Physical Therapy After a Knee Replacement

What to expect

At your first visit after your knee replacement, we will start with our thorough examination. We will check how much motion and strength you have in your leg.^1,2,3 We will also look at your incision site and make sure it is healing well. In addition, we will look for any leg swelling that may be occurring. Following our thorough examination, we will tell you what we would like to do for treatment and tell you what you can do at home to supplement your physical therapy visits and help get you back to your daily and recreational activities. 

Why we are looking at your motion, strength, incision, and swelling

You will have follow-up visits with your surgeon after the surgery to check in. The surgeon will want to see that with physical therapy you are having improved knee bending, knee straightening, knee strength, reduced swelling and that you are not having any signs of infection. Signs of infection we will be watching for are heat, swelling, change in color, and any drainage.⁴ We will also look at overall wound healing and suggest different dressings to help progress the healing of the incision. It is our job to measure where you are at when you first come to us and get you back to functional levels so you can get back to doing all your daily and recreational activities. 

How you can reduce swelling at home

When you come to your first visit we will document how much swelling your having.⁵ We will most likely recommend you get compression socks and a knee sleeve to help reduce the swelling. Compression socks have been proven to be effective in decreasing swelling.⁶ 

How will physical therapy get you back to your daily and recreational activities?

We will do a variety of exercises and treatment modalities.  These modalities such as ultrasound, dry needling, cupping, joint manipulations, and massaging will help reduce pain, bring blood flow to the area to help heal, and improve the muscles’ ability to stretch.⁷ We often start with modalities and follow the treatment of modalities with exercises to work on bending, straightening, and strength. The exercises may consist of heel slides, single leg raises, and riding the recumbent bike.  Some of the exercises done in the clinic you will be asked to do at home to help continue progressing the knees’ ability to perform all activities. 

Will I need a gym membership to perform my exercises?

No, you will not need a gym membership. All exercises given to you will be exercises you can do at home. You will not need any additional equipment.  Fun fact! Research shows that body weight exercises require more muscle activation than exercises you would do on a machine at the gym.²

Getting your knee replaced soon or just got it replaced recently and want to get back to doing all your daily activities? Call Imagine Physical Therapy today to schedule your appointment.  The following link will guide you to find the location closest to you. https://imaginept.com/locations

References:

1. Ebert JR, Munsie C, Joss B. Guidelines for the Early Restoration of Active Knee Flexion After Total Knee Arthroplasty: Implications for Rehabilitation and Early Intervention. Archives of Physical Medicine and Rehabilitation. 2014;95(6):1135-1140. doi:10.1016/j.apmr.2014.02.015
2. Jakobsen TL, Jakobsen MD, Andersen LL, Husted H, Kehlet H, Bandholm T. Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection. Journal of experimental orthopaedics. 2019;6(1):29. doi:10.1186/s40634-019-0193-5
3. Eymir M, Erduran M, Ünver B. Active heel-slide exercise therapy facilitates the functional and proprioceptive enhancement following total knee arthroplasty compared to continuous passive motion. Knee Surgery, Sports Traumatology, Arthroscopy. 2021;29(10):3352-3360. Accessed April 8, 2022.
4. Leong JW, Reed M. Knee arthroplasty: post-operative care, rehab-ilitation and follow-up. Orthopaedics and Trauma. 2021;35(1):49-55. doi:10.1016/j.mporth.2020.12.009
5. Brodovicz KG, McNaughton K, Uemura N, Meininger G, Girman CJ, Yale SH. Reliability and feasibility of methods to quantitatively assess peripheral edema. Clin Med Res. 2009;7(1-2):21-31. doi:10.3121/cmr.2009.819
6.  Gianesini S, Raffetto JD, Mosti G, et al. Volume control of the lower limb with graduated compression during different muscle pump activation conditions and the relation to limb circumference variation. J Vasc Surg Venous Lymphat Disord. 2020;8(5):814-820. doi:10.1016/j.jvsv.2019.12.073
7. Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Physical Therapy Reviews. 2014;19(4):252-265. Accessed April 8, 2022.