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 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
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.
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:
- doing knee bending and straightening stretches as directed by your therapist
- sitting with your knees bent during meal times
- not resting with your knee bent over a pillow
See mobility and activity techniques for more specific information about mobility techniques.
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.
Do your exercises lying down for the most comfort. Your bed is an excellent place to do your exercises.
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 Pack or Frozen Gel Pack
- While you are resting and elevating, place an ice pack or frozen gel pack around your hip. Use an ice pack or a frozen gel pack for 15 to 20 minutes at a time or as directed by your surgeon.
— If you are using an ice pack, put a clean, dry towel between your skin and the ice pack. Do not place the ice pack directly on your skin.
— If you are using a frozen gel pack, put it inside the sleeve pocket given to you before you put it on your skin. Do not place the frozen gel pack directly on your skin. Wait 90 minutes to 2 hours before you use the ice pack or frozen gel pack again. - Check your skin color, temperature and sensation before and after using ice packs and frozen gel packs. Do not use cold therapy on red areas or if you have any burning or numbness near the application site.
- Call your surgeon if you have any questions or concerns about your skin or how to safely use cold therapy.
Muscle 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.
Strengthening
Do these exercises to strengthen your muscles.
How often: 2 to 3 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 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)
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.
Leg slides (abduction/adduction)
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.
Straight 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.
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. Straighten 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.
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. Slide 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.
Sitting kicks (long arc quadriceps)
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.
Range of motion
Do these stretches to increase your knee motion.
How often: 3 times a day
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.
You can also do this stretch lying on your bed with a rolled up blanket or towel under your ankle.
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 warm up. You may want to use a plastic bag under your foot to help it slide easier.
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.
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 5 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.
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