Total Knee Replacement Protocol Exercises

Total Knee Replacement Protocol Exercises

 

 Following a Total Knee Replacement, the initial most important focus is to gain full knee extension range of motion.  As stated in  prior posts, in order to prevent the knee from being 'stuck' in a flexed position, pillows or towel rolls should not be placed under the surgical knee (even though this is much more comfortable than keeping the knee straight).  One of the more basic exercises that should be performed by patients recovering from a knee replacement is described below.  Multiple videos of the knee replacement protocol exercises are provided in the Strength On Demand Knee Replacement DVD. 

  Many times, immediately following surgery, the operative leg is not strong or flexible enough to perform knee extension or flexion through the available range of motion.  Therefore, using the stronger unaffected side to assist each movement is a great technique to maximize mobility of the surgical knee.  This activity is called Active-Assistive Range of Motion Knee Flexion and Extension.  In the two images above, the surgical knee is the exposed side.  The stronger side's foot is hooked under the weaker side's ankle.  In order to assist knee extension, the strong leg pushes the weaker leg into a straight knee position.  This is Active Assisted Knee Extension.

 

In these two images, the stronger side hooks on top of the weaker side.  To assist knee flexion of the surgical knee, the stronger knee bends, pushing the surgical side's foot back, under the chair.  This causes the operative knee to bend further and is called Active Assisted Knee Flexion.

With limited knee flexion and extension range of motion, daily functional activities such as transferring from sit to stand and vice versa are usually affected and asymmetrical. 

In the above three images, the surgical side is represented by the 'non-sock' side.  Usually, upon attempting to sit down, the patient will bring the affected side forward, lowering their body down to the chair using the non-surgical side.  This limits the amount of knee flexion required from the surgical side and places most of the body weight on the non surgical leg.  Initially, patients use this technique to avoid pain.  In the seated position you can see the difference in the amount of knee flexion range of motion required from either leg.  To return to standing, a patient usually takes on the same position, placing more body weight (and therefore more stress) on the unaffected side.  Using this technique for an extended period of time not only 'underworks' the recovering leg but also 'overworks' the unaffected leg.  This may cause knee problems on the "good side" in the future.

                  

The above three images show the goal for the sit to stand technique.  Both feet remain in alignment as your patient moves from stand to sit to stand.  There is no compensation and both knees appear to have similar flexibility.  Focusing on this positioning technique each time you attempt to sit or stand will actually help to stretch the recovering knee, allowing gains in both knee mobility and strength daily.

 

Some of the other common Knee Replacement Exercises provided in the Strength On Demand Video Protocol are: 

 

Ankle Pumps

Glute Sets

Quad Sets

Straight Leg Raises

Heel Slides

Hamstring Stretch

Mini Squats

Step Ups

Tugboats

Single Leg Stance.....
and more!