After your joint replacement surgery, your doctor will encourage you to begin movement relatively quickly after your hip replacement procedure or knee replacement surgery. Exercise will increase blood flow and circulation throughout your knee joint or hip flexor, allowing you to successfully recover. You may feel uncomfortable at first, but these exercises will help diminish pain as time goes on and speed up your recovery.
According to the American Academy of Orthopaedic Surgeons, the key to effective rehabilitation after a large joint replacement is focusing on your exercise program. During the physical therapy phase of your recovery, you’ll work to regain motion, function, strength and balance in your replacement joint. You’ll move onto more recreational exercises as you regain your strength and range of motion.
It’s very important that throughout your recovery process, you remember to move slowly to avoid injuring your replacement joint. You’ll begin to regain your strength as time goes on. If you at any time experience knee pain or hip pain (aside from general soreness), stop the movement completely.
Follow your orthopaedic doctor and your therapist’s instructions during recovery.
Soon after you’re in recovery following your knee replacement procedure or hip replacement surgery, your doctor will typically instruct you to perform simple exercises. This can happen while you’re still in your hospital room.
Contracting the muscles in your leg may seem like second nature but after a knee replacement or hip replacement, these exercises will help your body function like normal again. The point of these exercises is to increase blood flow throughout your legs, which will decrease swelling and help with recovery.
The post-operative exercises listed below are effective for both knee replacement surgery and hip replacement surgery.
Arc Quad Exercise: Lay flat on your back on the floor and put a rolled towel beneath your ankle. Press your ankle down against the towel. You’ll notice your knee will straighten and raise slightly off the surface you’re laying on. Avoiding a bouncing motion, hold the straightened position for five seconds. Then relax your leg. Repeat this motion 10 times.
Hamstring Contraction: Lay flat on your back and bend your knees at a 10-15 degree angle with your feet planted on the floor. Keeping your legs still, press your heels into the floor. This motion will cause your hamstring muscles to contract. Hold for five seconds. Relax and repeat this motion 10 times.
Ankle Pumps: Lay flat on your back on the floor. Flex your foot upward and back, then point your toes down. This exercise will increase blood flow through your leg, which will reduce swelling and promote healing.
Soon after your surgery, you’ll be instructed to slowly begin to take a few steps while you’re still recovering in the hospital. Walking is the best therapy for a knee or hip replacement.
Dr. Alvin Ong, an internationally recognized, board-certified hip and knee surgeon at Rothman Orthopaedics, makes sure his patients are moving around as soon as possible. He says, “After surgery, hip replacement patients are encouraged to walk. Initially, patients will begin walking the day of surgery. You will be able to put all your weight as tolerated on your new joint. Most patients will begin walking with a walker or a cane.” He also stresses the importance of utilizing these devices properly. “It is important to not place all of your weight on assistive devices, but to use them for stability and safety. I encourage my patients to transition to a cane after the first or second week following surgery and then to walking independently. This will help with body alignment and encourage the patient to ambulate with a normal gait pattern.”
Your therapist or doctor will help you as you first begin taking steps to help stabilize you and avoid any accidents. As you continue to practice walking, you’ll gradually be able to put more weight on your leg and take more off of the cane or walker.
After a few days of comfortably walking, move outside and increase the distance you walk. Not only will this help you on your way to recovery, being outdoors will help to lift your spirits after being cooped up as you healed.
After you’ve been walking comfortably for a couple days in a row, you’ll move on to slowly walking upstairs. The movement of “stepping” is very beneficial to increasing the flexibility and strength in your knee or hip joint following surgery. It’s crucial to remember to only take one step at a time. The first few times, rely on a cane or a crutch to do so and make sure a friend or family member is there to help support your weight.
Always remember to take the first step with your strong leg, and use your recovering leg to follow behind. As you become more comfortable, you can start to hold onto the railing instead of relying on a cane or crutch.
After you’ve successfully walked upstairs taking one step at a time, you can try to slowly climb stairs foot over foot. Do not attempt to walk up steps that are greater than the average stair height, which is about seven inches.
By now, you’ve conquered the first phase of joint recovery - allowing your new joint to regain range of motion and function normally. But your joint is still weak and cannot support your body properly yet. To fix this, you’ll move onto exercises that will strengthen your joints.
Dr. Ong notes, “After a knee replacement, the focus on walking and transitioning to independent ambulation remains the same. However, the knee replacement patient will shift some of the focus to bending and straightening the knee or flexion and extension.”
A general rule of thumb for strengthening exercises during total knee replacement rehab or total hip replacement rehab is to begin doing them every other day, beginning with one set of 8 to 15 repetitions. As you start to get more comfortable, perform several sets, resting 1-2 minutes in between. Move slowly and control your exercises and avoid holding the exercise.
If you’d like, repeat each exercise on the non-operated leg to keep your body loose and limber.
Standing Knee Bends: Standing up straight and holding onto a railing, a table, or your walker, lift your leg up and bend your knee. Hold for 5 to 10 seconds, then straighten your leg. Repeat until you’re tired or 10 times.
Assisted Knee Bends: While laying down on your back, hold a band or a folded towel around the ankle of your operated leg. Bend your knee and hold the band or towel taut to increase the bend. Hold for 5 to 10 seconds. Repeat until you’re tired.
Standing Hip Abduction: Stand up straight facing a counter or table for balance. Lift your operated leg out to the side, but only slightly. Make sure your foot is about one half-inch off the floor. Repeat 10 times. Once you’ve successfully completed this exercise, try adding a resistance band around your knees.
Squat: Stand up straight facing a counter or table for balance. Point your toes forward and lower your bottom, bending your knees as if you’re sitting down. Straighten your knees and rest for a few seconds. Repeat this squat 10 times. You may want to use a chair behind you to help your form.
Remember to be patient with your body and not to rush this recovery process. Dr. Ong notes, “It’s important to remember that more is not always better and that healing takes time. Joint replacement surgery is an active surgery that requires patient participation, realistic expectations and time in order to have successful outcomes.” Keep his advice and all of these tips in mind when recovering from your knee replacement or your hip replacement procedure. Learn more about joint replacement here.