When I talk about physiotherapy and surgery, people immediately assume I’m talking about recovering from an operation, when what is really needed afterwards is rest followed by a very gentle reintroduction to exercise and activity. But for surgery on joints, particularly knee replacement surgery, doing the right exercises to maximise leg strength before a procedure can make the post-op recovery much faster. Being physically prepared also has a very good effect on mental preparedness following an op.
Why is knee replacement surgery necessary?
Knee replacement, or arthroplasty, is most likely to be required by 50 to 80-year-olds who are suffering from a range of problems, including severe arthritis, injury, gout, cartilage loss, disorders causing unusual bone growth or bone death due to loss of blood supply (avascular necrosis). The procedure involves resurfacing the bones that make up the joint, including the kneecap, using metal or plastic parts to cap the ends.
Most patients can resume normal daily activities, including driving, within six weeks, but it may take three months to a year to recover completely and gain the full benefit from the procedure. Knee replacement surgery is often painful and recovery can take longer than a hip replacement. It’s useful to have this explained to the patient before the op to prevent anxiety.
If you’re having surgery you’ve probably lost a significant amount of function in your knee with a resultant weakness in the muscles surrounding it. Therefore, regaining the strength and movement in your knee, and entire leg, before surgery will improve your recovery after arthroscopic surgery because muscles play a crucial role stabilising the joint. Here is a list of exercises I choose from to give to my patients to perform two or three times a day in preparation for arthroscopy:
  • Quadriceps contractions
  • Straight Leg Raises
  • Knee Flexion/extension
  • Squats (one and two legs) if able
  • Single and two-legged balancing exercises
  • Lunges if able
  • Hamstring stretches
  • Cycling, either on a static bike or, if a regular cyclist, on a road or mountain bike. This is the most useful pre-op exercise as it maintains range of movement and strengthens all the leg muscles at the same time.
The difference made by pre-op exercise: two case studies
One of our patients at Petersfield Physiotherapy and Sports Injury Clinic came to see me prior to his knee replacement surgery and had this to say: “Just a short note to say how much the pre-hab has contributed to my recovery so far. The knee replacement was on the 21st, I was home on Saturday and I haven’t looked back. I have considerable mobility, no pain and walking is no problem. The staff were impressed with my leg mobility immediately post op – thanks to your guidance, Gerry.” However, another client wasn’t able to do so much preparatory exercises before his knee replacement surgery: “On reflection, I would have benefited from some physiotherapy work on the muscles beforehand to get the soft tissues in good order. Also, I would have had a better understanding of what to expect after the operation!”
Take action before your knee replacement op
Getting advice on the right exercises to do in the run-up before a knee replacement can make the post-op recovery much faster and more beneficial. If you’re booked to have arthroscopic surgery, talk to your physio about the best exercises for you. If you live in the Hampshire area and you’d like more information to help you recover more quickly from surgery and get back to a pain-free, active life, contact the Petersfield Physiotherapy and Sports Injury Clinic or ring 01730 267645.