No matter what type of knee surgery you had, your doctor may recommend a series of soft workouts, aquatic or water therapy. For those who had simple arthroscopic surgery, soft workouts or exercises can actually start anytime after the critical first week.
As for those who have ACL reconstruction surgery, this should be started around 2 weeks and total knee replacements from about 4 to 6 weeks post-op. Each movement of the workouts is designed to rehabilitate your knee and minimize pain.
It is recommended to use one of the aerobic training programs like stationery cycling, treadmill, or elliptical, core exercises like sit-ups to get a good warm-up. Always end with stretching and a cool down activity and be sure to exercise both legs. However, try to do a extra few reps on the surgical leg to help get your body back in balance.
If you had bilateral knee replacements, your knees are not perfectly symmetric. With bilateral total knee replacement, it may take longer before you are ready to start the more intensive workouts. One muscle quality that is left out of many recovery programs is speed.
You should have started working on changing speed during your exercises, movement patterns, aerobic training and water exercises. The changes in speed prime your neuromuscular system for life challenges to come.
The following 4 exercises below build on what your knee already know. If combined with your movement patterns and aerobic training programs, these moves are all your knee needs.
4 Knee Exercises To Promote Recovery After Surgery
Double –Leg Squats (With or without stability ball)
Starting position: Begin with your feet shoulder-width apart. Hold a chair or other secure object like dumb bells in your hands. You can also add a stability ball if you want. All these add a new element of balance and challenge. Place your feet just in front of your hips and lean backward, thus working slightly different muscles than the standard squat.
Keep your weight evenly distributed on both legs and keep your feet flat on the floor, avoid raising your heels. Depending on the size of your stability ball, you may have to move your feet farther forward than your normal squat positions.
Action: Squat as if you are sitting down in a chair. Keep your lower back straight and strong. And tighten the abs. Start by doing quarter squats to 45 degrees, eventually you may go down as low as 90 degrees. You are not born knowing how to squat properly, so have someone knowledgeable critique your technique. Do at least 3 sets of 10 reps, twice a day. To add on to the challenge, you can use heavier dumb bells.
Double-Leg Hamstring Bridges
The purpose of this soft workout is to strengthen your hamstrings. Most people stretch their hamstrings and strengthen their quads, but not enough people do the opposite. The hamstrings are a friend of the ACL, so whether you are recovering from an ACL tear or you want to avoid one, pump those hamstrings up.
Starting position: Lie on your back with your heels on a chair or bench. Your hips and knees should be flexed to 90 degrees, with your arms out to the side for stability. The chair should be on a rug, otherwise you will tends to shove it across the room.
Action: Press your heels into the chair and lift your hips until they are well off the floor. Lower your hips without touching them to the floor, and repeat. Strive for 2 sets of 10 reps, twice a day. The key to this exercise is to press your heels into the chair.
You can put your feet on a stability ball rather than a chair, and the rolling will allow more motion in your knee. Ideally, the ball’s diameter should be the same length as your thighbone.
The purpose of this workout is to combine strength, coordination (agility), and balance into one practical motion. They work your knee and your outer thigh muscles. Moving sideways is part of everyday life such as negotiating wet or icy sidewalks.
Stand next to a 3-inch step or a box that is strong enough to hold your weight (most steps are about 7 inches tall). As your strength increases, so should the height of the box or step.
Action: Step laterally (sideways) onto the box and shift your weight completely your weight completely to that leg. Next, push down into the box while lifting the opposite leg off the floor.
Stand up fully without locking your knee. Maintain a good co-contraction. Slowly lower your non-standing foot back to the floor. This is sometimes called the “eccentric” part of the exercise (lowering the weight). Eccentric motions are often better than “concentric” motions (lifting the weight) when it comes to gaining strength. Return to starting position. Do 2 sets of 15 reps, twice a day.
The purpose of this exercise is to become strong and balanced, but one leg at a time.
Starting position: Stand your weight on your front leg, using a chair or table for balance.
Action: Perform strong, slow, even squats. Start by going down only about 30 degrees (barely bending your knee). Slowly progress deeper as you get stronger. Lift your back leg and lose the chair as your balance improves. This is a tough exercise: 3 sets of 6 slow reps, twice a day. Single-leg squats, like leg balances should be done obsessively.
The above 4 exercises are vital motions for your knee’s health. Along with your exercises and movement patterns, add different aerobic training programs over the course of the week depending on your choice or the weather. You should structure your week into hard days and easy days.
In fact, activities like soft workouts, ROM stretches, movement patterns or aerobic pattern does not necessary to be done in one block. It can be broken into multiple sessions.
Benefits Of Water Therapy After Knee Surgery
- Water is the ultimate soft workout.
- Water greatly facilitates joint movement as rough cartilage surfaces separate by “natural traction” to allow motion with less pain.
- Being in water allows your muscles to move, stretch and work without the stress of gravity.
- Since your knee is not in pain in the water, you can get a great workout for all muscle groups.
After your sutures have been removed and the wounds have healed, usually by 2 weeks post-op, it is safe to begin water therapy. You can get into the water before this by covering the wounds with waterproof dressings or plastic bags, but this technology is less than perfect. To be safe, ask your doctor before submerging your knee in any water.
When you perform most weight room exercises, your muscles are not actually working through a full range of motion. When you lift your leg against gravity, the weights will provide resistance. However, in the pool, the water provides resistance in all directions, helping your muscles to resist uniformly in the entire arc of motion.
Besides, you can strengthen your muscles with minimal risk of tearing or injury. Strengthening through the range of motion also ensures that flexibility is not sacrificed for strength improvement. The relaxation effect of water, combined with the decrease in gravity, allows opposing muscle groups to relax and thereby gaining joint flexibility.
To enhance your water training program, consider getting some type of floating device such as vest, foam noodle, belt or barbells which will allow you to perform certain exercises more efficiently. In fact, soft workouts such as water therapy are a terrific way to burn calories and keep fit without constantly beating up your joints.
To start off with, you can find a gym, health club, rehab facility, or even a nearby hotel with a pool. In fact, even if you do not perform any exercise moves, you will still gain enormous benefits just by moving around.
The following are 5 basic exercises which you can adopt to boost your recovery level. Try doing the exercises for a set number of minutes rather than number of repetitions. Concentrate on practicing each motion deliberately and avoid rushing through the motions.
5 Water Therapy Exercises To Promote Knee Recovery After Surgery
Deep-Water Walking And Jogging Forward Or Backward
Ideally, doctors would have everyone walking and jogging in the water before attempting these activities on land. As such, you are able to practice these basic movement patterns in a safe environment.
Starting position: Stand vertically in deep water with a flotation device. Start with some easy “walking” both forward and backward. The deep water eliminates gravity, and your knee loves it. Once you feel that you are water-walking smoothly in the deep end, shift into an area with neck-deep water. Proceed to the shallower areas as you get stronger.
In addition to countering the effects of gravity, water provides resistance for muscle strengthening. Once you are walking well in the pool, head back to the deep end and start jogging.
Remember to do everything forward and backward, starting with slow and deliberate motions. The variations of the walking or running theme are endless, so feel free to make up games for yourself, such as interval “sprints” (speed changes).
This is a great core-strengthening exercise, again with endless variations.
Starting Position: Using your flotation device, stand upright in deep water.
Action: Maintaining an upright posture, raise your legs to a 90 degree angle with your torso, or as high as possible. Feel the strength in your back and abdomen.
The water is a great place to work on core exercises since the buoyancy is constantly pushing you to the surface and challenging your position.
Flutter Board Or Barbell Squats
This water soft workout improves balance and motion.
Starting Position: Stand with both feet on a heavy flutter board or barbell in deep water.
Action: Allow the board to rise while you slowly flex your knees. Then press the board toward the pool bottom. To make it more challenging, increase your speed.
This is a fun, dynamic exercise to work on lateral motion, speed and quickness.
Starting position: Using your flotation device, stand upright in deep water.
Action: Bring both knees up toward your chest and push them down at a 45 degree angle to the right, bring your knees back to your chest, and push them 45 degrees to the left.
This is also a great exercise for your abdominal muscles. Feel the strength in these core muscles to increases the efficiency of the exercise. Arthroscopy patients can move to chest-deep water, pushing off the pool floor, as soon as they feel good. ACL and TKR patients should probably wait until 6 weeks post-op.
This is designed to improve knee range of motion.
Starting position: Stand on the bottom rung of the pool ladder or stairs and hold the hand bar without using a flotation device. Squat into the water to stretch and work on ROM at your knee. The water takes the weight off so you can safely and comfortably squat lower than on land.