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Please start to practice your exercises now. They will help to strengthen your knee before the operation which will make it easier after the operation. It will also be easier for you as you will know the exercises off by heart. The best place to do these is either on your bed or on the sofa. These are the exercises that you will be required to do after your operation and you may start attempting the circulation exercises as soon as you feel able after your surgery. Your Physiotherapist will then teach you more advanced exercises as you progress.
Repeat each of the following exercises 10 times each (3 -4 times per day).
With your legs straight out in front of you, pull your feet up and down so your calf muscles pump the blood in your legs towards your heart.
Pump your feet up and down 20 times.
Next circle your feet 10 times one way and then 10 times the opposite way.
With your legs straight out in front of you point your toes up to the ceiling
and press the backs of your knees down into the bed or sofa by clenching your thigh muscles. Hold this contraction for 10 sec.
Sit with your leg out in front of you, point your toes to the ceiling and
clench your thigh muscles just like you have been doing in the previous exercise. Lift your whole leg up keeping your knee straight. Raise your leg up until it is just clear of the bed.
Sit with your leg out in front of you. Find a soft pillow or cushion and
fold it up to make a roll. Place this roll under your knee. Your knee will now be slightly bent and resting on the pillow. Press the back of your knee into the pillow and slowly straighten your leg. Hold it straight for a slow count of 3 and then slowly bend your knee until your foot is back on the ground.
This exercise is much easier if you have some thing with a smooth surface under your heel. Put a sock on your foot and then place a carrier bag under your heel. Slowly bend your knee up as far as it will go. Hold this full bend for a slow count of three and then slide your heel back down the bed until your leg is straight.
Sit or lie with your leg out in front of you. Put the heel up on a block or pillow so that the knee hangs in
mid-air. Let the knee stretch for five minutes, or less if it is too painful.
A DAY-BY DAY GUIDE AFTER YOUR SURGERY
We would like to stress that all patients have different requirements and different speeds of recovery. Also, the surgeons may have slight variations in treatment and care, this information is only a guide.
• Your physiotherapist will come to see you and assist you with gentle exercises, and you may get out of bed and take a few steps. You may sit out in a chair.
• You will be getting out of bed and starting to learn to walk using a walking frame. If you are safe using the frame you will be able to start walking by yourself. This will also mean that you may start using the toilet.
• If you have already been up then it is possible that you will be taught to use your walking sticks. You will also start your exercise programme to learn to bend your knee and strengthen your leg muscles. The physiotherapist will see you to measure the amount of bend in your knee. You may need ice therapy for pain and swelling.
• You will be able to sit out of bed in your chair. This will mean that you will be able to eat your meals sitting out. This is much better for your digestion.
• You will walk with your sticks today, these sticks are for you to take home. If you already have some sticks then please bring them with you. The physiotherapist will check them over and you can use them if they are OK.
• You will be expected to go for a walk and practice your exercises by yourself. We will also measure your knee bend again to see how much you have improved
• Remember to rest on your bed after lunch and do your circulation exercises if you have any swelling in your foot and ankle. You may find that after rest your knee feels a little stiff. If so, start to do your bending exercises to loosen the joint up. This is particularly important first
thing in the morning when you have been asleep all night.
• If your knee is swollen you may need ice therapy.
DAY FOUR / FIVE
• You should be able to bend your knee enough to sit comfortably in your chair with your knee bent and your foot on the ground so that it matches your un-operated leg. This is approximately 75 degrees. You should be going for your regular walks on the corridor every hour as well as practicing your exercise regime. Your physiotherapist will discuss any questions you may have.
• You will be taught how to manage stairs.
• When you go home your progress will depend upon you continuing to do your exercise programme following the precautions already explained to you.
You will be required to attend outpatient physiotherapy sessions and these will be arranged for you.
Author: DAVID P JOHNSON
MB ChB FRCS FRCS. MD
Consultant Orthopaedic Surgeon
© D P Johnson 2008 www.Bristol-Knee-Clinic.co.uk
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