Written by Laura Ham

Tips for Rehab After Knee Surgery

As some of you know, I have recently taken a bit of a trip down surgery lane for my left knee. In honour of this event, I thought it might be a good chance to discuss post op management and tips for rehab after knee surgery that might make your recovery a bit more successful!

How should I prepare?

Before the surgery, have a good chat with your surgeon about the amount of time you will need off work. Make sure you’re made aware of any rehabilitation requirements, for example any post op restrictions, how quickly you need to see the physio, or any exercises you should begin (or avoid!) straight away. Also discuss your own personal goals and get a rough idea about when you will be able be able to get started with your recreational activity of choice, whether that be the odd run around the block, or the half iron man 6 months from now!

It’s also worth noting that prehab is the best rehab: the stronger your knee can be leading up to the surgery, the better results you will get afterwards. If you can, get your physiotherapist to make you up a program prior to going under the knife for best preparation!

What should I do immediately after surgery?

The knee will be swollen and painful following any type of surgery. Regular icing, elevation of the leg and use of a compression bandage will assist in settling down oedema as soon as possible.

The knee is somewhat predictable in its post op behaviour, whether you’ve had an ACL reconstruction, minor arthroscopy or knee replacement. Your stabilising quadriceps muscles have a tendency to switch off in the presence of any pain or swelling, which can lead to rapid wasting (atrophy) of your thigh muscles. This in turn can lead to feelings of instability, weakness and poor tracking of your patella. To address this quickly, you can start an exercise called ‘quads setting,’ which aims at getting your quads muscles activated so that they can do their job controlling your knee!

To do this, lie on your back and straighten your operated knee as much as possible. You can place a towel under your heel to help if you like. Then tighten the muscles at the front of your thighs, and press the back of your knee to the ground. Hold for 3-5 seconds, then relax. Repeat x 10 repetition, 3-4x per day.

Swelling and pain will also cause your knee to stiffen up and lose its range of movement. Starting some range of motion exercises (bending & straightening the knee, within your pain limits) early on will ensure that you regain your movement again quickly. Take note that some surgeons may request splints or movement restrictions for a portion of the post-op period, so be sure to follow your post op guidelines for this.

When should I see the physio, and what will physiotherapy involve?

We usually recommend seeing a physio within the first week to ten days following any joint surgery, as long as you are working on your swelling management, range of movement and quads setting exercises at home in this time – otherwise you may want to see them sooner. Your sessions will include some soft tissue massage and joint mobilisation, however the most emphasis will be placed on your home exercise or Pilates rehab program. This will address your specific weaknesses and often include strengthening of not only your thigh muscles but also those of your hip and core.

As you become stronger, your program will include sports specific drills, in order to progress you right on through to your recreational goals! For example, I’ve currently got Bede running me through my paces with arabesques for knee stability!

Lunges are commonly used for lower limb rehabilitation, particularly when returning to running or sport. Here’s an example of what you can expect from your lunge re-training at Viva Physio!

If you have any questions or would like some advice, feel free to give us a call at the clinic, or come in to see one of us today!