The role of the physiotherapist

You will attend a therapy-led, pre-assessment clinic one week prior to your surgical date.

This will provide an opportunity for the physiotherapist to gather information, complete an assessment and identify your needs to ensure you are supported on the ward and on discharge.

Once admitted, a member of the physiotherapy team will provide any walking aids that you may need and answer any physiotherapy questions you may have. You will then be assessed following your surgery and the appropriate treatment sessions provided, until you are deemed fit for discharge.

Skip straight to exercises after surgery

Skip straight to frequently asked questions

Walking and walking aids

Every patient’s recovery is different. However, you can expect to be walking from between six to 24 hours after your operation. Initially, you will need the help of a walking frame, then progress on to elbow crutches/sticks.

This will be advised by your physiotherapist. Within three months many patients will be walking independently, depending on their baseline mobility status.

 

Using a walking frame

• When walking, push the frame forward keeping all four legs in contact with the floor.
• Keep a gap between yourself and the frame when walking.
• When turning, pick the frame up and complete small turns and steps.
• The frame should not be used to pull up on from a seated position.

 

Using two elbow crutches

• Place your arms in the cuffs and ensure the handles are facing forward.
• Place both crutches one step out in front.
• Step your affected/operated leg in line with the crutches and then bring your other leg in line.
• Regularly check for rusting and ensure the rubber stoppers  are not worn.

 

Stairs

If you have steps/stairs in your property, your physiotherapist will teach you how to go up and down stairs prior to discharge.

Going up: use a banister if possible.  Lead with non-operated leg, followed by operated leg and crutch.

Going down: lead with operated leg and crutch, then non-operated leg.

 

Ongoing physiotherapy

On discharge, you will be referred for outpatient physiotherapy to continue with your rehabilitation. Your outpatient physiotherapist will review your knee range of movement, your mobility and will progress your exercises until your goals are achieved.

 

Exercises

The physiotherapist will advise you on appropriate exercises to undertake on the ward and to continue at home to increase the range of movement and strength in your operated limb. You should be able to fully straighten your leg and bend it to 90 degrees by the second week (if you were able to attain this range pre-operatively). N.B. The outcome of your knee replacement very much depends on you taking responsibility to complete the exercises on your own.

 

Exercises after your surgery

The physiotherapist will encourage you to complete the following exercises after your surgery.

These exercises should be done from day one until full recovery.

 

• Ankle pumps - Bend your ankle up and down as far as able. Repeat 20 times every hour. Image shows a person lying on a bed to demonstrate the exercise with their right foot flexed and their toes pointing up towards the ceiling. 

 

 

 

 

 

 

 

 

 

 

• Static quads - Lie on your back on the bed. Press the knee of the operated leg into the bed, tightening the muscle on the front of your thigh. Hold for three seconds. Do not hold your breath. Repeat 10 times, four to five times a day. Image shows a person lying on a bed to demonstrate the exercise. Their right leg is flat, with the back of their knee pressed to the bed. Their left leg is bent at the knee.

 

 

 

 

 

 

 

 

 

 

• Gluteal squeeze - Squeeze your buttock muscles as tightly as possible and hold for three seconds. Do not hold your breath. Repeat 10 times, three to four times a day. There is no image to demonstrate this exercise.

• Knee flexion - Lie on your back. Bend the knee of the operated leg and slide your heel towards your buttocks. Repeat 10 times, four to five times a day. Image shows a person lying on their back with their right leg bent. 

 

 

 

 

 

 

 

 

 

• Inner range quads - Lie on your back or sit with a rolled towel under the operated knee. Lift your foot, straightening the knee and hold for three seconds. Do not raise your thigh off the roll. Do not hold your breath. Repeat 10 times, four to five times a day. Image shows a person demonstrating the exercise. They are lying on a bed on their back with a rolled up towel underneath their right knee. Their right leg is straight with the foot lifted off the bed. 

 

 

 

 

 

 

 

 

 

 

• Straight leg raise - Lie on your back. Lift your operated leg up five inches. Hold for three seconds and lower slowly. During this exercise keep the knee straight and toes pointed up. Repeat 10 times, four to five times a day. Image show a patient lying on a bed to demonstrate the exercise. Their right leg is raised. Their left leg is flat on the bed.

 

 

 

 

 

 

 

 

 

 

• Knee extension in sitting - Sit in a chair with your back against the back of the chair. Straighten the knee of the operated leg slowly. Repeat 10 times, four to five times a day. Image shows a person sat in a chair to demonstrate the exercise. Their right leg is straight, with their foot off the floor. 

 

 

 

 

 

 

 

 

 

• Knee flexion in sitting - In sitting position, cross your unoperated leg over your operated leg. Bend your operated leg as much as possible then give a gentle push with other leg. Repeat 10 times, four to five times a day. Image shows a person sat on a chair. Their left leg is crossed over their right operated leg.

 

 

 

 

 

 

 

 

 

• Extension stretch - If you have difficulty with straightening your knee, put a firm rolled towel under your ankle and press the knee down as much as you can. Hold for five seconds. Repeat 10 times, four to five times a day. Image shows a person lying on a bed. Their right leg is out straight with a rolled up towel under the ankle. The left leg is bent.