Knee Flexion After Surgery
Focus on Knee Extension First
Working on your knee extension will be your primary goal for the first 2 weeks following surgery. Full knee extension is required for normal walking mechanics, normal joint stability, and is the best predictor of good outcomes after surgery. By stretching into knec extension it will make your knee flexion range of motion much easier. Knee flexion is easier to get and something you can emphasize after the knee is straight. To get a knee to full extension after surgery see our favorite exercises which also includes the following. Sit on a chair, hold your leg out straight, and then bend it back down. You will want to do this at least twice a day to start. Initially, it may be hard to fully extend, and that is to be expected. Working up to a full range of movement is a work in progress. Once you can fully extend your leg and hold it for 30 seconds or more, you will know it’s time to add other stretches.
Use a Walker or Cane Until You Can Walk Without a Limp
As important as it is to utilize exercise, you don’t want to push things too fast. It’s important to use a cane or walker until you are able to walk without a limp. When you are not able to walk normally, you are adding stress to your joints, muscles and ligaments. Different parts of your body are being forced to compensate, and not in a healthy or natural way. The most common compensation is to walk with a bent knee. If this becomes a habit the knee can stay permanently bent.
Utilizing a cane will ensure all of your muscles heal the way they need to in order to support you as you strengthen your knee. The effects of rushing this step can lead to hamstring contractures, patella irritation, and other stress on your joints. This will further delay your recovery, and can decrease your knee flexion in the long term.
Exercise: Motion is Lotion for the Knee Joint
Exercise will help you build strength, improve mobility, and decrease your chance of forming blood clots after surgery. You can take it slow with stretches and gentle exercise at first. Work your way up to activities that cause you to bend and extend your knee further. Initial exercise may just include stretches such as knee extension and flexion. Over time, utilize bands to add additional resistance.
Calf and heel raises are a great way to build up stability and strengthen the surrounding muscles. For more intense exercises, you can do things like walking, wall sits, biking, and swimming. These are still relatively low-impact, but will greatly help you improve mobility of the knee while also building strength.
Always warm up before and after any exercise. You will start to notice that your knee always feels better after short bouts of walking or using the recumbant elliptical. By performing continuous exercise you bring more and more blood to the joint which speeds up healing and also lubricates the joint preventing stiffness. Our favorite exercise after a total knee is using a recumbant elliptical. The more you use it the better your knee will feel and the faster you will progress. Stiffness and swelling may be evident at first, but that is normal. Over time, you should notice your pain and swelling improving. Range of motion is a key indicator in your healing. Improving your range of motion is a sign that your swelling has decreased and that you are managing your pain well.
Hold the Stretches for Longer
There are a lot of stretches you can do. The Heel Slide is commonly recommended. While lying on your back, bend your knee as you slowly slide the heel of your operated knee towards your buttock.
You can also do the standing knee flexion stretch on a stair. From a standing position, put your affected knee on the first or second step and then lean forward causing the affected knee to bend. Hold this position as long as you can without causing severe discomfort.
Be sure to use a variety of stretches, and work up to holding them for longer periods of time. They should be held for at least 30 seconds, but you can slowly increase to to holding them longer. The longer you hold them the more tissue change that occurs.
Heel Slides with a Strap
Stair Knee Flexion Stretch
Use Heat Before Stretching
Using a heating pad can be a great way to loosen up your joint before stretching and exercising. The heat will get the blood flowing before you begin your routines, making it easier and your muscles more elastic. This will be especially helpful on days you are feeling stiff. And YES, YOU CAN USE A HEAT PACK WITHIN A WEEK OF SURGERY.
We recommend the Rester’s Choice heating pad
It is made of soft, comfortable material. It uses clay beads and is cordless, so it’s completely portable and won’t interfere with your exercises. Because of its versatility, you can even use it while stretching. Using a heat pack will also help decrease the pain during after stretching and may help lessen the need to use any drugs or medications.
Try Different Stretches Daily
There are many different stretches you can use to improve your range of motion. You can do them standing, from a chair, lying down, and even using a wall. It’s important to not only stretch your knee but also the surrounding muscles and ligaments. These will be supporting your healing knee as well, and shouldn’t be neglected. The more ways that you challenge all of the tight structures the quicker your knee will improve it’s range of motion. For more ideas one what stretches to do we recommend reading this article on the best exercises to improve knee flexion after surgery.
Don’t Push Pain Above Discomfort
It’s critical that you don’t push things too far, too fast. You can cause yourself set-backs in your healing by not taking things at a slow and steady pace. I’m sure that you have hear about the “No Pain, No Gain,” but that isn’t entirely true. Pain is a needed protective measure. If you do Overdo it, you can cause issues like muscle spasms and severe muscle guarding. These things will cause you to not be able to complete your daily activities, and will inevitably set back your recovery process and make you more stiff. The best rule of thumb is to not push beyond a true 4-5/10 when performing the exercises. If you are not sure what your pain level is, here is a good pain scale for reference.
Take things slow at first, and really work on knee extension for the first couple of weeks. This process is going to take time, and that is ok. You can’t expect results overnight, and pushing yourself too far will not benefit you in the end.
For the best possible recovery results, build things up in small steps over many weeks. Use a variety of stretches and exercises, and don’t neglect other muscles and ligaments. You use your calves, thigh, hamstrings, glutes and even hips to assist you in walking and all of these areas should be included in your activities as well.
It’s ok to have sore days, and use a portable heating pad to help with comfort. This road to healing will be a marathon and not a race. It’s important to focus on the quality of your stretches and mobility exercises to get the best result.
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Disclaimer: The information provided in this post is for educational purposes only. This is not a substitute for a medical appointment. Please refer to your physician before starting any exercise program.