Knee surgeon

Recovery
Exercises

For a complete recovery of the joint, it is necessary to carry out a rehabilitation process of both muscle and stretching. This should be directed by a professional who knows how to adapt to the possibilities of each patient.

Below are the recommended exercises for anterior knee pain, as well as for recover both full extension and flexion of the knee.

Exercises for
anterior knee pain

They are the fundamental element of any patellofemoral pain treatment. Keep in mind that if the thigh muscles are strong, the kneecap will move within the slide of the femur with less pressure.

Up to 95% of patients improve with a correctly performed rehabilitation.

Why rehabilitation is commonly wrongly executed?

Unfortunately, it is common to observe that many patients perform these exercises incorrectly, both in their form and in their frequency and intensity. Generally, this is due to a lack of detailed medical information that leads to performing recovery exercises incorrectly, which does not allow any improvement and can sometimes even aggravate the problem. This generates disappointment in patients, leading them to abandon their routine.

When?

Days

3 days a week

Intensity

Full intensity

Duration

30 to 60 minutes per sesion

How?

Sets

3 sets of each exercise

Repetitions

Between 10-15 repetitions per set

Resting

45 to 90 seconds between sets

Types of Exercises

1. Strengthening thigh muscles

INDICATIONS with or without weight

The mistake is usually made of focusing all the effort on the quadriceps muscle. Although working this muscle is very important, all the muscles of the thigh must be worked symmetrically to avoid generating muscle imbalances.

If you do not have access to a gym, the exercises can be done with or without weight on the ankle, with a weighted ankle bracelet of 1 to 4 kilos.

The last repetition done should be the last one possible to perform, with maximum effort. If you notice that you could continue doing more repetitions, then continue until you can not do more, but on the next set place or increase the weight on the ankle.

en hacer con o sin peso en el tobillo, con una tobillera con peso de 1 a 4 kilos.

La última repetición que se haga debe ser aplicando el máximo de esfuerzo. Si usted nota que podría seguir realizando más repeticiones, siga hasta no poder más, pero en la siguiente serie aumente el peso sobre el tobillo.

2. Hip and gluteus medius

For correct muscular balance of the knee, it is important to work the hip external rotators and hip abductors with the exercises shown in the following video.

3. Muscle stretching

DURATION 15 minutes

It is essential to stretch your muscles before, but especially after strength exercises. You should dedicate at least 15 minutes of time to perform these stretches, which should be done maintaining the stretching position for between 20 and 30 seconds so that the muscle fibers adopt and get used to the new position. 

Recommendations

4. Core

The core is the center of gravity of the body, it acts as a link between the lower body and the upper body and, therefore, is key to developing balance, stability and coordination, improves breathing and reduces the risk of injuries and improves the mechanics of the knee joint and other areas of the body.

5. Proprioceptive exercises

These exercises should be done once the previous ones are performed regularly and with a very refined technique. They help coordinate all the progress achieved by them, in a more physiological and harmonious way.

How to restore full extension

Full extension of the knee is essential for a normal knee function. While a certain loss of flexion is well tolerated, losing just a few degrees of extension generates an imbalance in gait with limping when walking, even affecting the hip and lower spine zone.

After surgery, full extension should be intensively worked on during the first weeks. Otherwise, extension deficits will be more difficult to correct.

Improve extension as soon as possible

As the knee better tolerates swelling at around 20º of flexion, patients after surgery find their knee slightly bent be more comfortable. This must be avoided, and after surgery, recovery of full extension must be worked intensely. This work must be done with a lot of effort and perseverance in the first weeks. 

The more time since surgery, the possible extension loss will become increasingly difficult to correct. After the first 2 or 3 months, the ability to restore more extension is practically gone. 

While after this time a flexion deficit can be recovered even with a simple surgery to release adhesions, the surgical treatment of an extension limitation is much more complex to correct.

What to keep in mind when doing the exercises

Constance and patience

Don’t try to recover everything in one day.

Constant pressure on the knee

Do not apply intermittent pressure or pushing.

The most effective exercise

Place an object under the ankle such as a rolled towel, and another person applying pressure on the knee for about 10-15 minutes constantly, without resting at any time so that the adhesions do not return to their initial position.

Apply ice for 10 minutes

At the end of the session, or even during it.

Repetitions

Two to 4 times a day, as needed.

Nothing below the knee

Never place anything under your knee while resting, even if it is a more pleasant position.

How to restore full flexion

Before knee surgery, and of course after the operation, it is very important to recover as much knee flexion as possible. Ideally, until it is the same as the knee on the other side, or the one the involved knee had before the injury.

It is true that sometimes it can be painful and difficult, but it is very important to work on it several times a day, progressively. For example, you can set the goal of gaining 5º of more flexion every day.

Type of Exercises

Restoring flexion

DURATION  Three or 4 times a day for 15 minutes

In this video, you can see some of the most recommended exercises. Again, it is very important that you work gently and constantly, progressively, and not in jerks that cause more pain. 

 

It is advisable to do these exercises 3 or 4 times a day, at least 15 minutes each time.

It always seems impossible until it's done