Most people do not think about what they should do before their knee replacement surgery. Instead, they’re focused on what will happen during and after surgery, which is understandable.
If you’re planning on having a total knee joint replacement surgery within the next two months, now is the ideal time to start getting your knee joint ready for a speedy recovery!
Additionally, if you are looking for more information regarding knee replacement surgery physical therapy, check out 5 Essential Tips to Help Speed Up Your Recovery At Home Following Knee Replacement Surgery...
The first thing is pretty easy to understand: some people recover faster than others. The 3-6 month window is a pretty big window… some people are feeling great at the 3-month mark (or earlier), have excellent ROM and strength, are very active, and have minimal pain and swelling. And others make slower progress and don’t achieve their rehab goals until closer to the 6-month mark. This observation brings up an interesting question: what’s the difference between these two people? We’ll get to that in a few more paragraphs…
The second observation that’s caught my attention is this: the fact that 5-10% of people NEVER make a full recovery following total knee joint surgery. These people will experience some ongoing knee pain, stiffness, and/or swelling for years. In addition to the question above, both observations lead back to a second question: what can YOU do to improve your chances for a full recovery in the shortest amount of time possible?
Here’s the simple answer to both questions: one of the most significant differences between those people who recover quickly and those who take longer to recover is their physical condition going into surgery. In other words, the best thing you can do to improve your chances for a full recovery is to focus on the condition of your knee (and your whole body) right NOW, before your knee replacement surgery. With that being said, I’ve compiled 8 of my best pieces of advice into this report to help you accomplish this goal. The tips are in no particular order, although I’ve tried to arrange them in a logical progression.
Here’s my best advice: implement as many of these tips as possible in the 2-3 months prior to your surgery, particularly the first four tips. Also, if you live in the Greater Milwaukee area, pay special attention to tip #8, as this is the most valuable tip inside the report. After reading the article, I hope you’ll have more confidence heading into your total knee surgery or total knee replacement physical therapy.
#1: Try To Keep Moving
One of the biggest mistakes people make when planning a knee replacement surgery is to assume that all they have to do is show up on the day of surgery, and the surgeon will take care of the rest. If you are inactive prior to surgery, your muscles will be very weak, and your joints will stiffen up, making your recovery more complex.
Keeping your body strong is essential because having surgery is like the physical equivalent of running a marathon (you wouldn’t try to run a marathon without training, would you?!) If walking has gotten too painful for your knee, some of the best ways you can stay active include: walking/exercising in a pool, riding a seated elliptical, and riding a stationary bike (I prefer recumbent bikes for total knee replacement surgeries).
While this first tip is extremely simple in nature, please don’t overlook it! In addition to helping you maintain your muscle tone and joint flexibility.
Regular physical activity will also help every aspect of your health, including keeping your cardiovascular system strong and your bone density as high as possible.
#2: Increase Your Knee Flexibility
The more flexible your knee is prior to surgery, the easier it will be to regain full motion after surgery. So make sure you regularly stretch your knee into full flexion (bending) and full extension (straightening) as much as possible in the weeks and months leading up to your surgery.
I have two favorite stretches to keep your knee as flexible as possible heading into TKR surgery:
Hamstring Stretch w/ Gentle Pressure (to straighten your knee): Stand at the base of your staircase, and place your heel on the second step, allowing your knee to straighten towards the floor (if you don’t have stairs, you can use a low chair instead). Gently hinge forward at your hips until you feel a comfortable stretch on the back of your thigh. If your knee appears completely straight, just hold this stretch for 30-45 seconds. If your knee isn’t relatively straight, you can place some light pressure on the top of your thigh to encourage full motion.
Stair Knee Flexion Stretch (to bend your knee): Starting again at the base of your staircase, place the foot on your surgical side flat on the second step. Using the handrails/walls for support, slowly lean your body forward, which will start to bend your knee. When you reach a good stretching sensation (just before pain), hold the stretch for 30-45 seconds.
Both stretches could be performed for 2-3 repetitions, several times each day, depending on your pain level and tolerance. If you try these two stretches start slowly and gradually build up your tolerance as your tissue becomes more pliable.
#3: Build Up Your Leg Muscles To Support Your Knee
Your “quad” muscle group on the front of your thigh can take a severe beating during knee joint replacement surgery and appear very weak following surgery. This is because the muscle group “shuts down” due to the swelling, trauma, and pain.
After surgery, you have to learn to re-activate this muscle group and start to build strength again. The stronger your quad group is before surgery, the easier it will be to activate after surgery. Establish your muscle memory before surgery by strengthening your quads. Two simple exercises help you with this task: seated knee extensions and straight leg raises.
In addition to maximizing your quad muscle strength, having optimal hip strength will also help you speed up your recovery and mobility after surgery. Not only do your hip muscles help you stabilize your knee when you walk and squat down, they also help you keep your balance during dynamic activities. And here’s a perk: there are several ways to strengthen your hips before surgery that won’t typically cause knee pain, including exercises like side leg raises and clamshells.
#4: Decrease Your Swelling BEFORE Surgery
For some people, this might be the most crucial tip in this article, as this tip is missed by nearly everyone in the medical field (including myself for the first 5 years of my physical therapy career). Allow me to explain… Following TKR surgery, the average person will experience a significant amount of swelling surrounding their surgical knee, and the swelling will often extend into their lower leg and upper thigh. This swelling is one of the most difficult things to deal with after surgery, as it causes a lot of pain and pressure in the knee, right at a time when you’re doing everything you can to work on improving your knee flexibility (aka “ROM” or “range of motion”).
If you’re lucky enough to work with a PT who will help you with your swelling after surgery, then you’ll have an advantage over the person working with a PT who doesn’t know how to treat swelling and will only help you with your exercises and some basic stretches. So that’s one tip: make sure you work with a good PT after surgery who will actively help you reduce your swelling and isn’t afraid to spend 30 minutes of your early treatments helping you with massage techniques.
In addition to that tip, I have an even bigger one for you: consider working with a physical therapist BEFORE your surgery to reduce any lingering swelling in your knee, lower leg, upper leg and/or abdomen. Any swelling you can clear out of your leg and abdomen before surgery will pay off with dividends after surgery, as your body will be in a much better position to reabsorb all that extra swelling.
#5: Drink Plenty Of Water
Did you know that when people are well hydrated before surgery, they typically experience less pain and nausea after surgery? Being dehydrated is a big mistake that could be contributing to your knee pain (even right now!) and zapping your energy. Dehydration alone can cause muscle aches, joint pain, fatigue, and dizziness. Try to drink water throughout the day.
A good rule of thumb is to try to drink half your body weight in ounces daily (so if you weigh 180 pounds, you’ll want to consume 90 ounces of water daily).
The easiest way to do this is to always keep a water bottle near you. Avoid excessive amounts of caffeine, including coffee, caffeinated tea (like green and black tea), alcohol, and energy drinks, as these will dehydrate your body even more.
Also, although it might sound counterintuitive, drinking more water will help reduce your swelling after surgery. If you’re preparing for TKR surgery, get in the habit of drinking water right now!
#6: Check Your Living Environment
When you come home from the hospital or surgical center, there’s a good chance you’ll be using a walker to get around the house. Take a walk through your home before surgery and identify areas where furniture is close together, or trip hazards exist. Take a close look at your bathrooms, remove any unnecessary rugs, and check to ensure that your walker will allow you to access your toilet and shower/tub. Make needed changes to these areas now so that your family members aren’t scrambling to re-arrange your home the day you come home. Any stress and work you can alleviate before surgery will make the recovery process more enjoyable.
#7: Have A Conversation With Your Support Team
For most people, the first week after surgery passes by in a hectic blur. This is why it’s so important to have someone at home with you that you can depend on, especially during the first week of your recovery. Talk to your expected support person, your spouse, a family member, or a close friend about their availability and willingness to help you. Explain to them that you’ll likely need help getting up and down from a chair, in and out of bed, managing medications, making meals, and getting to and from your PT sessions.
This tip has become even more critical over the last 1-2 years, as hospitals have attempted to shorten length-of-stays (most people will only stay in the hospital for one day now, versus the standard 2-3 days just a couple of years ago). In addition, it’s becoming increasingly common for people to visit an outpatient surgical center and go home the same day as their surgery. While this is a beneficial development in many ways, especially if you can avoid the hospital, it stresses the importance of having a good support person to help you navigate the first several days of your recovery. So start grooming this person as soon as possible… and don’t be afraid to butter them up a bit!
#8: Setup Your 20-Minute “Pre-Hab Phone Consultation” With A Physical Therapist…It’s FREE
There isn’t a better way to prepare for total knee replacement surgery than by working with a physical therapist before your surgery. We call this period the “pre-habilitation” or “pre-hab” phase, and research shows that people who participate in a guided pre-hab program BEFORE total knee surgery are stronger, in less pain, and are less likely to need to go to a skilled nursing or inpatient rehab facility (in other words…they go home from surgery sooner). And while the first seven tips in this report are designed to help you optimize the “pre-hab” period on your own, it can also be very valuable to meet with a physical therapist to address questions and concerns that are specific to your situation.
At Prestige Therapy and Wellness, we’re happy to offer you a FREE 20-minute “Pre-Hab Phone Consultation” with one of our PTs to help you maximize your knee strength and flexibility heading into your knee replacement surgery. During your complimentary phone call, your PT will give you specific advice on what exercises you should be doing in the weeks and months before your surgery, and they’ll answer any of your questions about the post-surgical recovery phase.
We’ve designed these phone consultations to give you as much confidence as possible heading into your surgery, so you can hit the ground running after surgery and regain your activity level as quickly as possible.
As a mobile physical therapy practice providing in-home physical therapy and occupational therapy provider in the Greater Milwaukee area, we help individuals aged 65+ improve their mobility to keep them active and living at the most optimal level.
If you are looking for assistance with your weight loss plan or exercises for seniors or wondering how to improve your mobility and live in Waukesha, Brookfield, New Berlin, Pewaukee, Delafield, Hartland, Oconomowoc, Greenfield, New Berlin, Muskego, Wales, Greendale, Franklin, Oak Creek, Whitefish Bay, or in surrounding Greater Milwaukee communities. If you’d like to request your FREE “Pre-Hab Phone Consultation” simply click here and complete the quick form and we will be in touch!!
Talk more soon!!
Preston, PT
P.S. If you’re experiencing stiffness in your knee or hip which restricts your ability to move without pain, click here to download our FREE knee and hip pain tips report which includes actionable tips we give to our patients at Prestige Therapy and Wellness, LLC. Click here to get your free guide.
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