After your knee replacement surgery, your doctor will refer you to physical therapy to help you overcome pain and disability and maximize your functional mobility. Most physicians consider physical therapy a critical step in the rehabilitation process.
What is Knee Replacement?
Knee replacement, also called knee arthroplasty, is a surgical procedure to replace damaged parts of the knee joint with artificial implants. Doctors often recommend knee replacement surgery for advanced knee arthritis, rheumatoid arthritis, psoriatic arthritis, or knee injury.
Knee replacement relieves pain, stiffness, and joint instability and improves strength, gait, flexibility, balance, and overall mobility.
There are two types of knee replacement surgeries:
- Total knee replacement — the surgeon replaces the entire knee joint.
- Partial knee replacement — the surgeon replaces only one damaged part of the knee.
Should I Have Physical Therapy Before My Knee Replacement?
Physical therapy before surgery, or “prehabilitation,” helps strengthen the knee and surrounding muscles and improve the range of motion. Studies have found that patients who work with a physical therapist before and after surgery may enjoy a more effortless and faster return to functional ability after surgery.
A study published by the National Institutes of Health (NIH) found prehabilitation before total knee arthroplasty “may improve strength and function before surgery and… has the potential to contribute to postoperative recovery” in older adults with severe osteoarthritis.
Working with a physical therapist before surgery also helps prepare you mentally for the procedure. Your physical therapist will explain what to expect during and after surgery and help you understand how the surgery will affect and benefit your overall health. The more knowledge you have, the less anxiety you will experience.
When you establish a working relationship with your PT before surgery, you know what to expect during your post-surgical physical therapy program.
Physical Therapy After Knee Replacement.
Most experts believe you should begin physical therapy after surgery while still in the hospital. Typically, a physical therapist will visit you the day after your surgery to help you sit up in bed, safely move from the bed to a standing position, and take some steps using a walker. The PT will also teach you to perform exercises to improve your range of motion and strength.
You may require skilled care in a sub-acute rehabilitation facility before you are ready to travel to a physical therapy clinic. It may take a week or two before you can stand and walk without significant pain, but you can begin outpatient physical therapy once that happens.
First Visit
At MOTION, we understand how physical limitations take away from your enjoyment of life. When you cannot perform activities you once took for granted because the movements are too painful, you may fear you will never get your life back. Our mission at MOTION is to “get you back to what moves you” as quickly as possible.
During your first visit, your MOTION physical therapist will evaluate your current physical status and your goals for recovery. Your PT will carefully review your medical history, doctor’s notes, X-rays, and other pertinent information and will ask you about your pain and functionality levels.
To determine your starting point, your physical therapist will perform specific tests to evaluate:
- How the incision is healing.
- Symptoms of scar tissue.
- Amount of swelling around the knee joint.
- Mobility, gait, and ability to use stairs.
- Ability to use a walker or another assistive device.
- Balance and overall stability.
- Range of motion and flexibility.
- Strength in hip, thigh, ankle, foot, and core strength.
Once your MOTION PT has gathered all pertinent information, they will design a treatment plan to get you moving comfortably.
Your MOTION treatment plan will include passive and active therapies and various modalities. Modalities are therapeutic approaches or devices that produce a physiological response. An example would be the application of a cold pack to reduce inflammation and pain.
Your physical therapist will address the following issues in your treatment plan.
Pain, Swelling, and Scar Tissue
Physical therapists deliver hands-on therapy to alleviate pain and improve movement. Massage therapy effectively breaks up existing scar tissue, helps prevent new scar tissue from forming, and improves blood flow to reduce pain and stiffness. By massaging the surgical scar and surrounding skin, your PT helps the skin move more freely.
You probably experienced pain and mobility problems before surgery because of your damaged knee. Although you are still likely to experience some pain and soreness after surgery, it will gradually improve. By about six weeks after surgery, most patients feel little, if any, discomfort. If pain is severe at any time after surgery, contact your doctor.
Mobility, Strength, Range of Motion, and Balance
Although your doctor has replaced the damaged parts of your knee during surgery, you need to commit to a post-surgical exercise program to restore functional mobility. If you do not attend physical therapy or engage in another evidence-based treatment plan, you are unlikely to achieve the mobility you desire and may continue to experience discomfort.
Your weakened knee may have caused abnormal stress on your other knee, affecting gait and balance. For this reason, your PT will work with you to strengthen both legs, your core muscles, and normalize your gait.
Your MOTION physical therapist will use various treatment techniques to improve the strength and flexibility of the muscles that surround and support your knees, including back and hip muscles. Methods often used during the early stages of rehabilitation include:
- Hot and cold therapy.
- Therapeutic massage.
- Exercise and stretching.
- Aquatic therapy.
- Walking program.
- Riding a stationary bike.
- Transcutaneous or Neuromuscular Electrical Stimulation.
- Low-level laser.
- Topical analgesics.
During later stages of your physical therapy program, you may progress to the following:
- Performing exercises with ankle weights
- Single leg standing exercises
- Balance exercises — more advanced balance activities may include using a BAPS board to improve your sense of equilibrium and balance
How Long Does PT Take?
The length of outpatient rehabilitation varies for each person. On average, expect to attend PT three times a week for four to eight weeks.
Your MOTION physical therapist will also teach you a home exercise program to perform in addition to your in-clinic program. We have seen firsthand that our patients who commit to their home exercise program recover more quickly.
We suggest you continue the home exercises recommended by your physical therapist for at least two months after completing your in-clinic program.
Why Consider MOTION Before and After Knee Replacement Surgery?
Our MOTION physical therapy team has been providing quality, transformative physical, occupational, hand, speech, pediatric, and work injury therapy services to clients of all ages since 2015.
Our skilled physical therapy team frequently works with patients before and after surgery to improve strength, circulation, and mobility, reduce swelling and pain, and minimize scarring. We promise to get you back to an active, independent lifestyle as quickly as possible.
Guided by our values of compassion, empowerment, integrity, and teamwork, we promise to communicate with you throughout your recovery, always listening to and respecting your feedback. You know your body best, which makes your input invaluable.
Our MOTION team has years of experience helping people reduce or manage pain, regain function, improve balance and flexibility, and learn to prevent future injuries or disabilities. We believe education is key to living your best life. Not only do our goals include resolving your current issue, but we will also teach you how to live a healthier lifestyle.
To help you stay on track after you complete your in-clinic program, consider our Wellness@MOTION program. The program offers annual wellness checkups, certified yoga, custom orthotics, ergonomic assessments, strength and conditioning, and golf performance (TPI).
We invite you to schedule an in-clinic or telerehabilitation appointment online or call us at 347-745-0122 to learn more about how we can help you before and after your knee replacement surgery.