Yudu - sportEX medicine - 1999-2010

PATIENT ADVICE Rehabilitation after knee surgery

The surgery to your knee will have been carried out in order to remove damaged cartilage in the joint. The aim of the surgery is to relieve pain and any ‘locking’ of the knee that you may have experienced before the surgery.

However following the surgery you may experience some pain due to the swelling and inflammation around the arthroscopic insertion points on the inside and outside of the knee. You may also experi- ence swelling or ‘tightness’ above the patella and/or at the back of the knee. This is not uncommon and is a direct response to the operation procedure. The aim of the rehabilitation programme in the first few days is to assist the removal of any swelling from the knee joint and surrounding soft tissue structures.

If this factor is ignored or neglected then this post-operative swelling will have a negative effect on your future rehabilitation goals which are mainly to:- ● Increase your range of movement ● Increase your muscle strength ● Improve your proprioception ● Return you to a good functional state

The following exercises are designed to help in the removal of this swelling and begin the process of increasing your range of movement and strength around the knee. As explained above it is important for you to do these exercises regularly as instructed by your therapist.

Early mobilisation - 1-10 days post-operation 1. Knee flexion using a band Find some sort of slippery surface such as a formica to reduce friction. Sit down and put a band around your foot with your heel resting on this surface. Bend your knee as far as possible. Gently pull the band to bend your knee a little more. Do this 10 times and repeat the whole process 5 times on your injured leg.

2. Knee flexion using gravity Lie on your back with your feet up in the air and your legs and bottom against a wall. Bend your knee and slide your heel down the wall. Do this 10 times and again repeat the whole process 5 times on your injured leg.

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3. Knee flexion in sitting Sit on a chair or stool with your leg outstretched in front over you, bend your knee and draw your heel back towards you until you feel any pain at the arthroscopy scars or in the joint. Do this 5 times and repeat the whole process 5 times on your injured leg.

4. Quadriceps strengthening in lying Lie on your back with your injured leg straight out and the other leg bent. (You can vary this exercise by pointing your foot of the straight leg either upwards, inwards or outwards.) Pull your toes up straightening the knee and lifting the leg 20cm off the bed/floor. Hold for 5 seconds and relax. Do this 10 times and repeat the whole set 3 times with both legs. To make the exercise hard- er put a 2kg weight around your ankle.

Strengthening exercises - weeks 1-4 5. Quadriceps strengthening in sitting Sit on a chair, pull your toes up so they point to the ceiling and tighten your thigh muscle and straighten your knee. Hold for 5 seconds and then relax slowly. Do this 10 times and repeat the whole set 3 times on your injured leg only.

6. Quadriceps strengthening using a step Stand sideways on a step with the uninjured foot hanging over the edge of the step. Slowly bend your knee allowing the other foot to brush the floor. Do this 6 times and repeat the set 4 times.

7. Balance training with wobble board Stand on your injured leg on a wobble board and rock the board first in one direction and then in the other for 30 second bouts. Repeat this 10 times.

The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for special- ist medical advice in each individual case. To the extent permissable by law, the publisher, editors and contributors accept no liability for any loss, injury or damage howsoever incurred (including negli- gence) as a consequence, whether directly or indirectly, of the use of any person of the contents of this article.