Are you planning to have a knee replacement in the near future? Maybe you already have a date scheduled for surgery. Or maybe you are weighing the pros and cons to getting your knee replaced.

Whatever your situation is, conservative treatment with physical therapy can be very beneficial! A physical therapist helps you to strengthen muscles and improve the motion around the knee joint in preparation for surgery [1].

Understanding Total Knee Replacement Surgery

To begin, you might want to know exactly what is being done during a knee replacement. Communicating with your doctor/surgeon can be helpful. This allows you to understand exactly what will be done and will give you the opportunity to ask any questions you may have. During a total knee arthroplasty, damaged cartilage and bone are removed and replaced with metal and/or plastic components. Strengthening muscles around and above the knee joint can help improve outcomes after the surgery [2].

The quadriceps muscle is a group of 4 large muscles on the front of the thigh. These 4 muscles come together and attach at the kneecap. The quadriceps are very important because these muscles help you to straighten your knee, walk, go up and down stairs, jump, and run. During a total knee replacement, depending on the surgeon, there is typically an incision made through the quadriceps tendon. This compromises the muscles post-operatively – making it both weak and painful [1].

Since the surgery is somewhat invasive, it is beneficial to prepare beforehand. Strengthening the quadriceps, hamstrings, hip abductors and hip adductors can improve recovery. Many prehab activities will be the same ones you will complete immediately post-op [3].

My top 5 go to exercises for patients planning to have a total knee replacement

1. Quad Sets

Place a small rolled-up towel or pillow under your knee and press down on the back of your knee into the towel/pillow. You’ll feel the muscles on top of your thigh tighten, helping to strengthen the quadriceps and improve your ability to stand, walk, and go up and down stairs.

2. Hamstring Curls

These exercises improve the strength of the muscles on the back of your thighs, which are important for walking, getting in and out of the car, and bending the knee. You can perform these slowly to make them more challenging.

3. Heel Slides

Lie flat and bend your knee, then slide your heel back as far as you can. This exercise helps ensure the knee maintains its range of motion, preventing it from becoming too stiff and painful.

4. Long Arc Quads

Sit at the edge of the table, straighten out the knee, and hold for 3-5 seconds. This exercise also helps strengthen the quadriceps muscle group, which is critical for maintaining mobility after surgery.

5. Mini Squats

Use a supportive surface, such as a countertop, and slightly bend your knees and squat as if you’re going to sit back in a chair. Go as low as is comfortable and tolerable based on current symptoms. This exercise helps improve hip and knee strength prior to surgery and is a functional activity.

Summary

Preparing for knee replacement surgery with physical therapy can make a significant difference in your ability to recover after the procedure. By working with a physical therapist and performing targeted exercises, you can strengthen the muscles around your knee joint and improve your mobility, making it easier to get back to your daily activities. So, if you’re considering knee replacement surgery, be sure to talk to your doctor about the benefits of physical therapy and how it can help you prepare for the procedure.

And, if you’re in the Augusta Area and want to get started on a pre-total knee replacement exercise program, request an appointment online!

Susannah Azofeifa, PT, DPT was born and raised in Owensboro, Kentucky but now calls North Augusta, SC home. She attended the University of Louisville and graduated with a bachelor’s degree in Kinesiology/Exercise Science in 2017. She then attended Breanu University where she received her doctorate of physical therapy in 2021. Susannah enjoys treating a wide range of orthopedic conditions and also specializes in treating pelvic floor dysfunction, and pre and post partum individuals. She enjoys spending time doing activities such as CrossFit, being outdoors, traveling, being with family, and spending time with her husband, Fabian. She heads up our Pelvic Floor Physical Therapy (PFPT) program here at ProActive.

References

1. Volden, C. M., Skulavik, I., & Garberg, E. C. (2017). Prehabilitation for total knee arthroplasty: A systematic review. Physiotherapy Theory and Practice, 33(11), 835-850. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707853/
2. Liu, F., Tao, H., Yang, R., Postma, W. F., Ma, C. H., & Xie, X. (2017). Strengthening exercises improve knee function after total knee arthroplasty: A systematic review. Journal of Physiotherapy, 63(1), 7-13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593278/
3. Huang, K. T., Huang, Y. C., Chen, J. H., Lin, Y. N., Lin, Y. H., Chang, C. H., & Liou, T. H. (2019). The effectiveness of prehabilitation (preoperative exercise) for elective total hip and knee replacement surgery: A systematic review. Journal of Clinical Medicine, 8(4), 480. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6666977/