Recovering Back to Knee Functionality with Physical Therapy for Total Knee Replacement

  • November 16, 2023
  • blog

Exercise for effective recovery of the knee after a total knee replacement surgery, the patients need to follow a strict exercise routine. Regular physical therapy for total knee replacement is required to help patients regain and restore their strength and mobility. 

Where medication is required for pain management; exercise and physical therapy is recommended to bring back the knee to full functionality. Professional therapists will suggest exercises that will bring back mobility and help you sit down, stand up, walk, climb stairs, and do other regular movements easily. 

In this article, we will share exercise and physical therapy for total knee replacement. 

In the Aftermath of a Total Knee Replacement Surgery

Once the surgery is complete, the patient will remain in the hospital for a couple of days to a couple of weeks depending on knee health and overall condition. There is a fixed criteria for discharge;

  • The patient must have regained the ability to walk normally without using any assistive devices. 
  • The patient is able to climb up and down the stairs safely. 
  • The patient can get in and out of the car without any difficulty. 
  • The patient is able to wear and remove socks and shoes easily. 

Within the hospital, the patient’s exercise and therapy will begin after the total knee replacement surgery. The onus of continuing the exercises and therapy at home is on the patient and their caretakers. 

Types of Physical Therapy for Total Knee Replacement

Doctors recommend patients after total knee replacement surgery perform several types of exercises. These exercises and therapies are targeted to improve knee functioning and health. 

Range of Motion Exercises: Range of Motion (ROM) in the recovery process after total knee replacement surgery is essential to regain knee mobility and functioning. The exercises prescribed in ROM also help reduce pain and improve overall quality of life. 

A good way to achieve the intended results with all the ROM exercises is performing preoperative ROM exercises. Going for an operation after doing limited ROM exercises can increase post-surgery recovery challenges. 

With regular ROM exercises, the patients will observe visible changes in knee functionality and mobility. 

  • Heel slides
  • Ankle pumps
  • Knee flexion

Strengthening Exercises: Strengthening exercises are crucial to restore muscle strength in the knee. They help reactivate the knee muscles and improve the knee joint support. The exercises in this category are also helpful in improving the range of motion on the knee. 

As the patients continue to perform these exercises, the knee’s functionality and mobility will continue to improve. 

  • Quad sets
  • Glute sets
  • Hamstring sets
  • Straight leg raises

Joint Mobilization and Stretching: These exercises are also essential for the rehabilitation of the knee. As a result, they help with restoring range of motion and reduce pain, stiffness, and overall knee mobility.

These exercises provide joint mobilisation leading to the breaking down of scar tissue, improving joint lubrication, and promoting flexibility. 

  • Quadriceps stretching
  • Season stretch
  • Knee in chest

Proprioception: These exercises are essential to improve the body’s ability to sense its position and movement relative to the existing space. The exercises in this category help patients regain balance and coordination. 

In addition to improving balance and coordination, proprioception exercises improve range of motion and reduce pain, and stiffness. 

  • Single Leg Stance
  • Static balance on Bosu or Wobble Board

Endurance: Endurance exercises help improve cardiovascular health. These exercises strengthen the heart and lungs and reduce the risk of heart disease and stroke. Moreover, regularly performing endurance exercises reduces pain and inflammation in the knee joint. 

For overweight patients undergoing total knee replacement, endurance exercises are essential as they help with weight management. 

  • Walking
  • Cycling
  • Elliptical training

Important Therapy and Exercises or Total Knee Replacement

Each exercise and therapy session following the knee joint replacement surgery is meant to improve blood circulation. These exercises prevent blood clots and strengthen the muscles while improving knee movement. 

Here are a few exercises patients must follow after the surgery;

Quadriceps Sets

Quadricep sets are recommended to restore the range of motion in the knee. The knee motion reduces after the surgery due to a lack of flexibility. Hence, the knees must have the required range of motion to perform daily activities. 

Another benefit of this form of physical therapy for total knee replacement is strengthening the quadriceps muscles. These muscles are among the primary muscles required to extend the knee. After the surgery, the quadriceps muscles weaken, hence quadriceps set is recommended. 

Performing them daily improves knee balance and coordination along with increasing the recovery speed. 

How to Perform?

  • Begin by tightening thigh muscles and straightening the knee. 
  • Hold this position for about 5 to 10 seconds. 
  • Do the same for about 2 minutes, at least 2-3 times a day. 

Quadriceps sets are slightly painful and cause discomfort when performed after knee surgery. However, it’s important to perform this exercise until the patient can tolerate the pain. 

Straight Leg Raises

Another one of the important physical therapies for total knee replacement is straight leg raises. The motive of performing this therapy exercise is to improve the range of motion, reduce swelling, and inflammation, and prevent quadriceps atrophy. Regular practice of this exercise will also strengthen the quadriceps muscles. 

How to perform?

  • Lying on the back, roll a towel or blanket and keep it under the knee. 
  • Straighten the knee – tighten the thigh muscles and lift the leg (the one which has got a new knee) several inches from the surface. 
  • Hold the leg in that position for about 5 to 10 seconds.
  • Bring the leg back down slowly and repeat this exercise 10 times for 2-3 times in a day. 

Straight leg raises may also cause some pain and discomfort, which is normal. But it’s important to weather some pain as this exercise will help regain motion and improve knee functionality.  

Static Quads

Another exercise to perform for strengthening quadriceps muscles, static quads does not require moving the joint muscles. plus, performing this exercise also helps reduce pain and swelling in the knee joint. 

Status quads improve blood circulation and help with lymphatic drainage. As a result, the range of motion of the knee joint improves with regular exercise. 

How to Perform?

  • Lie on the back and straighten the leg towards the front. 
  • Tighten the thigh muscles and push the knee downwards towards the surface.  
  • At the same time pull the toes towards the head and hold the position for 10 seconds. 
  • Repeat this exercise at least 10 times a day. 

Here again, there will be some pain during and after the exercise. But pain can be managed by applying ice over the knee joint before and after exercising. 

Ankle Pumps

Ankle pumps are recommended after total knee replacement surgery as they help improve blood circulation and reduce swelling. This exercise helps move blood back to the heart, preventing it from pooling in the legs. This physical therapy exercise also helps with lymphatic drainage, which reduces swelling in the knee. 

Regularly performing ankle pumps can also prevent blood clots, which can occur after the surgery. 

How to Perform?

  • Contract the calf and shin muscles while moving the foot up and down rhythmically. 
  • Do the same for 2 to 3 minutes in a day and 2 to 3 times in an hour. 

Ankle pumps don’t require the patient to get into a specific position. Anyone can this exercise while watching TV, using a phone, talking to another person, etc. Generally, ankle pumps are not painful, but if there is some pain, consult the doctor. 

Knee Bends

An important series of physical therapy exercises for total knee replacement is knee bends. The most important exercises include;

  • Bed-Support Knee Bends: Bend the knee towards the body while keeping the heel attached to the bed. Hold the knee in this position for 5 to 10 seconds and bring the knee back down. Repeat this exercise until the knee is fatigued. 
  • Sitting-Supported Knee Bends: The sitting-supported knee bends are done while sitting on a chair or a bed. Give support to the foot of the operated knee in bringing it back with the other foot. 

Bend the knee bringing the heel towards the body and hold it there for about 10 seconds. Repeat this exercise until the knee is tired or 2 minutes in continuation. 

Knee bend exercises help bring back the knee’s functionality. It helps with adjusting the new knee in its place after the surgery and prevents blood clotting. 

Ready to Get Back to Great Knee Health?

A total knee replacement surgery is a taxing procedure as a recovering knee is painful and inhibits the individual’s movement. Surgeons and physical therapists recommend physical therapy for total knee replacement to gain complete functionality of the knee. 

At Santokh Hospital, we have successfully completed hundreds of total knee replacement surgeries. Moreover, our post-surgery assistance includes physical therapies customised to the patient’s needs for a quicker recovery. 

Schedule your appointment today with our resident orthopaedics to get the best treatment for your knee problems.