Exercise And Physical Activity
The final phase of recovery, as Dr. Parks considers it, is returning to exercises and extra activities, including hiking and biking. It typically takes eight to 12 weeks to get to this phase, he says.
In terms of full knee replacement recovery, patients generally need a year to completely heal and regain total function.
After a couple of years, you forget that youve even had knee surgery, says Barnes, who would go on to have her left knee replaced a year after the surgery on her right. Before surgery I couldnt garden. Now I walk, snow shoe, and climb ladders. I do what I want and dont have pain.
What Should I Be Doing In The Early Stages Of My Recovery
- Continue your exercise program and increase activity gradually your goal is to regain strength and function.
- Follow all therapy instructions.
- Resume activity as you gain strength and confidence.
- For total knee replacement, swelling of the knee or leg is common with an abrupt increase in activity. If this occurs, elevate the leg above the level of your heart , and apply ice directly to the knee. You may continue with elevation and icing as needed to help decrease swelling and discomfort.
- Continued exercise at this early stage is important to achieve the best outcome with your new joint replacement. Based on your needs, your therapy may be continued at home or in an outpatient setting of your choice. You will be given an exercise program to continue exercising at home.
Dont sit for longer than 30 to 45 minutes at a time. Use chairs with arms. You may nap if you are tired, but do not stay in bed all day. Frequent, short walks either indoors or outdoors are the key to a successful recovery.
You may experience discomfort in your operated hip or knee, and you may have difficulty sleeping at night. This is part of the recovery process. Getting up and moving around relieves some of the discomfort.
You should climb stairs with support. Climb one step at a time good leg up bad leg down. Hold on to a railing, if available.
When youre a passenger in a car, sit on a firm cushion or folded blanket to avoid sitting too low.
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Activities With A High Risk Of Falling
After a total knee replacement, loss of strength, range of motion, and balance lead to an increased risk of falling. A fall can damage the prosthesis or interfere with the healing process.
A 2018 study found that 17.2 percent of a group of 134 people who had undergone a knee replacement fell at least once within 6 months of their operation. Roughly two-thirds of these falls occurred when walking.
Some lifestyle modifications to reduce your risk of falling include:
- using the handrail when going up and down the stairs
- using a rubber mat or shower chair when showering
- sitting down when putting on shorts or pants
- keeping the floor clear of stray toys, slippery rugs, and other objects that pose a tripping hazard
- avoiding slippery terrains like mud, ice, or wet grass
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Recovery Timeline For Knee Replacement Surgery
One of the most common questions patients ask after knee replacement surgery is how quickly they expect to recover. The recovery timeline varies slightly depending on age, weight, and general health.
If you have had surgery, the physiotherapist will come to your room within 24 hours of your operation. Youll start by standing and moving around using crutches or a walk. This is so that you dont lose muscle strength after being bedridden for days post-op.
Your medication has been prescribed beforehand. This means less discomfort while recovering at home alone once discharged!
This is important because it minimizes atrophy caused by extended time in bed. It reduces other medical complications associated with immobilization, like blood clots and pneumonia.
You will then attend an outpatient physiotherapy clinic where you visit a physio twice weekly for 30 minutes. You will then slowly reduce your appointments as needed.
However, rehab is not over yet because theres still lots of work that needs doing following this period! Barring any complications, you can expect to be discharged from the hospital after 3 days.
After youve recovered, rehab will focus on continuing to improve your mobility with an exercise program. This is to help build strength and range of motion.
How Can A Physical Therapist Help
The physical therapist is an integral part of the team of health care professionals who help people receiving a total knee replacement regain movement and function, and return to daily activities. Your physical therapist can help you prepare for and recover from surgery, and develop an individualized treatment program to get you moving again in the safest and most effective way possible.
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The Role Of Physical Therapy After Knee Replacement Surgery
Our therapists at North Boulder Physical Therapy know that understanding the role of physical therapy after knee replacement surgery is important to your recovery. Physical therapy helps you heal faster.
An article in Healthline lays out the timeline for the rehabilitation process after knee replacement surgery that can help you focus on getting back into an active life. Heres the step-by-step description of what you can expect during the 12 weeks of recovery and rehab after your orthopedic surgery. It also sets out the goals for your healing.
Day 1
Rehabilitation begins as soon as your surgery is over. Your doctor will want you to begin standing and walking using an assistive device with the help of a physical therapist within the first 24 hours. The sooner you get up and use your new artificial knee the better.
Every day the physical therapist will guide you through exercises with the goal of strengthening your muscles. The therapist will also show you how to get in and out of your bed and move around with the aid of an assistive device, like a walker, crutches or a cane.
They may also set you up with a continuous passive motion machine to use at home and some people even leave the operating room with their leg already in a CPM machine. The purpose of the CPM is to keeps your knee in motion to help prevent the buildup of scar tissue and the stiffness that results from immobility.
Day 2
Discharge
At discharge, you should be able to:
Your goals at Discharge are to:
First Outpatient Physical Therapy
This first visit will take about an hour. Expect to come to physical therapy twice a week for six to eight weeks. Its important that you take the same amount of medication you are normally taking to do your daily activities. Please dont take more or less medication for your PT visits, as this can make the session unnecessarily challenging.
- Wear loose-fitting pants or shorts so your therapist can see your knee
- Please wear good supportive shoes
- Your PT will ask about your knee and how you have been doing
- He or she will watch you walk, get out of a chair, and measure the strength and mobility of your knee
- A few light exercises, similar to what you have been doing at home, may be added to your routine
- Your therapist will develop a new home exercise program and schedule visits for the next month.
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Recovery From A Total Knee Replacement
The knee joint can be vulnerable to injury and to chronic conditions such as arthritis, which can cause pain, swelling, and stiffness. Knee replacement surgery, known also as knee arthroplasty, is often necessary when the knee joint is significantly worn or damaged.
This surgery replaces all or part of the knee joint with artificial parts depending on the damage that must be corrected. Knee replacement surgery can be a great solution to increase your mobility and provide significant pain relief once you have begun recovery from the operation.
How Will I Feel The First Few Days Back From Joint Replacement Surgery
No matter how much you prepared for your homecoming, it will be an adjustment. You will likely experience anxiety and question whether you were discharged too early. This is a normal feeling, so relax and focus on your recovery.
Depending on your surgeons policy, you may get a call from a care coordinator. This is your opportunity to report any problems and ask any questions. You may also get a visit from the physical therapist or occupational therapist within 48 hours of discharge. Your provider will let you know what to expect and the timelines involved.
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Range Of Motion After Knee Replacement Surgery: The Basics
Jul 5, 2017 | Uncategorized
This post was co-authored by Grace McClure and Dr. Nicholas Frisch
Throughout your knee replacement recovery, youll likely be monitoring, obsessing over, and measuring one thing: range of motion. Chances are your doctor and physical therapist will give you range of motion milestones to hit and chances are it wont be easy to get there. Gaining back knee flexion , extension , adduction , abduction , rotations must be worked towards. It not something that happens overnight.
When thinking about range of motion , that irritating saying, no pain, no gain comes to mind. To hit your range of motion goals after knee replacement surgery, youre going to have to work through some pain and dedicate yourself to improvement. Besides putting in good old fashion work, there are things you can do to accelerate and improve your post-op knee range of motion. Read on as we walk you through the best things you can do after knee replacement surgery to hit your ROM goals.
When Can I Stop Using A Cane After Knee Replacement
Within two weeks of surgery, some patients may walk without any device in the morning, but become tired in the afternoon and need the device again. The same concept applies to changing surfaces , inclines, or steps. It may be easier to walk in the house on a firm and predictable surface without a cane or walker, but going outside on uneven and unpredictable ground would be safer with an assistive device.
On the other hand, walking without a limp while using a walker will be necessary before moving on to walking with a cane or no assistive device at all. Tossing the walker or cane to the closet too soon can cause delayed recovery and possibly not regain a normal gait pattern.
Almost every PT has had a strong-opinionated patient that chose to walk without a walker or cane before the therapist was in agreement and had less successful outcomes in terms of their walking abilities. It is highly recommended that an assistive device is used for as long as needed to achieve the required strength, flexibility, and gait pattern.
This process requires patience and understanding from the patient that every surgery and recovery is different. This means that even though someone they know was walking without a walker after surgery before they are that they are not necessarily behind.
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Should Physical Therapy Hurt After Knee Replacement
Some pain after a knee replacement should be expected. Most rehabilitation programs for knee replacements usually include range of motion exercises, quadriceps strengthening, gait training and daily life training exercises. Its important to avoid straining or overworking the knee during your recovery period.
Using Physical Therapy To Ease Pain
Your therapist may choose from one or more of the following tools, or modalities, to help control the symptoms you may have from your knee surgery.
Rest: Rest is an important part of treatment after surgery. If you are having pain with an activity or movement, it should be a signal that there is still irritation going on. You should try to avoid all movements and activities that increase your pain. Be sure to use your crutches as assigned by your doctor, and put only the amount of weight on your leg as approved by your doctor.
Ice: Ice makes the blood vessels in the sore area become more narrow, called vasoconstriction. This helps control inflammation that is causing pain and can easily be done as part of a home program. Some ways to put ice on include cold packs, ice bags, or ice massage. Cold packs or ice bags are generally put on the sore area for 10 to 15 minutes.
Heat: Heat makes blood vessels get larger, which is called vasodilation. This action helps to flush away chemicals that are making your knee hurt. It also helps to bring in nutrients and oxygen which help the area heal. True heat in the form of a moist hot pack, a heating pad, or warm shower or bath is more beneficial than creams that merely give the feeling of heat. Hot packs are usually placed on the sore area for 15 to 20 minutes. Special care must be taken to make sure your skin doesnt overheat and burn. Its also not a good idea to sleep with an electric hot pad at night.
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How To Improve Knee Flexion
FREE
- HOW: Sit at the edge of a table or some sort of elevated surface. Ideally, you dont want your feet to touch the ground. Place your unaffected leg under your affected leg, fully supporting it. Slowly let your affected knee bend by lowering your feet. At some point, you will feel a gentle stretch. Hold for the desired amount of time, and then use your unaffected side to help straighten your knee out once again. Repeat.
- FEEL: If you are doing this after surgery, it is normal for this to feel a bit uncomfortable. There should never be any sharp pain, but aching is fine.
- COMPENSATION: Relax! Use your other leg to support your affected side.
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When Can I Get Back To My Usual Activities
Typically, patients can return to their usual activities such as work and exercise after six months. However, you mustnt push yourself too hard during this period because your body needs time to heal.
This expected recovery time is obviously variable and depends on several factors such as the skills and experience of your surgeon, how well you follow medical advice, and whether or not there were any complications during surgery.
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What Does Knee Replacement Surgery Involve
The team at Tri-State Orthopaedics provide the latest advancements in treating chronic knee problems. When conservative options arent enough, your provider may recommend knee replacement surgery. Also called arthroplasty, this procedure involves replacing the structure of the damaged knee joint with metal and plastic parts to restore the normal function of the knee and relieve chronic pain.
Knee replacement is an incredibly common and successful procedure. Over 90% of people who have knee replacement experience significant improvement in pain and their ability to get around. For most people, knee replacement restores a good quality of life, giving back independence and allowing you to engage in activities you used to enjoy. However, recovery is often a long road. If youre scheduled for or considering knee surgery, here are some helpful dos and donts in your path to recovery.
How Long Does Pain Last After Knee Replacement Surgery What To Expect
Knee pain can appear in many forms. Arthritis, an injury, and gradual wear and tear as you age can all have an effect on your activities and comfort level. If youre unable to walk or climb a stairs because of your pain , knee replacement surgery may be the best way to get your life back. While the benefits of the procedure may significantly outweigh temporary discomfort, its important to have realistic expectations regarding your recovery timeline and knee replacement pain after surgery.
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Stair Climbing And Descending
The ability to go up and down stairs requires both strength and flexibility. At first, you will need a handrail for support and will be able to go only one step at a time. Always lead up the stairs with your good knee and down the stairs with your operated knee. Remember, “up with the good” and “down with the bad.” You may want to have someone help you until you have regained most of your strength and mobility.
Stair climbing is an excellent strengthening and endurance activity. Do not try to climb steps higher than the standard height and always use a handrail for balance. As you become stronger and more mobile, you can begin to climb stairs foot over foot.
Stair climbing and descending using a crutch
Knee Replacement After One Month: Range Of Motion
Im currently going to physical therapy 3 times a week and working out at home on my off days. Im able to ride a stationary bike, albeit slowly, take walks a mile long, and do leg strengthening workouts .
Because the swelling has decreased I feel its helped with my ability to bend my knee. Also, my muscles and ligaments are continually being exercised and stretched I would not be doing as well if I wasnt active.
On my 4th visit to the offsite therapy my therapist measured my flexion at 115 degrees. He was pleased and told me I was doing better than the average patient and to keep up the hard work.
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Pain Medications After Knee Replacement Surgery
If a nerve block was used during knee replacement surgery, it may wear off shortly after being discharged. This means patients may have more pain at home than they did in the hospital. To decrease and avoid pain, patients will need to take oral medications.
The oral pain medications used may include:
- Opioid medications, such as oxycodone
- Non-steroidal anti-inflammatory drugs , such as ibuprofen and COX-2 inhibitors
- Aspirin, a pain reliever as well as a blood thinner
- Gabapentin, a medication developed to treat seizures but sometimes prescribed to treat nerve pain
People should not wait until their pain becomes severe before taking medications. Oral pain medications do not take effect immediately. In addition, pain is easier to stop before it starts.
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