Knee Replacement Guidebook
Physical & Occupational Therapy
Knee Replacement Guidebook Home | Getting Ready for Surgery | What to Expect the Day of Surgery | Physical & Occupational Therapy | At Home After Surgery
An occupational therapist may see you after surgery to assess how you are able to take care of yourself, suggest possible modification you should make in your home, and make sure you have the equipment you need for everyday tasks. These equipment items may include:
- Long reacher and/or dressing stick
- Long-handled sponge
- Sock aid
- Long shoehorn
Dressing yourself
- When dressing your lower body, sit in a chair or at the edge of your bed.
- Dress the surgical leg first.
- If you have trouble reaching your feet after surgery, place your feet on a stook or wastebasket to reach them more easily.
Tips for walking
- On the stairs: go up with the good (unoperated) leg and down with the bad (operated) leg
- Walking on level ground: a rolling walker is the best option. It allows you to walk naturally "step-over-step" (allowed in the first week after your surgery)
- Walking with crutches: your therapist will show you the safest way to use crutches
How to approach stairs
Your therapist will teach you the best technique of how to approach stairs:
- Sideways, holding the railing as you go up and down
- Facing the stairs with the railing on one side and one crutch on the other side as you go up and down
- Stepping up backwards with walker if you only have to go up one large step
- Stepping down with walker if you only have to go down one large step
What to do if you fall
- If you are hurt, do not get up. Call for help.
- If you are not hurt and are on the ground floor:
- Scoot on your buttocks to the bottom of the stairs
- Bring a crutch or your walker with you
- Bump up two or three stairs and slowly get up, using the crutch or walker to support you
- If you are not hurt and are upstairs:
- Bring a crutch or walker with you
- Scoot on your buttocks to the top of the stairs
- Use the railing to get up to your feed
- OR
- Bring a crutch or walker with you
- Arrange a stool in front of chair
- Bump up onto the stool and then onto chair, then to your feet
1. Ankle pumps: the most important exercise of all
- While lying down or reclined on the bed, point your toes up to the ceiling and then point down as far as you can go.
- Repeat ten times every hour.
2. Buttocks exercises
- While lying down or reclined, pinch your buttocks (“cheeks”) together.
- Hold for a count of five, then relax.
- Do ten repetitions, six to eight times daily.
3. Inner-thigh exercises
- While lying down or reclined, squeeze a pillow between your knees to tighten the muscles of your inner thighs.
- Hold for a count of five, then relax.
- Do ten repetitions, six to eight times daily.
4. Thigh exercises (to strengthen muscles on front of thigh)
- While lying down or reclined, have someone place a rolled-up towel underneath the knee of the operated leg.
- Push the back of that knee down and try to straighten your leg.
- The muscles on the front of your thigh should tighten.
- Hold for a count of five, then relax.
- Do ten repetitions, six to eight times daily.
5. Hamstring muscle exercises
- While lying down or reclined, dig your heel into the bed (or your recliner's foot rest).
- You should feel the muscles on the back of your thigh tighten.
- The back of your knee should lift off the bed slightly.
- Do ten repetitions, six to eight times daily.
6. Heel slides
- While lying on your back, bend the knee on the operated side with your heel touching the bed the entire time.
- Then flatten out your foot.
- Slide your foot back down and slowly straighten your leg.
- Do ten repetitions, three times daily.
7. Quadriceps exercises
- While lying on your back, have someone place a rolled pillow under the knee on your operated side.
- Lift your foot up to make the knee straight.
- The back of the knee should not come off the pillow.
- Do ten repetitions, three times daily.
8. Straight leg raises
- While lying on your back, bend the non-operated knee with your foot resting flat on the bed; keep your operated leg straight.
- Push your operated knee down so it is completely straight.
- Slowly lift your operated leg into the air to the height of the other knee and then slowly lower it.
- Do ten repetitions, resting in between each, three times daily.
Those with bilateral knee replacements should follow the above instructions and do one leg at at time; support the relaxed knee on a pillow.
9. Sitting active knee bending and straightening
- Sit on the edge of a bed or in a chair.
- Bend your knee on the operated side as far back as you can with the foot on the floor.
- Hold steady for a count of five, then release.
- Straighten your knee as far as it can go while keeping your thigh down and completely supported, hold for a count of five.
- Do ten repetitions, four to six times daily.
10. Passive knee straightening
- Sit in a chair, facing another chair.
- Rest the foot of your operated leg on the other chair.
- Rest in this position to allow your knee to gradually straighten.
- Do for 1-15 minutes, three to six times daily.
11. Passive knee bending and active straightening
- Sit in a chair, facing the wall with your toes facing the wall.
- Little by little, push yourself closer to the wall by scooting your buttocks toward the edge of the chair to increase the bend in your knee.
- Try to hold this position for at least one minute, or longer if you can tolerate it
- At the end of one minute, rotate the chair to the side.
- Lift your foot to straighten your knee completely several times, being sure to keep your thigh completely supported on the chair
- For those with a single knee replacement, you can position yourself at the end of a wall and then lift your foot into the open space.
- For those with bilateral knee replacements, use an armless chair and you can rotate to the side of the chair; to get out of the chair, use the back and the seat to push up to a standing position.
- Do five, one-minute stretches, six times daily.
12. Knee bending and straightening on back
NOTE: Do this exercise only after you can comfortably complete exercise #8 (straight leg raises).
- While lying on your back on the bed, pull your operated knee up toward your chest.
- Place your hands under your thigh to support your knee.
- Hold this position for 30 seconds, then straighten your knee for five seconds.
- Do five to ten repetitons, three times daily.
13. Standing knee bends
Position #1
- Stand behind a chair or with your walker.
- Lift your leg up in front of you to allow your knee to bend
- Do ten repetitions, three times daily.
Position #2
- Stand behind a chair or with your walker.
- Bend your foot up behind you, towards your buttocks.
- Keep your thights in line with each other
- Do ten repetitions, three times daily.
Position #3
- Stand behind a chair or with your walker
- Shift your weight onto your operated leg while straghtening your knee.
- For bilateral knee replacement, shirft your weight side to side using the same technique in order to exercise both knees.
- Do ten repetitions, three times daily.
14. Passive knee straightening and active bending on the stomach
Position #1
- Lie on your stomach with your feet hanging off the edge of the bed.
- Progressively move further toward the edge of the bed so that your entire lower leg is off the bed and the edge of the bed is just above your knee.
- Hold position for one to five minutes to stretch; can add two or three pound ankle weights to enhance the stretch as you get stronger.
- Do five repetitions, three to four times daily.
Position #2
- Lie on your stomach with your feet hanging off the edge of the bed.
- Bring your heel towards your buttocks to bend your knee as far as possible.
- Do five repetitions, three to four times daily.
15. Standing calf stretch with quadriceps set
- Stand with support on a step or stair with your heels hanging off the edge of the step.
- Straighten your knee as far as possible by tightening the front of your thigh.
- Feel the stretch in your calf and back of your knee. Hold for 20-3- seconds, then rest.
- Do five repetitions, three to four times daily.
Knee Replacement Guidebook Home | Getting Ready for Surgery | What to Expect the Day of Surgery | Physical & Occupational Therapy | At Home After Surgery
