Knee Replacement: Improve Your Balance and Walking

Knee replacement surgery is a proven way to decrease pain from knee arthritis.  This surgery also results in substantial improvements in your walking and overall mobility.  However, surgery alone cannot restore your muscle strength or balance.  For this reason many people who undergo knee replacement are plagued by poor balance and falls.  This article highlights several exercises you can perform to decrease your risk of falling after your knee replacement.

A 2019 review of more than 1 million patients undergoing knee replacement showed the following factors increase the risk of falling:

  1. Females
  2. Living alone
  3. Previous history of falls
  4. Previous history of joint replacement surgery
  5. Use of pain or psychiatric medications

Proven Exercises to Improve Your Balance after Knee Replacement

A 2018 review article in Sports Medicine looked at more than 700 people undergoing knee replacement surgery.  Greater improvements in walking and balance were observed following physical therapy programs placing a greater emphasis on balance training when compared to conventional methods of rehabilitation.  Balance training also improved function and knee range of motion to a greater extent than conventional methods of rehabilitation.

Balance training

Research from the University of Pittsburgh has identified specific exercises that improve your balance and walking after knee replacement surgery.  Five of these exercises are described in this article. They can be easily performed in your own home or under the guidance of your physical therapist. For the best results, perform balance exercises daily.  At a minimum start with 3 times per week.  These exercises will only take you about 20 minutes to perform. For safety, perform each exercise close to a wall or counter in case you need some extra support.  It is best to wear sneakers or walking shoes while exercising.

Side Step Walking

Stand facing a wall or counter.  Space your feet about 2 inches apart with your toes pointing straight ahead.  Focus your eyes forward with your head up.  Walking with your head down and eyes on your feet is one of the early signs of a balance problem.  Take 5 small steps to the right.  Do not allow your feet to touch.  Keep your chest and shoulders up.  After 5 steps to the right, take 5 steps to the left.  Perform 5 laps right to left and left to right.

Shuttle Walking

Walking with changes of direction can be challenging for people with balance problems.  The shuttle walk helps with this problem.  Place 4 cones or objects (shoes are fine) on the floor about 5 to 10 feet apart.  Stand at the first cone and walk to the second cone.  Stop at the second cone and then walk backwards to the first cone.  Next, walk to the third cone.  Stop.  Walk backwards to the first cone.  Finally, walk to the fourth cone.  Stop.  And walk backwards to the first cone.  Complete this cycle 5 times.

Carioca Walking

Carioca’s are a progression of the sidestepping exercise.  With this exercise, alternate front and back cross-over steps.  It is best to start holding on to a counter or wall until you become confident with this exercise.  This exercise requires adequate flexibility in your hips and legs.  If this is a problem for you, incorporate some stretching exercises into your routine.

Toe and Heel Walking

Stand on your tip toes.  Walk forward 10 steps without allowing your heels to touch the floor.  Turn your body around and try walking on your heels for the same 10 steps.  Do not allow your toes to touch the floor. Perform 5 laps each on your toes and heels.   If this is not difficult for you, try walking backwards on your toes and backwards on your heels.

Tandem Walking

You may notice that your feet have become spaced further apart when you walk.  A wide base gait pattern is one of the early signs of a balance problem.  Tandem walking corrects this.  Stand near a wall or counter.  Walk with a narrow base of support like you are on a “tight rope”.  Your heel of one foot touches the toes of your other foot with each step.  This is a challenging exercise.  It is okay to use one hand or finger on a counter for light support when first starting out.

Closing Thoughts on Improving Your Balance after Knee Replacement

The right rehabilitation is crucial to your outcome after knee replacement surgery.  Range of motion and strength require dedicated exercise to make improvements.  Balance training is often left out of physical therapy programs after knee replacement.  However, research shows high-intensity exercise combined with balance training is best.  The 5 exercises included in this article can get you started.  If you would like more help, give us a call.


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