Updated February 26th, 2023
Introduction
So you had your knee replaced, the day has finally come! Most people stay in the hospital for 1-3 days, depending on how they react to medications and if they can “pass” physical therapy. This doesn’t mean you have to show us all of the exercises you learned. This means you are able to get up and move around with a walker and demonstrate adequate balance and safety. Most PTs will also want to see you get up and down a few stairs if you have some to enter your home. So get up and move so you can go home and be more comfortable!!
Starting Physical Therapy
In the hospital, your PT will likely give you exercises to start at home until you start either home or outpatient physical therapy. Although it sounds very convenient to have a therapist come to your home, it may not be as beneficial as outpatient therapy.
Here are some advantages to outpatient PT:
More equipment - weights, straps, and machines that you likely won’t have at home.
More transfers - leaving the house means you will have to get in/out of the car and any other chairs you will need along the way.
More steps - you will be getting steps to/from your car, your home, and the clinic. At this point in the game you need to be using that knee as much as you can tolerate.
If you are someone who is primarily home-bound or does not have a ride to a clinic, home therapy is still a great option. Some patients will do a week or two of home therapy and then switch to outpatient care afterwards. The important thing is that you are pushing these next two moves!!
Two Important Movements
As we all know, the knee does just two things right? Bend and straighten. Technically it does rotate a little tiny bit, but that’s not important at this time. What is important is that you need to get these two movements back as soon as you can.
Most doctors will want to see you bend your knee to at least 90 degrees within the first 2-3 weeks. This is definitely achievable if you put the work in. What you are looking for when you bend or straighten your knee is stretching pain that is only present while you are performing the movement. This shouldn’t be a significant sharp pain that lasts all day after you bent your knee a little further. Yes, you will be sore afterwards but guess what? You will be sore whether you exercised your knee or not. So you might as well get it moving right?
Check out these videos below for some ideas of how to bend and straighten your knee more at home. A Physical Therapist can help you gain this range of motion, but you will need to work it more than 2-3 times per week.
Don’t Ditch Your Friends
Your two best friends for the first few weeks are going to be your walker and your physical therapist. Yes, your PT will push you into some movements that may be painful or sore. But they will help get you moving better than you did before surgery!
As for your other buddy, the walker, don’t stop using it just because you can. You may be able to balance without a problem within a week or two, but how does your walking pattern look? Do you have a noticeable limp or need to take very short steps? Use the walker to help you return to a normal gait pattern without causing damage or pain! Your physical therapist will help you determine when you are ready to progress without the walker. Watch the video below for more explanation.
Exercises
Here are some videos of my favorite exercises to have my patients do in the first few weeks after a knee replacement. Some of them may take you a while to achieve, but they all have a great purpose: to get you stronger and help you move better.
Conclusion
As you push through these first few weeks, I would like to remind you to not give up. Your progress will seem so small day by day, but as a PT we see many improvements every session. Your range of motion, walking pattern, ability to get in/out of bed or a chair, and your pain tolerance will all progress. Take these small victories and use them to motivate you and keep moving forward!! Keep an eye out for the next article on the finishing touches to moving better after your knee replacement.
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