Original Reference: YouTube Channel Ask Dr. Jo Publish Date: Apr 11, 2016
No Pain No Gain
Unlike most of the other advice you will find on this website, Dr. Jo says a total knee replacement exercise is a time for punching into the pain.
The first week after surgery is the most important because scar tissue is building up in the knee if you aren’t moving the knee joint. Lack of movement also causes problems related to increased swelling and further fear of movement.
I would say that while I agree with the importance of movement during those first few days and weeks after surgery, there is a difference between pain and discomfort, and pushing into the discomfort is acceptable while pushing into the pain may be unnecessary. Video Timestamp: 00:17
Total Knee Replacement Exercise #1: Heel Slide While Sitting in a Chair
Sit comfortably in a chair with your foot flat on the floor. Wearing a soft sock you can slide your foot back toward your body. Stop at the point where your knee starts to get uncomfortable.
It is normal to feel a tightness or pulling across the incision and front of your knee as you are sliding your foot back under your seat.
After your foot has moved back as far as you feel it can go, start to slide your foot forward keeping your toe on the ground. This is moving your knee into extension.
* Tip: If you sit forward on the seat of the chair you can get more extension through the knee joint.
This heel slide exercise is usually repeated 10 to 20 repetitions and it is normal for the first couple of repetitions to feel the stiffest while the last repetitions provide the most range of motion.
Video Timestamp: 00:43
Total Knee Replacement Exercise #2: Heel Prop
To perform the heel prop, simply sit in one chair and have a similar chair positioned in front of your body. Prop your surgical knee heel on the chair in front of your body. It is important to keep your toe pointed straight up at the ceiling if possible. Your leg will likely want to twist to the outside, but this will place excessive stress on the lateral structures of your knee.
Maintain this heel prop position for 2 to 4 minutes or until the back of your knee starts to hurt. This exercise may be repeated several times a day, especially if you are experiencing difficulty with full knee extension.
Video Timestamp: 02:01
Total Knee Replacement Exercises #3: Supine Heel Slides
Position yourself in your bed or on a couch laying flat on your back. You will perform the heel slide exercise from #1 above while laying on your back.
*Tip: you can use a strap, belt, or dog leash to help pull your foot back while flexing your knee.
Repeat this exercise for 10 to 20 repetitions or until the leg muscles fatigue.
Video Timestamp: 3:06
Total Knee Replacement Exercises #: Quadriceps Sets
In the same position, while laying on your back, there is no movement involved in this exercise. You will tighten the muscles of your glutes and thigh while pressing the back of your knee down into the surface of the bed or couch.
Hold the muscle squeeze for between 5 and 10 seconds per repetition and perform 10 to 20 repetitions per episode.
Video Timestamp: 4:36
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