The recovery and rehabilitation process following knee replacement surgery plays a critical role in helping patients get back on their feet and resume active lifestyle. Proper rehabilitation accelerates the healing process and improves chances of long-term success. In fact, while the surgery helps to correct the knee problem, only a carefully designed exercise schedule can strengthen muscles and restore normal function to the knee.
Immediate physical therapy
For post-surgical rehabilitation to be effective, it should begin soon after knee replacement surgery, possibly within the first 24 hours. During this early stage, the therapy should be aimed at basic things such as pain control, monitoring of incision sites and the range of motion at the knee joint. Attention should be given to the movements the knee is able to make soon after surgery, particularly bending (flexion) and straightening (extension) movements. These movements are controlled by thigh muscles—with quadriceps (front thigh muscles) pulling the leg out straight while hamstrings (back thigh muscles) bending it.
Using the knee extension machine
At FYZICAL Sarasota Downtown, we prefer to have patients start exercises to restore their range of motion (ROM) immediately after knee replacement surgery. That’s because the knee can only be fully functional if it can move efficiently. But the problem with immediate activity on the knee is that the patient is usually in a lot of pain that should not be made worse by pulling and pushing the knee. To overcome this challenge, we recommend the use of a knee extension machine for range of motion exercises soon after surgery.
The knee extension machine provides calibrated impact on the knee and gives the patient control over knee movements. The patient sits in a relaxed position and sets the desired range of motion, which the machine delivers by gently flexing and extending the knee joint. Machine-assisted exercises are simple and convenient with the patient in a comfortable position during each session and the knees worked against controlled resistance.
Subtle and incremental application
The extension machine is usually set to zero degrees before any range of motion work begins. At the start of a session, the patient sets the machine to a range of motion determined by the acuteness of the injury. Once the patient has worked at a certain range for a period of time, typically holding a position for 5 seconds to 1 minute, the machine is set to the next range to enable the patient to build on the increases gradually.
Ideally, the patient should begin work at a lower level, but with prolonged duration (high repetitions) at each level, and then build slowly with every set. Using a high range of motion earlier can cause damage to the knee by stretching the joint. As always, the best way is to begin with light exercise and increase the intensity as the level of pain can allow.
Benefits of using a knee extension machine
1. Tackles extension lag
When knee extension is not done within the first eight weeks, it is generally more difficult to extend the knee later because patients usually tend to suffer from extension lag, which means that the knee is stuck in a slightly bent (flexed) position. Using the knee extension machine soon after knee replacement surgery prevents extension lag or reduces it to just a minor issue that cannot lead to a chronic or permanent problem.
2. Improves compliance with stipulated exercises
Whatever exercises the physical therapist may choose to perform on the knee soon after replacement surgery, the pain in the knee may make it difficult to do them effectively. However, the knee extension machine is a safe, controlled and effective way to improve both strength and range of the knee without the push and pull that comes with manual therapy. Hence it improves compliance with therapeutic exercises and improves chances of restoring normal extension and function.
3. Remedy for knee stiffness
One of the most common problems with knee replacement surgery, and a major reason why patients may be dissatisfied with the results of the procedure, is knee stiffness. The problem can be so severe that some patients struggle to resume normal activities due to abnormal knee motion. But when the knee is worked using the knee extension machine soon after surgery, scar tissue does not develop and stiffness does not occur.
4. Convenient and effective
The use of knee extension machine reduces the need for knee manipulation and delivers a more rapid increase in motion following surgery. The machine makes it easier for the patient to control the way the knee is moved while in a relaxed position. And depending on the degree of pain and discomfort, patients can easily push to their limits quickly and work gradually to their normal range of motion. The machine also provides data that patients can use to track the progress of their recovery path and discuss this progress their physical therapists and surgeons.
At FYZICAL Sarasota Downtown, we recommend knee extension machines to our patients for easy compliance with the requisite therapeutic exercises. We want to help our patients recover from traumatic knee conditions in the most painless and flawless way, so we recommend the use of knee machines to increase blood circulation, minimize joint stiffness, relieve muscle spasms and restore normal movement of the knee without damaging the new joint before its muscles can be strong enough to control it.
We support our patients all the way as they learn to use exercises to regain mobility and independence. We also ensure that our clients complete all the necessary exercises in order to resume their normal activities as soon as possible. For more information about our physical therapy, balance and orthopedic rehabilitation exercises, visit the FYZICAL Sarasota Downtown website.