Recovering from Knee Replacement Surgery — What to Expect in Physical Therapy

Recovering from Knee Replacement Surgery — What to Expect in Physical Therapy

Your knees have taken you many places in your life. They’ve helped you walk, run, squat, and climb stairs countless times. You may have put them through long shifts at work and/or years of competitive sports. With all the activity they've done it makes sense that they will eventually begin to wear down. When they become worn down enough to cause pain and limitations, then an Orthopedic Surgeon may recommend a knee replacement surgery. 

When you experience a knee replacement surgery, Physical Therapy is a crucial factor in making the most of your new knee. When recovering from this procedure you can expect swelling, pain, limited range of motion, weakness, and a substantial scar down the front of your leg. Your leg would have gone through a major operation. It's understandable that it will take some time to get back to normal. You may not want to know all the details but let's just say the Surgeons use a fair amount of medical-grade power tools and specialty hardware to create your new knee. I don't say this to make you nervous. Almost 800,000 knees are replaced in the US last year. Over 90% of them successful for well over 10 years. That number seems to be constantly improving. There's an entire industry of professionals constantly working to improve the procedure even more. I've experienced many patients saying they were happy they had the procedure and now live without knee pain. You just have to get through the recovery and rehab process to unlock the full benefits of getting this joint replacement. For most, that means going to Physical Therapy. Let's learn about what the Physical Therapy may consist of. 

What are the goals of Physical Therapy after knee replacement?

1. Achieve Full Range of Motion in the Knee

      After surgery your knee is going to be very stiff and swollen. Your Physical Therapists first goal is going to be to get you back to full range of motion, including bending your knee to about 135 degrees and completely straightening your knee to 0 degrees. You may be limited in both directions initially after surgery. 

2. Regain Strength

      You will initially begin to relearn how to use the muscles surrounding your knee. The movements may be painful at first but you will gradually increase the difficulty of exercises and resistance until your new knee is at optimal strength. 

3.  Return to your daily tasks and activities you enjoy. 

              Eventually you will be able to return to doing what you love. Share details with your PT about what your typical daily activities are. Share your profession, hobbies and other things you enjoy spending your time with. This could include working in a factory, playing pickleball, keeping up with your grandkids, doing yard work, etc. This will help shape your Physical Therapy plan in order to get back to your day-to-day activities.  

What can patients expect during physical therapy sessions?

Stretching

You can expect stretching during your PT sessions, especially in the beginning before you have achieved full range of motion. The therapist will likely manually stretch the knee by bending it and straightening it. This can be the most painful part of your rehab. Just know that this is temporary and it will get better. In my experience the first session or two are the most painful and it becomes more tolerable each session. You should also be doing some stretching at home. Your PT or PTA may give home stretching exercises such as Heel Slides.

Work on trying to get your knee to bend as far as possible. Initially you will feel some discomfort at the end of your range of motion. Go as far as you can tolerate and hold for 15-30 seconds, then release, and repeat 10-15x multiple times per day.

You can use a belt, towel, or our favorite CTLR Stretch out Strap to help you achieve a greater stretch. 

Strengthening
Your strengthening exercises will start out simple so you can relearn how to properly engage the muscles that move your knee. You'll likely get used to performing Quad Sets, Straight Leg raises, knee extension and knee flexion exercises. Your goal is to strengthen the muscles that help straighten and bend your knee. Perform each of these 2-3 sets of 10-15x daily. 
As you get stronger, you may start to do more challenging exercises and add resistance to your current exercises with ankle weights or resistance bands. You can easily add resistance to your exercises with Renoj Resistance Bands or Sportneer Adjustable Ankle Weights. Add squats and step ups onto step to your exercise program if you are able to tolerate them. This will continue to improve your knee strength, stability and ability to return to normal daily activity. 
Another crowd favorite for improving knee strength and range of motion is the Seated Elliptical. A convenient exercise product that allows you to pedal in your living room, using your knee muscles and promoting knee range of motions and circulation. A highly recommended product. 

Managing Pain and Swelling
Your pain and swelling is going to fluctuate for several months throughout this process. Your therapist will likely elect to finish your PT sessions of with Ice, Compression, and/or E-Stim (Electrical Stimulation). Keep in mind that there are contraindications for E-Stim such as having a Pace Maker, other heart conditions, cancer and infections. Talk to your medical provider before use. 

Here are some products you can use at home to help control pain and swelling: 
Revix Gel Ice Pack- We love this ice pack because it stays cold for long periods of time and it's a good size that will surround your knee. This ice pack will become your best friend for the first several weeks after surgery. 
Incrediwear Compression Sleeve- This is a great tool to manage the swelling in your knee that will occur in those first few weeks after surgery. Combine this with periods of ice and elevation to keep your knee from swelling up. 
Highest Rated TENs Unit on Amazon- This TENs 7000 unit will provide an electrical stimulation to your knee to help with pain and swelling. Arrange the pads in an X formation, crossing your knee from from top to bottom and side to side. Turn up the unit to a strong, yet tolerable intensity and keep on for about 15 minutes. This can be done simultaneously with your ice pack. Make sure you check for contraindications, such as heart conditions or presence of a pace-maker. 

The Road to Recovery
Initially you are going to experience some pain, swelling, and tightness in the knee. You'll undergo some intense sessions of stretching and exercising your new knee. Hang in there, continue to do the work each day and you'll begin to see the benefits of your knee replacement. As soon as 2-3 months after surgery you should begin to feel more like yourself before you were having knee pain. Remember to stay consistent with your stretching, exercises, icing, elevation, and managing your pain and swelling. Soon enough it will all pay off. 

*This blog post contains general information about health and exercise. It is not intended as medical advice and should not be relied upon as a substitute for professional medical consultation. Always consult your physician or a qualified healthcare provider before starting any new exercise program, especially if you have any medical conditions or concerns.

Additionally, this post may contain affiliate links to products on Amazon.com. As an Amazon Associate, I earn from qualifying purchases. This means I may receive a commission if you make a purchase through these links, at no additional cost to you.

 

Back to blog