Orthopaedic Physiotherapy
This leaflet is for anyone who has recently had a total knee replacement, it has information on symptoms, pain management, mobility and some physiotherapy exercises – both basic and one’s to help with progression.
Common symptoms
Pain (ache, bruised, tenderness, sharp pains).
Swelling (down leg and into calf, around the scar).
Redness or bruising around the scar.
Tiredness and fatigue.
Leg feeling heavy and weak.
Pain management
You will only be given one week supply of pain relief medication on discharge from hospital – it is important to contact your GP in good time should you need more or want to change what you are currently taking.
Effective pain relief – particularly in the acute stages – is crucial to allow you to move and exercise more comfortably.
Ice and elevation are key to helping control the swelling and can help with pain.
Mobility
- It can be painful to walk, again this should naturally become more comfortable with time.
- We would rather you use a mobility aid for longer and walk better, than walking unsteadily without an aid, for the sake of getting rid of the stick.
- Your mobility will gradually improve with time naturally, it usually comes down to confidence rather than physical ability when getting rid or weaning off a mobility aid.
- Exercises on the following pages are optional and you can pick and choose which ones you do.
Further information
- Versus Arthritis’ online has useful information and exercises.
- Please ask you’re GP if you would like more information on weight loss management programmes.
- Please ask your physio or GP about local services near you that could help your rehabilitation.
What to do next…
Continue to build up your activity, things should continue to improve. However, if you find you are struggling and things are not getting better, please contact the department to book a one to one physiotherapy appointment.
Start with the following exercises…
Seated knee flexion and knee bend
To help get your knee bending, in a sitting position, slide your heel back and bend your knee (see image 1).
To help push this, you can gently nudge it back with your other leg (see image 2) or you can keep your foot still on the floor and push yourself forwards in your chair (see image 3).
Passive extension and heel hangs
To encourage getting your knee as straight as possible, we want you to practice sitting with your leg out in front of you, allowing gravity to help passively straighten your knee.
It is important you do not sit in this position for too long or it will stiffen up, only work within what your pain allows.
Over time, this may become more comfortable, and you can slowly build up the length of time in this position.
Patella mobilisations
Sometimes. If your knee cap gets a little stiff, then this can limit your knee bend.
Gently move your knee cap from side to side to mobilise this joint.
Static quads
Slowly tighten the thigh muscles of the straight leg, by pulling the toes up to point towards the ceiling and pushing your knee down into the bed.
Inner range quads
Place a rolled towel under your knee. Raise the lower part of your leg until your knee is straight.
Straight leg raise
Bend your un-operated knee to help brace yourself as you lift a straight leg up, about ten inches off of the bed.
Stair lunge
Place your operated leg up onto a step. Hold onto the banisters or walls for support.
Lunge forwards to bend your operated knee as much as possible.
Progress to these exercises…
Squats
Place a chair behind you for safety or hold onto a chair in front of you. While standing, with feet shoulder width apart and in front of a stable support for balance, bend your knees and stick your buttocks out (as if going to sit down).
Your body weight should be mostly directed through your heels. Return to a standing position. Knees should bend in line with the second toe and not pass the front of the foot.
Do not try and go too low. You should be able to comfortably return to a standing position.
Variations
- Shallow
- Sit to stand
- Perform a squat with your back against the wall. Have your feet far enough away so that when you squat down your knee is at a 90 degree angle
- Hold a weight in both hands in front of your chest
- Single leg squat
Bridging
While lying on your back with knees bent, tighten your stomach muscles. Squeeze your buttocks, and then raise your buttocks off the floor or bed. Creating a “bridge” with your body. Hold for 5 seconds and then lower yourself and repeat.
Variations
- Increase the length of time holding the static position at the top.
- Stagger your feet and put more weight through the leg that is closest to your buttocks.
- Single leg bridges.
- Weighted – hold a weight or object over your pelvis and then push up.
- Place a resistance band around your knees and push outwards as you lift and lower your buttocks.
Step ups
Using the bottom of your stairs, step up with your operated leg followed by your un-operated leg.
Step back with your operated leg followed by your un-operated leg.
Variations
- Sidestep up
- Weighted
- Eccentric (single leg lower)
Single leg stand
Hold onto a chair or table for support and practice standing on your injured leg for 30 seconds.
Variations
- Try and let go of support.
- Do it with eyes closed.
- Hold onto weight.
Lunges
In standing, with feet hip width apart, back straight with hands on your hips.
Take a large step forward with one leg and bend both knees to approximately. 90 degrees. Your back knee should be just above the floor.
Slowly and controlled, take a step back and repeat.
Variations
- Walking (perform a series of lunges whilst moving forwards – as shown in “Lunges image”).
- Shallow depth (to make it easier, knee does not need to reach the floor, just perform a small knee bend).
- Weighted (hold weights in either hand)
Contact us
Please contact the physiotherapy department that you are attending if you have any questions or concerns, Monday to Friday: 08:00 until 16:00.
- Friarage
Telephone: 01609 763046 or Email: [email protected] - James Cook
Telephone: 01642 854453 or Email: [email protected] - Redcar
Telephone: 01642 944682
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the patient experience department of any special requirements, for example; braille or large print by emailing: [email protected]