Continuing Your Recovery Post a Total Knee Replacement: weeks 2-4

Thoughts for the next few weeks:
“Exercise is medicine and this is my daily dose”
“Each day I get better and better”
“Recovery is a process”

Things should be starting to improve. In my experience of working with patients, from being sore most of the time, there are good times in the day, patients still complain mostly about the pain at night. This is normal and will take time for this to improve.

There is a shift in exercises from mobility and quads strength, to working on strengthening of the lower leg.
They do not all have to be done at once. I have divided them into lying on your tummy, lying on your back and sitting, and standing.
Aim to work through a video 2x per day. Not all exercises have to be done every day.Listen to your body. Some exercises may cause discomfort but they should never cause pain. If an exercise causes pain, then back off. Try another exercise and then come back to the one that was harder.

Exercise is a journey. For some of you it is a journey back to a routine you had prior to surgery, for others of you it is perhaps a new step. We are all in different places, but the ultimate goal is to get better and live our best life.

The next video has exercises that are done lying on your back and on your tummy. They are:
• hamstring curls
• prone knee bend/ quads stretch
• prone knee
• prone knee extension
• mermaid push up/ cobra/ sphinx

The next set of exercises:
• Hamstring stretch
• Bridging- with and without a band
• Contract relax quads for knee bending

There are also some exercises in standing- ‘rock around the clock’

With a band around both legs pull the band with the operated leg.

  • to the side
  • to the back
  • bend the knee and back
  • forward

(You probably noticed that the standing leg did alot of work, from 3-4 weeks post op, you can start to balance on the operated leg and pull the good leg to the side, back and forward with the band. You will notice a different workout on the knee)

We still want you to use both your crutches and wear your stocking on the operated leg.
You can start going out a bit- no driving yet.
Go out for a coffee. Assess how you feel.

A common question we get- how do I know if I have done too much? You will either have pain during an activity, increased pain after (eg that night), or increased pain the next day.  A good example is to think if you want to go out for lunch, as you sit there you knee start to get sore- it is probably a sign that you want to start getting home instead of ordering a coffee. But week on week you will be able to do more and more. Your knee may also be more swollen than normal. When home the elevate your leg for a bit and get the swelling down. Using your ice pack can also help with the pain.

You may experience pain as you take on more things e.g.

  • around 4-6 weeks, when we start driving and with that comes doing more things
  • Returning back to work
  • Start doing more domestic duties e.g. household shopping etc.

This is normal and not something to worry about; however it does mean that you may have to adjust some activities e.g.

  • If you can, start by returning to work half day for the first week
  • Do some of the shopping at one time, rather than a big household shop. Take someone with you to help.
  • Adjust some of your activities on those days

As you get fitter and stronger you will take on more things. Be realistic about your progress. We expect things to take about 6 months to get back to normal and full recovery to take place within a year to 18 months.

The best treatment of osteoarthritis is diet and exercise.

Around two weeks post surgery, it is often useful to see a physio, to help you with the exercises and tailor them specifically for you. Also they can help you with range and guide you in the recovery process.

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