What Does Physical Therapy Look Like After A Knee Replacement?
Leave a CommentAre you planning on having a knee replacement? Did you recently just have one? Knee replacements are one of the most common types of replacement surgeries. Many patients experience a lot of uncertainty around the recovery process post-surgery. In this blog, we’ll dive deeper into the recovery journey so you can be prepared to head into your procedure.
It is important to understand that you will likely have pain after surgery, and this discomfort isn’t necessarily a cause for concern. An episode of Extreme Home Makeover just occurred inside your knee! Your surgeon will prescribe you pain medication as needed. They usually recommend that you take these meds about an hour before your therapy sessions to get the most out of your time with your physical therapist. Swelling and bruising are normal! In addition to swelling around the incision and knee joint, you will likely get some swelling near the hip, as a tourniquet is used to decrease bleeding during surgery. Swelling at the foot and ankle is also common due to gravity.
Unless you are at risk for any complications, you will likely be going home the same day you have surgery. Before going home, the doctors and staff will ensure you can get up and walk with an assistive device, most likely with a walker. Depending on your doctor’s preferences, you will either start your physical therapy at an outpatient clinic location the day after surgery or have one to two weeks of therapy in your home.
Athletico performs outpatient home therapy services if you wish to stay with the same therapist throughout your entire care, as long as your surgeon does not also require nursing during that home therapy period. Athletico’s therapists can change bandages that a physician provides and take blood pressure measurements. A nurse could be needed to discuss medication. It is very important that during home therapy, you focus on regaining your range of motion. Your therapist will likely push your knee into bending and straightening to help with this. Just remember that you need to be going into these motions on your own as well when your therapist isn’t there!
Once you finish with any home care services, you will start in an outpatient therapy clinic. Your evaluation there will consist of your therapist getting to know your situation, obtaining measurements of range of motion and strength, and developing a home exercise program and plan of care to get you back to where you want to be. If you choose to have outpatient rehabilitation in the home through Athletico, the evaluation portion can be skipped as this would have already been performed, and you can start your session on day one!
If you were working with me, therapy sessions would likely start with cardio and assisting with knee bending. I like to use the stationary bike or Nu-Step to get the blood flowing and the knee moving. Next, your therapist may work with you at a table to do some manual therapy on the knee. This will likely consist of massage to minimize swelling at the knee as well as mobilizations to the kneecap to ensure no scar tissue forms under it. Scar tissue formation can reduce your knee’s ability to bend and straighten. Exercises will focus on regaining that range of motion and promote knee strengthening. Functional strengthening exercises ensure you can go up and down stairs reciprocally, get up and down off the toilet easily, get in and out of the car, and walk around your community without an assistive device. At the end of your sessions, your therapist may suggest a modality such as ice or electrical stimulation to help reduce swelling and pain. Again, this tends to be how I have my patients go through a session, but this can vary between therapists.
Milestone moments that we look for in therapy are:
- Getting full knee extension or strengthening: This allows you to walk with normal mechanics (no limping!)
- Getting 90 degrees of knee flexion or bending within about 2 weeks
- Getting 120 degrees of knee flexion
Outpatient physical therapy usually lasts several weeks to a couple of months, depending on how quickly your recovery occurs and your goals. You’ll be ready to be discharged from physical therapy when your range of motion and strength are at a point where you can continue your exercises and daily tasks as safely as possible. It is important to know that it can take 6 months to a year to feel “normal”. This does not mean that you won’t be able to do everything you want to do before this! There will be days where you feel some soreness, but this will be far less often and less intense as it is closer to the start of care. You may also hear noises in the knee, but it does not mean something came loose!
To ensure you are in a better position to recover from your knee replacement, consider doing physical therapy before surgery. This is known as “pre-hab.” Improvements in strength and range of motion prior to surgery can put you in a better position post-surgery. Working on strength and range of motion can also reduce your overall pain symptoms and may put off the need for surgery for some time. Remember, a “bone-on-bone” diagnosis from an X-ray does not always mean you need a knee replacement if you aren’t having pain or limitations during your life. Arthritis is like having wrinkles on the inside – most people have or get it, but it’s only a problem when it limits what we want to do with our lives.
Physical Therapy Can Help
If you have more questions about your joint replacement recovery journey, please contact your local Athletico Physical Therapy clinic to schedule an appointment. To learn more about our joint replacement therapy services, click here.
*Per federal guidelines, beneficiaries of plans such as Medicare, Medicaid, Tricare, VHA and other federally funded plans are not eligible for free assessments.
The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.
