In recent blogs, we’ve been extolling the virtues of exercise – whether you’re recovering from injury, living with arthritis pain, or facing a major operation like knee joint replacement (“TKR”).
It’s true, of course, that exercise can be very difficult if you’re struggling with joint pain. So the general mantra is to do what you can within the bounds of what’s comfortable and appropriate for your own body. But the benefits of exercise to overall joint health are pretty clear. For example…
Blood flow – a healthy circulation transfers oxygen and nutrients to the soft tissues in your joints
Bone strength – activity stimulates bone-building chemicals and helps to ward off osteoporosis
Strain reduction – losing excessive weight can make a major difference to the pressure on your joints
Muscle strength – stronger muscles provide better support for a painful or damaged knee
Exercise and knee replacement
That last point is especially important if you’re thinking about a knee replacement. Perhaps this type of surgery has only recently come onto your radar. Or maybe you’re on the waiting list for a new knee right now and reading as much as you can about it.
Either way, you’ve probably begun to hear a lot about how important it is to build up your muscles. Not just after the operation but, if possible, in the run-up to surgery too.
That’s because your new knee will need support as you recover. And you will also want to maintain a good range of motion in your knee as your body adjusts to it. After all, a knee replacement operation only replaces the surfaces of your joint. It doesn’t replace the surrounding muscles. So it makes sense to invest in your muscle strength in order to promote a strong recovery.
What kinds of exercises do physios recommend?
Short answer: the specific exercises you do before and after surgery will depend on your own context. That is, your age, your pain thresholds, your relative fitness and capabilities, and so on. But what might they look like? Below are three common examples for building strength and stability. (Please note they’re for general guidance only; be sure to follow the advice that your physiotherapist will tailor for you before and after surgery.)
Straight-leg raises
These exercises target the quadriceps, hips and abdominal muscles. The patient begins by lying on their back, arms held flat against the floor or bed. They move their (unoperated) leg up into a bent position (this gives some support during the exercises). The other leg is then gently raised – kept straight, without bending – until it’s about 25cm (10 inches) above the floor. You might hold this position for five seconds or so, before gently returning the leg to the floor.
Knee extensions
These exercises focus on bringing stability to the joint and improving your range of motion. They can be done sitting or lying down:
Sitting – The patient sits in a straight-backed chair, back straight and both feet on the floor. They raise one leg gently upwards and straighten it out above the floor, holding it for 5-10 seconds if they’re able to
Lying – The patient lies on their back, with one leg bent and the other flat against the floor or bed. They then slide their heel away from their bottom until the leg straightens, before sliding it back to return to the original position
Squats
Squats are great for strengthening hamstrings, glutes and quadriceps, which help to bring control and stability to your knees. The gentlest way to do them is with a chair as support. The patient stands behind a sturdy, straight-backed chair. Holding the top of the chair rest, they slowly squat down so the weight goes into the heels. If it feels comfortable, you might hold this position for 5-10 seconds before returning to the original, straight position.
And finally… Being realistic
Although muscle strength and flexibility are important for recovery, we need to be realistic about what’s achievable – especially when chronic knee pain is a daily struggle. It’s better to do the little you’re able to do, stay persistent and try not to compare your own recovery journey with others’. As we’ve said before, a very short walk may be better than no walk at all. A gentle swim is likely to be more beneficial than a painful 2km run. Your knees will thank you for the exercise you can give them – but not for overdoing it.
Ready to read on? You may find these articles helpful…
Why is exercise good for arthritis knee pain?
An example programme for knee replacement recovery (University Hospital Southampton)
ESCAPE-pain review: a course to help you manage knee pain
Are you suffering from persistent knee pain? If so, it’s important to have it properly investigated. You can do that here in the clinic by booking an appointment with us. We’ll make sure you’re seen, examined and treated as soon as possible.
