Physical Therapist's Guide to Knee Replacement Rehabilitation

The two main muscle groups involved in moving the knee are the quadriceps and hamstrings. Having your patient strengthen and stretch these muscles through a variety of therapy exercises will speedup their knee replacement recovery process. You must emphasize to your patient the importance of being diligent and consistent in performing their physical therapy exercises. Their recovery is their responsibility. You are there to guide them.

In-Patient Exercises

• Get your patient up and walking. Walking will strengthen the entire leg and needs to be started the day after surgery, states the American Academy of Orthopedic Surgeons. Prior to your walking exercise, have your patient put on some nonslip slippers to protect him from slipping. Wrap a belt around your patient's waist and hold on to it in case he starts to lose their balance. Assist your patient in getting out of bed and onto a walker. Have the first walk be one-half hallway length and back. The following day, increase the amount of time spent walking.

  Recommend ankle pumps. With your patient laying in bed, have them point their toes away from them and towards them. The movement will be similar to moving their foot up and down while keeping their leg on the bed. This will help prevent blood clots from forming.

Outpatient Exercises

• Knee Stretching
  Do a hamstring stretch. Use ankle weights. Have your patient put a two-pound weight around her ankle on the surgical leg. With your patient lying on a flat surface, have her place their foot onto a wall. Have her scoot her buttocks as close as possible to the wall to increase the hamstrings stretch. Hold for as long as possible. Return to original position. Repeat.

  Stretch the quadriceps. According to thephysiotherapysite.co.uk, have your patient sit in a firm chair. His feet will be firmly placed on the floor. Gently and slowly have him move forward in the chair, causing his knee replacement leg to bend. Hold for 15 seconds. Repeat.

  Knee Strengthening
  Strengthen hamstrings. Have your patient sit in a wheel-based chair. Instruct her to pull herself around the room with her knee replacement leg. Depending upon the room size, give her a goal to reach.

  Strengthen quadriceps. Have your patient lay on a flat surface. Roll up a towel and put it underneath his knee replacement knee. Tell him to tighten his thigh muscles (quadriceps) and pull his knee down to the surface.

  Do heel slides. Virginia Mason Orthopedics recommends that you have your patient lie on her back on a flat surface with her legs extended. Have her lift the heel on her surgical leg up, which will bring the knee towards the chest. Hold for two seconds. Slowly slide heel back down to original position. Repeat five times.

Pain Medications

• Recommend pain medications to your patients. Since physical therapy can be very painful after a knee replacement, suggest that your patient take a pain medication 20 to 30 minutes prior to a therapy session. Pain medications can help your patient get more out of the physical therapy sessions with you.

Icing

• Ice your patient after a knee replacement therapy session. Icing, according to the American Academy of Orthopedic Surgeons, will help with both decreasing your patient's pain level and the inflammation caused by rehabilitation exercises. Suggest that your patient ice at home after doing home exercises, also.