After you have undergone knee replacement surgery you are started on a rehabilitation program almost immediately while in the hospital. After hospital discharge, you either will be sent home for physical therapy or to a rehabilitation center. Wherever you end up, you and your physical therapist should have outlined goals you will want to achieve during the rehabilitation process. Following are three goal that everyone should be working on and included in their physical therapy plan of care.
1. Increase Your Knees Range Of Motion. This is done in a several ways however, once your physical therapist has explained to you and demonstrated the method on how to increase both your knee flexion and extension mobility, it will up to you to get the results.
I find sitting in a straight back chair and placing the stronger opposite legs heel over the surgical leg and gently pulling back holding your knee in flexion for a slow count of five. This works great in producing results you need when it comes to bending your knee. When it comes to extending the knee, you have to position your leg where you can stretch your hamstring muscles. This also can be done sitting in a chair and placing your operated leg on to a chair placed in front of you and placing gentle pressure on top of your knee and hold that position for a five count. Also ask your therapist to show you the long sitting position, this is where you sit up in bed with your legs out in front of you and slowly lean forward until you feel a slight stretch, hold this position for a slow count of 10.
You are looking to get at least 110 degrees of flexion and 0 degrees of extension for your knee to be functional however, you will be encouraged and generally expected to get anywhere from 115 to 125 degrees of flexion in time.
2. Reduce Your Pain and Swelling As Soon As Possible. This is a must to be effective in your rehabilitation. The increased swelling is just a part of the natural healing process, so that will always accompany the procedure. It will be your job to keep the swelling at a minimum through proper foot elevation, using ice as needed during the day and evening and after each rehabilitation session. If you cannot keep the swelling down to an acceptable level, that will hinder both you and your therapist from obtaining proper mobility with your knee. One of the biggest problems I find with patients is that they do not ice and elevate their knees enough after surgery and during the rehabilitation process.
3. Strengthen Your Quadriceps, Hamstrings and Calf Muscles. This believe it or not is generally the easier of the three goals to work on and achieve after surgery. I find that in most cases, your strength will come back rather quickly. Your muscle has memory so it will bounce back during the rehab process within 3-5 weeks. The important part that you and your physical therapist will need to discuss is the muscle imbalances that have developed long before you decided to have the knee replaced.
Your quadriceps will weaken over time and are considered to be the most important predictor to possible disability. You will spend considerable amount of time getting your quadriceps strength back to help you with your ability to walk again and also to help with any balance problems you may have had before or after surgery. Hamstring and calf strengthening will be a major part of the rehab program as well. Getting these muscle groups strong again will help you with your daily activities and help in supporting the prosthesis properly.
Once you have achieved these goals you will be on your way to living your life pain-free again along and being able to walk unlimited distances and stand for unlimited amounts of time along with getting a good nights sleep again.
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