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What Is The Normal Range Of Motion After Knee Replacement

How Long Does It Take To Recover From Knee Surgery

Increasing Range Of Motion after total knee replacement

The timeline for recovering varies from patient to patient, but typically the rehabilitation process takes 10-12 weeks of therapy to reach goals of achieving range of motion, strength, and performing functional activities such as standing from sitting, walking, and climbing up/down stairs independently without difficulty or pain.

Knee Replacement Recovery Continues Once Youre Home

Even though hospital stays for knee replacement surgery are shorter than they used to be, getting back on your feet still takes time, says Dr. Parks.

The next phase of recovery continues at home, as patients begin acclimating to normal activities, such as moving between rooms, getting up and sitting down in furniture, and using the bathroom. While everyone is different, many patients are likely to have similar experiences during the early weeks of recovery.

For Barnes, stability was a big issue. I became very aware of where I was placing feet, for example, when stepping off a curb. I just felt a little clumsy early on after surgery so I was afraid of falling.

In addition, she experienced a lot of swelling. The hospital gave me a special brace that circulates cold water around the knee, which was great and helped with swelling, she says.

Whether your doctor has prescribed formal outpatient physical therapy or has entrusted you with an at-home regimen of walking and exercises, patients progressing through recovery achieve some big milestones along the way.

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What Is Considered A Functional Rom

In order to complete your normal activities of daily living with ease, your knee has to be able to move freely. After a total knee replacement, at the very least 100-110° of knee flexion is needed to perform basic ADLs such as sitting, walking, and stair climbing. However, some activities may require even more knee flexion for optimal performance and comfort.

  • Walk on level surfaces: 60-75°
  • Go up and down stairs: 80-90°
  • Sit and stand from a regular chair: 90-95°
  • Sit and stand from a low chair: 90-115°
  • Squat: 110-165°
  • Sit in a bathtub: 135°

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What To Expect After Knee Replacement Surgery

Typically a patients knee will be swollen, stiff, weak, and sore following surgery. This makes functional activities such as walking and standing up difficult to perform.

The timeline for regaining strength and range of motion after knee replacement is variable. These two elements are key to successfully completing the total knee replacement recovery process.

Why Is Early Rom Important After A Total Knee Replacement

Range Of Motion Chart After Total Knee Replacement

After surgery, you will likely experience some degree of pain and swelling surrounding the knee joint. In addition, scar tissue formation as part of the healing process can cause the knee joint to become stiff or âstuckâ in a position that negatively impacts range of motion. Performing ROM exercises early on can help reduce swelling around the joint and decrease the formation of scar tissue, both of which will help the knee to move with greater comfort and allow for increased range of motion so that you can get back to doing the things you love sooner.

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How Long Will I Be On Pain Medication After My Knee Replacement Surgery

Every patient experiences recovery from a knee replacement surgery differentially and as such, everyone will require pain medication at different intervals and for different amounts of time. There is no standard approach to this, although generally we do expect patients to be weaned off their narcotic analgesics within 2 to 3 weeks of the surgery and by 6 weeks after the surgery should only be requiring occasional Tylenol or a less potent analgesic to control their pain.

With that being said, there are a number of different factors that can affect a persons ability to tolerate pain medication or indeed their ability to have the pain medication kill their pain. As such, each medication regimen will be tailored to the individual. It is important to regularly communicate with your surgeon or healthcare provider regarding your experience of the pain and your current pain medication regimen, so that it can be altered to suit you and your needs.

Second Week Progress After Tkr: Range Of Motion

During the 3rd session my therapist added another set of 5 standing exercises to go along with the 5 that I was already doing on my bed. She complimented me about my ability to do the exercise and was impressed with the progress I was making and she made note of the reduction in swelling.

At the end of the session, she measured my flexion at 95 degrees. The exercises and the measurements were both painful. The results were worth the pain.

The two exercises that hurt the most but that did the most good were: the ankle slides on the bed using a robe rope to pull the foot as far as I could towards my butt and the foot slides sitting on a chair sliding my foot in a plastic bag on a tile floor as far back to the chair as possible.

During the second-week post-surgery I continued to make progress with my flexion. The pain did not decrease during the workouts but the results motivated me to continue the workouts when I felt like cheating or skipping one.

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During the 2nd week, the swelling went down so much that the surgical knee began to look like a knee instead of a swollen mass. Day 10 post-surgery, I had 98 degrees flexion. Day 12 after surgery, I had 100 degrees flexion, and Day 14 after surgery, I had 110 degrees flexion.

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I Feel Pain When Performing Rom Exercises Is It Normal

While total knee replacements are routine surgeries with great outcomes, thereâs no denying that movement during the recovery process is likely to be painful. Be patient with yourself – your knee just underwent a surgical procedure and the surrounding tissues are healing. Contrary to what you might think, early movement is essential for recovery and will decrease pain and stiffness in the long run. Your physical therapist will guide you through exercises that are safe for you to perform in order to increase ROM, even if you feel some soreness. Donât worry, just breathe, take it one step at a time, and know you are on your way to getting better.

What Restricts Knee Rom

Painful Range of Motion Issue After Knee Surgery – ACL Reconstruction

There are a number of things that can restrict normal knee range of motion, the most common being:

  • Swelling: increased fluid inside the knee joint restricts movement. Find out how to reduce knee swelling to regain knee ROM
  • Pain: when pain is bad, it can stop us wanting to move the knee.
  • Impingement: where something gets stuck inside the joint and blocks movement e.g. meniscus tear
  • Muscle Tightness: tight muscles may limit how much the knee can bend or straighten. Knee strengthening exercises can really help
  • Muscle Weakness: if there is sufficient loss of muscle power, then you might not be able to fully bend or straighten your knee. Knee stretches can help to improve your flexibility and knee ROM
  • Wear & Tear: degeneration of the knee bones and the formation of bone spurs can impede knee movement, most typically due to knee arthritis

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Range Of Motion Basics You Should Know

Impress your physical therapist and care team by knowing some of the basic terms and important measures surrounding your range of motion.

Range of Motion The normal movement of your joint, measured in degrees from the center of your knee. Range of motion includes flexion , extension , adduction , abduction , rotations . ROM is measured using an instrument called a goniometer. For instance, a completely straight knee joint measure 0° while a fully bent knee clocks in at about 135° degrees of flexion.

  • Knee Flexion The measurable degree in which your leg is bent. Think about laying on your stomach and bending your leg toward your buttocks. This requires knee flexion.
  • Knee Extension The measurable degree in which your knee is extended. Think of standing on one leg and raising your surgical leg behind you like youre stepping backwards or karate kicking someone behind youhiya! This requires knee extension.
  • Active Range of Motion Moving your knee joint to its maximum potential without any assistance.
  • Passive Range of Motion When your therapist or a piece of equipment moves your knee through a range of motion without any effort from you.
  • Active Assistance Range of Motion Moving your knee through a range of motion exercise with some assistance from your therapist of a piece of equipment.
  • Extension Lag When you cannot extend to a completely straight position .
  • Flexion ContractureWhen you cannot extend your leg, with or without assistance.

Pain After Total Knee Replacement

You will experience some postsurgical pain in the area that has been operated on after your knee replacement. This is normal and you will be prescribed medications by your surgeon to attempt to control your pain and bring it within tolerable levels. It is important to remember that, at this stage, it is unrealistic to expect that there will be no pain and so a small amount of soreness in and around the knee is normal. It will take one to two weeks for the postsurgical pain to dissipate however, this does not indicate that the knee has fully healed.

There will be some discomfort in the knee up to around 6 weeks following the surgery and in some patients, this may even persist up to 3 months following the surgery. The pain is caused by a number of factors including the muscles around the knee recovering from the surgery and regaining strength that they have lost as a result of the surgery, as well as other tissues around the knee healing and getting used to the new biomechanics of the knee joint.

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What Is Full Range Of Motion For A Knee

The normal knee is involved in five main movements. These include:

  • Flexion, or bending
  • Adduction, or moving toward the center of the body
  • Abduction, or moving away from the center of the body
  • Rotation, or twisting in and out

Recovering from knee replacement requires regaining the full range of these movements. However, the term “knee range of motion”and specific measurements of your progressfocus mostly on flexion and extension.

Knee range of motion is measured in degrees of flexion. A fully extended knee will measure 0º of flexion. Meanwhile, a fully bent knee will measure 135º of flexion.

Even otherwise healthy patients vary in their ability to match these measurements. This means that as you recover from surgery, you should not necessarily target these measures of full flexion and extension. Rather, you should evaluate your progress by your own ROM measures before surgery.

You should also evaluate your progress by your ability to carry out daily activities. In general, knee flexion measures in the range of 105º-110º enable the completion of many necessary activities. Reaching 125º and higher permits additional activities that involve intense bending.

The following measures offer a general guide to the flexion required for daily activities:

  • 65º for walking
  • 95º for getting up from a seated position
  • 105º for tying your shoelaces
  • 115º+ for sitting cross-legged or riding a bike
  • 125º+ for most other activities

Looking After Your New Knee

Range of motion and why it is important following knee replacement
  • continue to take any prescribed painkillers or anti-inflammatories to help manage any pain and swelling
  • use your walking aids but aim to gradually decrease the amount you rely on them as your leg feels stronger
  • keep up your exercises to help prevent stiffness, but do not force your knee
  • do not sit with your legs crossed for the first 6 weeks after your operation
  • do not put a pillow underneath your knee when sleeping as this can result in a permanently bent knee
  • avoid twisting at your knee
  • wear supportive shoes outdoors
  • do not kneel on your operated knee until your surgeon says you can
  • raise your leg when sitting and apply an ice pack wrapped in a tea towel for 20 minutes every 3 or 4 hours to reduce any swelling

Page last reviewed: 02 August 2019 Next review due: 02 August 2022

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Comprehensive Physical Therapy In Myrtle Beach And Horry County To Help You After Knee Replacements

There are few things more rewarding than seeing patients return to their everyday activities without pain or discomfort. For millions of Americans, knee replacements have helped them regain the life they once enjoyed before knee pain.

Conway Medical Center has become a leader in this life-changing surgery by utilizing the latest advancements in medical technology and pain management. We offer both total and partial knee replacement procedures by leading orthopedic experts who have the extensive expertise and experience to help you.

Want to know more? Just contact us.

What Causes Limited Range Of Motion In The Knee Before Surgery

Prior to surgery, your knee range of motion will be limited by pain, swelling, and misalignment. Studies show that 80% of patients with osteoarthritis experience a limited ROM.

Most patients opt for knee replacement when the inflammation of osteoarthritis produces pain, swelling, and stiffness that cannot be managed by conservative measures. Severe osteoarthritis also involves deterioration of the bones in the knee joint. This deterioration can cause deformities, which further limit knee ROM.

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Range Of Motion 4 Months After Tkr

As Ive mentioned in other articles, your range of motion will increase the most in the few weeks after knee replacement .

However, you can still achieve some improvements in the 3rd and 4th months.

I would encourage you to continue to do the range-of-motion exercises that were prescribed by your physical therapist. I use a fitness center to continue my workouts Use your Silver Sneakers free pass if you are over 65.

Ive developed a routine with the physical therapy exercises, the stationary bike, and regular bicycle rides 6 to 10 miles. I believe they continue to help me maintain flexibility and help me to increase my range of motion, slowly, by a few degrees.

I am not seeing the huge gains as I did early on, but I am increasing my range of motion little by little.

I continue to massage my knee with Free Up before and sometimes after workouts. It helps to loosen the knee before activity and feels better when I begin my exercise.

Possible Benefits Of Total Knee Replacement Surgery

Best Range of Motion after Total Knee Replacement

Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement is performed the goals and possible benefits are the same: relief of pain and restoration of function.

The large majority of total knee replacement patients experience substantial or complete relief of pain once they have recovered from the procedure. The large majority walk without a limp and most dont require a cane, even if they used one before the surgery. It is quite likely that you know someone with a knee replacement who walks so well that you dont know he even had surgery!

Frequently the stiffness from arthritis is also relieved by the surgery. Very often the distance one can walk will improve as well because of diminished pain and stiffness. The enjoyment of reasonable recreational activities such as golf, dancing, traveling, and swimming almost always improves following total knee replacement.

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Minimize Pain And Improve Range Of Motion

When there is pain in the knee our team of Atlanta orthopedic doctors will also evaluate your hip, foot and ankle to ensure that all those bones and muscles are strong and aligned properly. When the hip is misaligned, there is an added stress put on the knee resulting in added pain. Working to improve the quality and strength of your hip has shown to improve and reduce the pain felt in the knee.

When muscles are tense, they can often be attributed to knee pain as well. If there isnt adequate flexibility in the calves, hamstrings and quads this can oftentimes lead to increased or chronic knee pain.

As your knee is located in the middle of the hip and the foot, building a support system can take away the added pressures felt by this middle joint which sustains and endures a lot of impact. Strengthening and increasing flexibility to the surrounding areas will help build a solid support system for the knees.

How To Improve Knee Flexion After Surgery

After surgery, understanding how to improve knee flexion is absolutely critical. While weve discussed the importance of regaining knee extension extensively, restoring knee flexion is a close runner up for your rehab goals after surgery. Restoring knee flexion is often not comfortable , but with dedication and consistent time spent working on your mobility, we are confident you can get there! In this article, were going to cover some of our favorite exercises to improve knee flexion after surgery!

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Knee Flexion Active Range Of Motion

Knee flexion AROM was measured in a supine position via long-arm goniometry . Briefly, patients were allowed to practice bending their knee 5 times, with therapist-assist as needed, prior to the therapist making the final assessment. For the final assessment the knee was placed in extension, and the patient was instructed to flex the knee as far as possible using only muscle power, leaving the heel on the surface. The fulcrum of the goniometer was placed at the medial joint line, with the lateral malleolus of the fibula and greater trochanter of the femur as distal landmarks . Physical Therapists were trained on a quarterly basis in this protocol, to standardize the collection of outcomes measures. Flexion AROM was measured on a semi-weekly basis throughout postoperative rehabilitation.

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