by Jim Driggers
Increasing range of motion. Initially, the trauma of surgery and subsequent swelling will significantly reduce how much you can straighten (extend) and bend (flex) your knee. Scar tissue may form as your knee heals, and it too can reduce range of motion. According to Charlie Lee, PT, also of Pleasanton, California, people who have had a knee replacement should eventually be able to straighten their leg fully. People who are inactive — who typically walk short distances and only occasionally climb stairs — should aim to be able to bend their knee to 100 degrees, and more active people should aim for at least 120 degrees. Use these as goals and don’t worry if you haven’t reached them in a few weeks. The important thing is to keep improving your range of motion week by week.
To help improve range of motion, some doctors will have you use a continuous passive motion (CPM) machine, which bends and straightens your knee while you are in bed. Normally, people recovering from knee replacement use the machine for about two hours at a time, two or three times a day, until they can easily reach 90 degrees of flexion.
Although CPM is often used after knee replacement surgery, its effectiveness has been questioned. Current research doesn’t show that it significantly increases flexibility. Some doctors still believe CPM is a valuable tool to help increase your range of motion; others believe it’s a waste of time and money. Some doctors reserve it for people who they believe will not exercise enough on their own. If your doctor does prescribe a CPM machine, make sure it’s adjusted correctly to fit the length of your leg, and use it as instructed.
Whether or not you use a CPM machine, you’ll increase your range of motion primarily by stretching. (If you do use a CPM machine, bear in mind that it isn’t a substitute for other exercise. You must still keep doing the stretching and strengthening routine given to you by your physical therapist.) Among the physical therapists interviewed for this article, it’s accepted that more frequent, less intense stretching is better than infrequent, intense stretching. Try to stretch multiple times a day and especially when your pain level is low. If you’re grimacing, you’re probably pushing too hard.
According to Klass, swelling is the main factor limiting flexibility in people who have had a knee replacement. Exercise may cause your knee to swell; if it does, use the RICE strategy. After the swelling has gone down, you should continue with your exercise program.
Positive mental attitude. It can take anywhere from two or three months to a year to fully recover from knee replacement. Keeping yourself positive during this time can be a challenge, especially if you’re used to being physically active and independent. In the first few days of recovery, you’ll be totally dependent upon others. Feeling frustrated is normal. In his book, Dr. O’Neill recommends “positive self-talk (repeating affirming words, phrases, or compliments)” as a way of dealing with the pain and setbacks that may occur during recovery. Don’t ignore your problems and concerns, but try not to magnify them. Talk with your doctor if you have concerns about your level of pain, your flexibility, or any other issues related to your recovery. Depression can make the mental aspects of rehabilitation especially difficult, so if you have depression, talk to your doctor about strategies for coping with the recovery process.
The main mental challenge is to avoid becoming so discouraged that you give up. Talking with others who have had a knee replacement is a great way to get support and discover that others have had to deal with the same issues you’re having. (See “Recovery Resources” to learn how to connect with others who have had a knee replacement.)
Recovering from total knee replacement will be challenging, but so is living with arthritis. By following your doctor and physical therapist’s advice, you can probably return to everyday tasks such as light chores about three to six weeks after surgery. If your recovery is faster, then that’s great. If your recovery is slower, be patient and don’t get discouraged. Don’t think of recovery as a race — instead, consider it an investment in the rest of your life.
Last Reviewed on April 20, 2011
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