Post-Op Physiotherapy
Acute Management / Protected Loading Phase
Timings should be agreed with your clinical team these are approximate for guidance: 0-4 weeks
Overview of phase:
Regaining muscle strength, balance, and basic co-ordination.
Regain a 'quiet' knee.
Basic range exercises, quadricep setting, ice, compression, analgesics (as per doctor)
Ankle pumps
Sitting or lying on the bed
2 x 20 Reps
3 x a day
You can do this exercise either lying or sitting. But make sure to keep the leg straight from hip to ankle as you briskly 'pump' your ankle up and down. Do this 20 times, rest briefly and repeat. Work both ankles together.
Knee bends flexion
Sitting or lying on the bed
10 reps
2-3 x a day
You can do this exercise in bed, either sitting up or lying on your back. Stretch both legs out in front of you. Without your feet lifting from the bed, bring one foot towards your buttock to bend your knee and then straighten your leg back out again.
Static quads contraction
Sitting up in bed
2 x 20 Reps
2-3 x a day if pain free
You can do this exercise sitting up in bed. Straighten your leg in front of you, then tense the thigh muscles – you should feel your knee pushing down into the bed. Hold for 3 seconds and relax.
Straight leg raises
Standing or lying on your back
20 reps
2- 3 x a day if pain free
This exercise can be done standing up or lying on your back, whichever you prefer. Keeping the leg straight - no bend in the knee - lift your leg as far as is comfortable, hold for 3 seconds and then lower gently.
Side-lying hip abduction
Cushion/pillow
2 x 20 Reps each side
3 x a day
Lie on your side, with your legs straight and a pillow or cushion between your feet - your injured leg should be on top. Now tighten the muscles in the front of your thigh and lift the leg 9-10 inches off the cushion. Pause, and gently lower back down.
Prone Knee Hangs
Bed
Hold the position for 20 seconds
2-3 x a day
Lie on your front with your lower leg hanging off the bed. The edge of the bed should be just above your knee. Relax into this position letting your knee straighten as much as is comfortable. Hold this position for 20 seconds.
Prone Hamstring curl unloaded
Bed
2 x 20 reps each side
3 x a day
Lie on your front on the bed. Bend your leg at the knee, using your hamstring muscles to pull your heel towards your buttock, then release and lower the leg back to the bed.
Criteria to move to next phase:
No/Minimal pain
Fully Weight Bearing,
No altered gait pattern
Comfortable day to day,
Minimal to no swelling
Range: Active Terminal Knee Extension of 0 degrees and active flexion of 120+ degrees
Strength: good active extension (0-5 degrees) during Single Leg Raises x 10 reps
Supplementary goals which are considered to be a bonus, although highly encouraged, they should not act as a 'Road Block' to move to the next phase.
Competent in performing a bodyweight squat
Pain free with the appropriate hip strategy;
and minimal knee valgus