What you need to know to best prepare for knee surgery

Our physiotherapist tells you what exercises are best before knee surgery.

Need help to prepare for knee surgery?

Faye is booked to have knee replacement surgery and is seeking advice on what exercises she can do before the surgery so that she is as prepared as possible. We asked physiotherapist Jason Lee for his advice. 

Q. I am booked to have a total replacement of my right knee as I have got to the stage of bone on bone. I have some pre-existing complications that go back to when I was a toddler. I have been on crutches for about 30 years. Living on my own has created a lot of problems, for instance, how to cook and carry a plate of food to the table. I have personal carers to shower me three days a week. All people are different – and I am very different – but I’m hoping you can advise on anything I can do to help me prepare for the operation and to speed up my recovery.  

A: It is fantastic to see you are doing all the right things and seeking exercises to strengthen the knee before surgery.  

As you’ve noted, everyone’s prehabilitation will differ and it’s important to tailor your prehab based on your individual circumstances. It is great to see that you have been attempting to strengthen muscles that will be specifically affected following knee surgery, such as the thigh muscles, including the quadriceps and hamstrings.  

In addition to strengthening muscles surrounding the surgical site, I also recommend you improve your overall strength and endurance before the surgery. For example, I’d encourage you to do exercises to improve the endurance and strength of your upper body. Anything that improves muscles in the forearms, shoulders and chest would be beneficial. 

 It is amazing how reliant we become on these muscle groups when using crutches during the first few weeks after surgery. Try exercises such as bicep curls or shoulder presses. The weight does not need to be heavy as endurance is more important. Try using a light weight, such as a drink bottle or a can of tinned food, and build up to between 25 and 30 repetitions.  

On the knee, I would also recommend strengthening other muscle groups in the lower limb. Calf strength is equally important, so do some calf or heel raises – in either a sitting or standing position. 

You can also improve your hip strength by performing ‘bridges’, that is, lying on your back, knees bent, feet on the ground, and raising your hips.  

Importantly, as you have been doing, continue to be as mobile as you can before surgery. Incidental walking or even walking around home in short bursts will be of great benefit. While it sounds very simplistic, walking is one of the best exercises you can do before surgery. 

Both prehabilitation and rehabilitation are gradual, challenging and steady processes.  It’s fantastic to see you persist despite a range of challenges. Best of luck with the prehabilitation and rehabilitation following surgery! 

Jason Lee APAM
B. Physiotherapy
Malvern East Physiotherapy 

Jason is happy to answer any questions you may have. Simply send an email to newsletters@yourlifechoices.com.au

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    COMMENTS

    To make a comment, please register or login
    Bob
    14th Dec 2017
    3:27pm
    The advise given to Faye by Jason is all very well as it will stand her in good stead for the upcoming surgery, but believe it or not the operating surgeon is not going to place her in any danger as it is bad for business. What Faye really needs is advise on post operation exercise this is the most important part of all that you will be put through in the on going 12 months of recovery.
    My advise and I have both knees done is get yourself a skateboard and make sure that you have an open legged chair high enough to have your thigh above or at least parallel to the floor, I used a mobile walker with a seat. Sit on the chair/seat and place the skateboard under the foot of the operated leg and move the skateboard back and forward under the seat, ensuring that you bend that knee as much as you can, but you must at least reach 90 degrees of bend each time. Do this for at least 20 minutes per day during the recovery period if you want to be happy with the final outcome. If your surgeon has done a good job there will be minimum pain involved and if required use some Aspirin or so, but get the job done. I followed this regime for both knees and I have full bend of 115 degrees in both knees and couldn't be happier. Another tip DO NOT WAIT FOR THE CPM MACHINE, as soon as you know where you are, try lifting the operated leg thigh of the bed to point straight up in the air and let the shin/bottom of the leg droop as much as it can, you won't cause any damage to the operation site. Do this every half hour you will be surprised how much you can achieve, and how much easier it will be than going through it with the CPM Machine and the Physio, they are happy when you reach 90 degrees of bend. By the way I think the CPM stands for Corporal Punishment Machine, probably doesn't but it sure as hell feels like it if you are not aware that it is coming to get you.
    So I hope that this makes sense to you, and I wish you all the best for a speedy recovery.
    ROB
    14th Dec 2017
    5:21pm
    THIS IS FOR PEOPLE THAT UNDERSTAND THERE ARE ALTERNATIVES TO TRADITIONAL METHODS THAT NOT ONLY WORK BUT WORK EXTREMELY WELL!
    DID YOU KNOW, There are Non Transdermal patches being used to quickly ease knee pain and rebuild cartilage? These are the same technology patches used in hospitals in Europe and elsewhere about the world. These simple to use patches are safe for ALL ages, easy to use, low in cost, create accelerated healing, are extensively clinically studied to prove their effectiveness and have NO Harmful side effects. Please ask if you have any questions on these patches. We applaud anything that can help ease pain but find these patches the one product that is changing so many lives to the better. Rob wellnessplus@adam.com.au
    KNEE PAIN EXAMPLE from October 2017
    Below is just ONE example of what the Lifewave Non Transdermal patches are doing. We have hundreds of instances where we are personally assisting people in many countries with these patches.
    Earlier Last month (September) Barbara and I had driven to Victoria and on the way back to Adelaide we stayed with friends near Melbourne for a couple of days. The husband had some long term knee pain. The wife had severe knee pain; the knee area was very swollen and she was using a stick to walk about. They also showed us the X-Rays showing she had “Bone on Bone”. She is programmed for a knee procedure/replacement in February 2018.
    The first night we placed two of our patches on the husband’s knee. He immediately felt some relief and when we placed two patches on the wife’s knee she felt “Warmth” around the knee and had less pain but still had pain when she moved the leg further in any direction than she had been used to doing.
    The next day the wife took us for a visit to the Werribee Mansion. If you know of this place there is lots of walking as the house and gardens are huge. While we were concerned about the walking for the wife she was not concerned, the swelling on the knee had already reduced and her knee was feeling much better. We spent a considerable time walking about the house and gardens, up and down stairs in and out many rooms and buildings and the wife appeared to getting about quite well. We left them both some extra patches before we returned home the next day.
    A few days later when back home in Adelaide and talking to this lady she was telling us the husband’s pain was much reduced and she had not experienced any pain at all after the visit to the mansion. They had not yet used the extra patches but had simply left the first ones we applied in place for a couple of days before discarding them as instructed by us.
    The results with the husband are wife are typical when using the patches for pain relief and repair. If the knee has lost considerable cartilage it could require an extra pair of patches some weeks or even months in the future to continue the repair but overall people generally have no pain ongoing and well into the future. Considering the patches cost around $5 each ($100 for a packet of 30) and you may only need a few to avoid a knee replacement or other risky (and often painful procedures) the patches are proving a very worthwhile alternative.
    We can’t wait now to find out how she presents with any Pre Op checks in the future.
    We believe anything you find to ease pain, to improve movement and in particular to restore quality of life is a bonus for you. What we offer is an alternative to consider? We also provide ongoing support, free of charge worldwide, to ensure everyone has the best result possible with these patches. The patches are also accepted by the medical authorities in all the 100+ countries the patches are available including Australia and will not interfere with current medication or procedures.
    As a footnote:
    For people that have never even tried these patches, but feel they must be a scam or impossible to do what they are proven to do, then we would suggest to keep an open mind before you try and steer people away from something you have not even tried yourself. The patches often start easing the pain in minutes, even seconds so you will know very quickly if they are for you. We are happy to demonstrate these patches if local, no cost and no obligation for purchase unless wanting too. Does your doctor or specialist offer this service? Rob and Barbara


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