How to Strengthen Knee Muscles After Knee Replacement

Total knee replacement is an extensive surgery that uses metal and polyethylene prostheses to replace the articulating surfaces of the knee joint. The surgery can help improve mobility and activities of daily living in patients with joint degeneration. Given how essential the knee is for daily activities, it is crucial to regain full strength in the muscles that surround and support the knee. Recovery from the surgery is a multi-stage process, beginning the moment you wake up from surgery.

Things You'll Need

• Table or Chair
• Ankle weights (1-lb. increments from 1 to 10 lbs.)
• Small towel

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Instructions

Day 1

• 1

  Sit or lie down in bed so that you can see the foot on your injured leg. Focus on flexing your ankle upward as far as it will go (only the foot and ankle should move, not the leg). Hold it in this position for one second, then extend the ankle as far down as it will go, also holding for one second. Perform two sets of 8 to 10 ankle pumps on the injured leg.

• 2

  Lie on your back or similar surface. Keep the injured leg straight and attempt to contract the quadriceps (muscles in front of thigh) without moving or lifting the leg. Since the surgery involves cutting through live tissue, the contractions may have very little force, but that's OK. It is important to try. Perform three sets of eight quadriceps contractions, holding each for three to five seconds.

• 3

  Lie on your back in bed or on a flat surface. Contract the muscles in the back of your injured leg and butt without moving the leg. Hold each contraction for three to five seconds and relax. Perform three sets of eight gluteal contractions.

Day 2 to 5

• 4

  Continue to perform the ankle pumps, quad and gluteal contractions, and add heel slides, straight-leg raises, and isometric hip adduction. You may be instructed on transferring yourself between a bed and wheelchair, standing and sitting, and toilet use.

• 5

  Perform heel slides either lying in bed, or on a flat smooth surface. Bend the uninjured knee so your foot is as close to your butt as possible. Keep the heel of your injured leg touching the table and slide it up toward your butt as far as you can. If needed, use your hands to help get your leg started, but focus on using your leg muscles mostly. When you get as far as you can, mark the spot and slide the heel back down to the starting position. Try to slide the heel further up each time. Perform three sets of 10 heel slides.

• 6

  Lie down on a flat surface and bend the uninjured leg so your foot rests next to the injured knee. This will help give you support when you perform the exercise. Keep your back flat on the bed and lift your injured leg straight up. Try to bring it as high as your other knee, hold it for a second, then slowly let it back down. Perform three sets of 10 straight-leg raises.

• 7

  Perform this exercise seated if possible, and lying on your back if not. Place a rolled-up towel between your knees and squeeze your knees together. Your legs should not actually move. Hold the contraction for three to five seconds, then relax. Perform three sets of eight repetitions. This is known as isometric hip adduction.

Day 5 to 4 Weeks

• 8

  Continue to perform heel slides, straight leg raises, and adduction exercises at least once per day. As your range of motion and strength return, more challenging exercises like seated leg extensions, standing hip adduction, and eventually knee bends.

• 9

  Sit in a chair or on a table with your feet hanging, not touching the ground. Start with your knee bent at 90 degrees, and extend your lower leg upward as far as you can. Try to get the leg completely straight. Hold the leg at the top of your extension, then slowly lower it to the starting position. Perform three sets of eight quadriceps extensions.

• 10

  Hold on to a railing or wall to stabilize yourself. Keep the knee straight and lift the injured leg out to the side as far as you can. Hold the contraction at the top for a second, then slowly lower your leg back to the start. Perform three sets of eight repetitions. This is called hip adduction.

• 11

  Stand with your feet shoulder-width apart, and your hands holding on to something for support. Slowly bend both knees to lower yourself into a semi-squat. Do not bend your knees more than 30 degrees. Push from the bottoms of your heels and raise yourself back up to standing. This exercise may be done while leaning your back against a wall for support as well. This will also keep your back straight. Perform three sets of five knee bends to start.