Total/Partial Knee Replacement
Basic/Range of Motion Exercises Day 4
Terminal Knee Extension
While in a seated position, place the strap (such as the one in our Knee Kit) around your arch or midfoot. Be careful not to put it too high toward your toes or you will stretch your calf instead of focusing on your knee. Place one hand on your thigh just above your affected knee, and with your other hand grab both ends of the strap. Push down with your hand above the knee while you pull the strap with your other hand. The goal is to keep your thigh on the surface you are sitting on and get your heel to go up in the air as far as your non-affected heel would go. Hold the stretch for 3-5 seconds and repeat for 10 repetitions. Again, you may feel discomfort/stretch in your knee, and that is very normal.
Place your heel on the bolster (such as one in our Knee Kit). You can be either lying or sitting; lying is a good starting place, but progress until you have done this successfully in a seated position. The goal is to completely relax your leg muscles to allow your knee to go as straight as possible. You may feel a pull in the back or even in the front of your knee. As with all of these knee stretches, that is okay, nothing bad is happening.
While you are stretching try to tighten or contract your thigh muscles and attempt to press your knee further down. This takes a fair amount of practice but everyone can and will be able to do it. Progress to hold the contraction for 3-5 seconds and repeat for 10 repetitions. On your last repetition hold the stretch for 30 seconds. If both knees are affected, repeat with other leg.
Aim for getting your new knee completely straight. Your other knee may have hyperextension, but total knee replacements seem to do better with just going completely straight, which is the goal.
Straight Leg Raise
Start with first getting your knee in full extension (straight) and making your quadriceps tight (referred to as a quad set). Once your quadricep muscles are tight and your knee is in full extension, then lift your leg up several inches. It is important to keep your knee in full extension the entire time you are lifting your leg. It may be easier to start with your heel propped up on a roll (available in our Knee Kit) to allow it to fall into full extension before going from a quad set into a straight leg raise. Repeat 10 times.
This exercise is easier to perform while laying down, but the goal is to perform them while seated with your other knee bent. When some people first start performing this exercise, they may have cramps or spasms in their quadriceps muscles. If this occurs, let the quadriceps relax, and then resume. As you continue to perform the exercise, the spasms will stop. See example below. Repeat 10 times.
Wrap a strap (such as one in our Knee Kit) around the bottom middle of your foot and cross over in front of the ankle as indicated in picture above (See fig. a). Grab the strap ends, one in each hand, and slide your heel toward your buttocks by pulling on the straps (See fig. b). Bend your knee as far as you are able, expecting discomfort to maximize the exercise’s benefit, and then straighten your knee.
Complete the exercise by tightening your quad/thigh muscle and pressing the back of your knee into the surface you are laying on. Repeat this process for the first 9 repetitions. On the tenth repetition, hold knee bent for 30 seconds, then try to bend a little further before returning your knee back to the straight position.
It is highly recommended to take the time to ice your knee after your exercises. Prop your heel on a bolster from your Knee Kit, or the LRU Pillow, and wrap the ice wrap from your Knee Kit. Rest for 20 minutes.