No matter what type of knee surgery you had – and there are a lot, including arthroscopy, ligament reconstruction or replacement, or a partial or full knee replacement – you will need rehabilitation therapy to optimize the outcome of your procedure.
“Every knee injury is different and surgical methods vary among surgeons,” explains Samira Razavi, a Certified Athletic Therapist with Futsal Club Toronto and Competitive Edge Physiotherapy in Mississauga. “However, the general rehabilitation protocols remain the same.” It generally follows the same three basic phases:
- Reduce the swelling and pain from the surgery
- Work on increasing your range of motion
- Strengthen your leg, and core, so you can function better moving forward.
Remember, the exercises you work on with your therapist, your recovery time and the outcome will differ based on a variety of factors, including how severe your original injury was, how healthy you were before surgery, any prehab exercises you did, your age and how much you stick with the therapy program.
You will typically start your athletic therapy 3-5 days after your surgery. Your therapist’s goal at this point is to reduce the post-surgical swelling and pain in your knee. “We focus on removing swelling, minimizing pain and protecting the tissue,” says Samira. They can accomplish this by using different techniques, including manual soft tissue release, ultrasound and electrical stimulation. Your therapist will also “get the knee moving as early as possible,” explains Samira. “Full range of motion for a knee is 130-140 degrees. If I can get to 90 degrees of knee flexion by days three post-op, I’m happy. By the end of the week, I want 100-110 degrees flexion.
The next phase usually starts 2-3 weeks after surgery. Your therapist will focus on working on your range of motion, with exercises such as a single leg stand, simple stepping up and down, partial lunges and squats. “At this point I am trying to get the client back to full weight bearing and off the crutches,” says Samira. This is also a good time to start a walking program if your therapist gives you the green light. Start slow and with short distances and add on as you get stronger.
“Once the client is walking without a limp and has full range of motion, it’s time to get the leg strong again,” says Samira, adding that the goal is for the leg “to be able to handle the pressures of the client’s preferred activity.” During this third phase, you will work with your therapist on exercises that strengthen the muscles above and below your knee, and working on your core and stability as a whole. Your therapist will be looking for good control when your leg is in motion and no pain when you complete sport and work specific motions.
The hardest part of the therapy? Losing motivation when you don’t see results as quickly as you want. “Clients tend to see results immediately post-op. Once we start to work on the range of motion and they start to get that back within the first week they get motivated,” says Samira. “The downside is as they start to get better, the results are more subtle and they feel like they are plateauing.” Samira deals with this by making the therapy sessions more interesting. “I make some exercises a competition between them and me. For example, if its balance exercises I will do it with them and see who can balance longer.”
As you work through the phases, and add more intensity to your rehab exercises, you might experience some swelling and/or pain in your knee. If this happens, use the RICE protocol: rest, ice, compress the area and elevate your leg. And let your therapist know when you see them at your next session. They might need to modify the exercises or the intensity of your therapy.
Most important: be patient. You will recover from your knee surgery, and be back at your favourite activity before you know it.
BPHE, ATC, CAT(C)
Currently Head Athletic Therapist at Futsal Club Toronto, Samira provides immediate on-field emergency care, injury prevention techniques, and rehabilitation and has worked with varsity athletes at George Brown College, the University of Toronto Soccer teams, and the Ontario Soccer Center at both the provincial and national level. She also works at Competitive Edge Physiotherapy and Sports Conditioning when not on the soccer field or futsal court.