Nearly 5 million people live in the U.S. with a total knee replacement.  This number is rapidly growing.  Knee replacement surgery is helping many people lead happy and active lives for many years.  However, 1 year after surgery only 1/3 are completely satisfied.  Even worse, 30% are dissatisfied.  This is because of knee pain, weakness, difficulty climbing stairs, poor balance, and problems walking.  The truth is that a successful outcome is equally due to the surgery itself and your rehabilitation.

Physical therapy after knee replacement surgery requires patience and commitment.  There will be ups and downs.  The recovery process is not smooth.  Your physical therapist is your guide.  He or she assesses your progress along the way and determines the best program for you.  Factors that are important include minimizing your pain, decreasing your swelling, restoring your knee range motion, improving your strength, and correcting your walking pattern.

Quadriceps Muscle Strength after Knee Replacement

Many research studies prove the importance of quadriceps muscle strength after knee replacement surgery.  Your quadriceps is the large muscle on the front of your thigh.  A 2009 study from the University of Delaware showed superior results 1 year after surgery in people who performed progressive quadriceps exercise compared to those who received standard physical therapy.

Other research shows patients who undergo knee replacement surgery move differently than those who do not.  This occurs when getting out of a chair, climbing stairs, and walking.  If you develop these compensations you often develop pain in your other knee, low back, or hip.

Performing quadriceps exercises before surgery and soon after surgery is important to achieve the best outcome after your knee replacement.  Early on perform your exercises within your pain tolerance.  You do not want to over-stress your knee joint.  By controlling pain and swelling you will be able to better exercise your quadriceps.  You can perform the 5 exercises in this article within the first few days after surgery.  Progress them based on your ability levels and goals.

Quadriceps Isometric Set

This exercise minimizes quadriceps muscle loss following surgery.   It also helps restore full knee straightening which is important for walking without a limp.  Begin with your knee extended and a small towel roll placed under your heel.  Push the back of your knee down towards the floor while simultaneously tightening the front of your thigh.  Hold the contraction for 10 seconds and perform 10 repetitions.  Perform this exercise multiple times per day.

Short-Arc Quadriceps

Lie on your back with a foam roll, pillow, or towel roll under your knee.  Fully extend your knee by kicking the foot up.  Hold this position for 3 to 5 seconds and lower back to the starting position.  Achieving a fully straight knee is very important during this exercise.  Perform 10 to 20 repetitions for 2 to 3 sets each day.  Weights can be added to your ankle as your strength improves.

Terminal Knee Extension in Prone

Lie on your stomach with your ankle bent so you are supported on your toes.  Fully straighten your knee to contract the quadriceps.  Hold this position for 3 to 5 seconds and lower back to the starting position.  Achieving a fully straight knee is very important during this exercise.  Perform 10 to 20 repetitions for 2 to 3 sets each day.  Weights can be added above your thigh as your strength improves.

Terminal Knee Extension with Band

Stand with a resistance band looped around your leg just above your knee.  Begin with your knee slightly bent.  Pull your knee straight by contracting the quadriceps on the front of your thigh.  Hold this position for 3 to 5 seconds then return to the starting position.  Again, achieving a fully straight knee is very important during any quadriceps exercise.  Perform 10 to 20 repetitions for 2 to 3 sets each day.

Sit to Stand

Many people struggle with rising from a chair after knee replacement surgery.  The movement is often painful and limited by weakness.  Start with a higher chair or a chair with several pillows stacked on top.  Be sure to distribute weight equally between legs so you don’t develop compensations.  Perform 5 to 10 repetitions several times per day.

See Your Physical Therapist after Knee Replacement 

Many people are plagued by persistent pain and limited walking ability long after knee replacement surgery.  However, progressive strengthening exercise targeting your quadriceps is a proven treatment approach.

These 5 exercises are only a small sample of an early and effective physical therapy program.  Your physical therapist will perform an individual assessment and design an exercise program based on your abilities and goals.  Contact us today if you have questions about which exercises are right for you.