in building the muscles around the knee and increasing the range of motion.

Exercise and physical therapy after knee replacement not only helps in the early return to activities but also decreases the pain and swelling associated with the surgery. The improvement in circulation with the exercises help in decreasing the swelling. Stiffness of the knee is a common complication when adequate exercise regime is not followed after surgery.

Specific Knee Replacement e Exercises:

Now that we understand the importance and benefits of knee replacement exercises, let’s explore some specific exercises you can incorporate into your rehabilitation routine:

1. Quadriceps Sets:
   • Sit or lie down with your legs extended.
   • Tighten the muscles at the front of your thigh (quadriceps) by pressing the back of your knee down onto the bed or floor.
   • Hold for 5-10 seconds, then relax.
   • Repeat 10-15 times for 2-3 sets.
2. Straight Leg Raises:
   • Lie on your back with one leg bent and the other straight.
   • Tighten the muscles of the straight leg and lift it off the ground to the level of the bent knee.
   • Hold for 5 seconds, then slowly lower the leg back down.
   • Repeat 10-15 times for 2-3 sets on each leg.
3. Hamstring Curls:
   • Stand behind a chair or hold onto a stable surface for support.
   • Bend one knee and bring your heel toward your buttocks, contracting the muscles at the back of your thigh (hamstrings).
   • Hold for 5 seconds, then slowly lower your foot back down.
   • Repeat 10-15 times for 2-3 sets on each leg.
4. Heel Slides:
   • Lie on your back with both knees bent and feet flat on the floor.
   • Slide one heel along the floor, straightening the knee as much as possible.
   • Hold for a few seconds, then return to the starting position.
   • Repeat with the other leg, alternating between legs for 10-15 repetitions on each side.
5. Step-Ups:
   • Stand in front of a step or sturdy platform.
   • Step up onto the platform with one foot, pushing through the heel to lift your body up.
   • Step back down with the same foot, then repeat on the other side.
   • Perform 10-15 step-ups on each leg for 2-3 sets.
6. Stationary Bike Riding:
   • Start with low resistance and pedal at a comfortable pace.
   • Gradually increase resistance and duration as tolerated.
   • Aim for 10-15 minutes of stationary biking per session, gradually working up to longer durations.
7. Leg Press:
   • Sit on a leg press machine with your feet shoulder-width apart on the footplate.
   • Push the weight away by straightening your legs, then slowly bend your knees to return to the starting position.
   • Start with a light weight and gradually increase resistance as strength improves.
   • Perform 2-3 sets of 10-15 repetitions.

It’s essential to consult with your healthcare provider or physical therapist before starting any exercise program, especially after knee replacement surgery. They can provide guidance on which exercises are suitable for your specific condition and stage of recovery, as well as any modifications or precautions you should take.

Conclusion

Knee replacement exercises are integral to the rehabilitation process following knee replacement surgery. By strengthening muscles, improving flexibility, and enhancing overall function, these exercises can help individuals regain mobility, reduce pain, and achieve better long-term outcomes. Scientific research supports the effectiveness of structured exercise programs in promoting recovery and maximizing the benefits of knee replacement surgery. By incorporating specific exercises into your rehabilitation routine and working closely with your healthcare team, you can optimize your recovery and enjoy a higher quality of life post-surgery.