Undergoing a knee replacement is a positive life changing event for an individual.

It is a decision to improve one’s quality of life, but will take preparation prior to surgery and a lot of mental and physical effort after surgical intervention. Skilled outpatient physical therapy can provide many benefits prior to surgical intervention such as patient education, improved range of motion, increased strength, and improved functional mobility.

Patient education prior to surgery will decrease the patient’s anxiety and help prepare the home. The therapists will provide education for the lengths of hospital stay, rehabilitation facility stay, home health physical therapy, and outpatient physical therapy rehabilitation. Education will also be provided regarding modifications to the home. Primary modifications should be made to avoid falls post surgically such as removing throw rugs and re-routing electrical cords that lay on the floor.

Physical therapy intervention prior to surgery will improve the knee range of motion, muscle lengths, muscle extensibility, and muscular strength. There are two different types of range of motion. Passive range of motion is when an external source moves the knee without effort from the patient. Active range of motion is similar but is when the patient utilizes their own muscles to move the knee. Both are equally important to maximize prior to surgery to decrease the length of rehabilitation. Passive range of motion will be limited by the extent of structural damage to the joint, the tightness of the joint capsule, and the musculature mobility. Active range of motion is additionally limited by muscular strength.

Muscle mobility is influenced by muscle flexibility and by muscle extensibility. Flexibility is improved with stretches held for at least 30 seconds each stretch, but the stretches should not increase pain in the joint. Muscle extensibility is the ability of the muscles to glide past one another without “sticking” together and limiting motion. Extensibility can be improved with self-massage techniques and with advanced massage techniques using beaded rollers or foam rollers.

Try these 3 exercises:

Side lying straight leg lift without weight

Clamshells without a band

Laying on back heel slides

Strength is a large component of recovery from a knee replacement. The earlier the strengthening begins before surgery the stronger one will be after surgery, and the faster the return to ambulating with the least restrictive assistive device. The strength that must be obtained is not only the strength of the knee itself, but strength of the hips, lower leg, abdominals, arms, and general conditioning. The hips and lower leg have musculature that plays a critical role in proper knee alignment and function, and are difficult to strengthen. Abdominal strength is critical to provide a solid base for the legs to work from, because all motions are first initiated from the body’s center.

The benefits of skilled outpatient physical therapy are numerous and will all contribute to maximizing a patient’s ability to move about functionally without limitation.

If you have questions about how physical therapy can help you give us a call to schedule your free pain consultation.

By Edward “Ted” Greeley II, DPT

Back in Motion Physical Therapy – Gorham, Maine

Related: The Most Important Exercise You Can Do

Fighting the Opioid Epidemic with Physical Therapy

Top Physical Therapist Approved Shoes