Its fairly common to leave hospital with approximately 90 degrees knee bend or flexion after total knee replacement. If you have more - great!. However, if you have less than 90 degrees, you will have some work to do. Don't be too alarmed if your knee seems to get a bit stiffer and you actually lose a bit of knee bend once you get home. Your knee will be swollen, sore, won't appreciate walking for too long and remember despite appearances, you just had major knee surgery.
It is important to find a balance in getting your knee moving (both knee flexion and knee extension) from the word go, but also not overdoing it and causing further swelling in your knee. Its best to time your exercises to 30-40 minutes after taking your prescribed pain relief as you will be able to accomplish more exercises and push your knee movement further.
Common reasons as to why your total knee replacement won't bend:
1. Pain or inadequate pain relief - remember to follow your doctors instructions
2. Swelling. The fluid in your knee wont compress, so if there is alot of swelling, elevate and ice!
3. Stiff kneecap. Start self patellofemoral mobilisations.
4. Tight quadriceps, ITB and adductors. Remember that you should see your physiotherapist to start massage from approximately 2 weeks post-surgery.
5. Not doing you exercises!!
Below you'll find an easy exercise to do soon after surgery called a heel slide. Slide your heel up and down whilst lying down in bed. If this is difficult, place your foot on a plastic bag to make your foot slide easier. Slide your foot up bending your knee as far as possible within limits of pain. Some discomfort is ok, just don't bend it beyond the point of strong pain. Complete 2-3 sets of 12 repetitions up and down, 3-4 times day.
This exercise is really only appropriate in the early stage of your recovery (ie first 2-4 weeks). You will need to commence self mobilisations, quadriceps stretching, foot slides with assistance, calf and quadriceps strengthening, calf stretching and more....
The Recovery guide to total knee replacement has the full protocol and DVD to guide you through it. Follow it to get stronger and more knee movement sooner. Find out more at www.recoveryguides.com.au
Physiotherapist, Exercise Physiologist, Co-author of Recovery Guides series 2006-2010.