Recovery from knee replacement surgery: what to focus on first.

This particular article is for anyone who has recently had a total knee replacement.
When you’re discharged from the hospital after a surgery the doctors and nurses generally load you up with lots of instructions and lots of paperwork and send you on your way.

Don’t feel bad if you feel overwhelmed and a little confused by the time you get home. That amount of information in a very short period of time frequently leaves people in the dark about what is supposed to happen when they get home.

For anyone who has recently had a knee replacement surgery, from a physical therapy standpoint, there are only two things you really need to be concerned about. And there are three things that you really need to focus on doing.

Your home health nurse can especially help you with the two things you need to be concerned about. They are number one, preventing and infection, and number two, preventing a blood clot or DVT.

the three things you need to focus on doing after a knee replacement surgery are bending the leg, straightening the leg, and elevating the leg to manage your swelling.

It’s really that simple from a physical therapy standpoint. This is because the only thing that really does not return without a lot of effort after a knee replacement surgery is your range of motion.

Your ability to walk will return on its own. The ability to lift your leg will return on its own. The ability to get up and down from a chair, or get in and out of the bed, will return on their own.

But what makes all of these activities a lot easier to do, is having good range of motion in the surgical knee.

This is just as important for those who had their knee replacement some time ago. If you’re still not able to bend your knee or straighten your knee it’s a lot more difficult to move around.

So what should you be focusing on?

For knee flexion really focus on any activity that allows you to stretch the knee into flexion. This could be the heel slide. Or it could be something as aggressive as standing up and sitting down from a chair with your knees bent. If you try to do this last movement please make sure that you’re not trying to put all your weight on your leg.

In order to straighten your leg, the exercise you want to focus on is the hamstring stretch or the calf stretch. Both of these movements can be done either in sitting or lying down on the bed. Or with the calf stretch you can do that when you’re standing up. I have written a previous blog post about that with a photo.

So just remember for those of you who have recently gotten out of the hospital and are a little confused with what to do next, the emphasis should really be on preventing infection as well as blood clots or DVD.

And also you should be emphasizing bending your leg, straightening your leg, and elevating your leg.

If you number that mild that’s really only five things that you really need to think about and focus on in order to have good recovery from a total knee replacement.

Physical Therapist

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6 thoughts on “Recovery from knee replacement surgery: what to focus on first.
    1. Physical Therapist

      This is to be expected Karen. Work on managing your swelling. Anticipate discomfort and pain due to the surgery. But avoid causing unnecessary pain by “over doing” your exercises or spending too much time on your feet or with your legs below heart level (yes, that means out of the recliner too!) After your first week, most people see some improvement and then after week two, much more.

      Wish you the best with your new knee

  1. Yasin

    A client recently came to me for personal training and is ten weeks post op from having total knee replacement surgery. She wants me to design a plan for her but I’m very reluctant until I get a note from her doctor clearing her and at least his recommendations for any program. I don’t want to limit my client but I don’t feel comfortable having them do any exercises with the lower body because I am afraid to aggravate any condition. What are some good and effective exercises for someone who is wanting to be fit after their surgery?

    1. Physical Therapist

      Hi Yasin,
      I think that you’re on the right track. You should get confirmation from her orthopedic doctor of which exercises and movements should be avoided. Generally, anything that is low or high impact I would think should be discouraged.
      Isolated upper extremity movements and abdominal workouts shouldn’t put any impact on the surgical repair. These may be something that you could do. But keep in mind, I can’t really tell you how to train a person I am unfamiliar with. It may be that you make a list of exercises that you typically work your clients through and send that along with the patient to see the surgeon. Then let the doctor choose which ones of your exercises are appropriate.

      I’m glad that you’re working with this client because continued supervised activity and strengthening is essential in making a full recovery.

  2. nicole brozena

    I have underlined CP and I had a full knee replacement January 2014. I also have c-56 this in my neck that has injury. My question is how do I trust my right need to get my life back

    1. Physical Therapist

      Hi Nicole,
      It seems you have more than one challenge. I appreciate the fact that it can be nerve wracking and scary when you have several things happening at the same time. What should you treat first? What if something I do aggravates another problem I have? What if I cant do what a therapist asks me to do?

      There are a lot of questions that can get overwhelming at times. Unfortunately, this blog or other online resources are not the best place for you to find the answers you need.

      I recommend that you seek out a physician that is familiar with your physical challenges and limitations and ask them to help you find a physical therapist that can work personally with you one on one. I think that would be the best approach for you to take. It may take you a while to find someone but be persistent in your search. Health care workers love helping people. So, try asking your doctor or anyone else who may have a line on a good therapist.

      Best of luck with your rehab.


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