Exercise and Knee Surgery

Knee X-rayDear Chris,

I am a 69-year young lady who has gone to pot! I am booked for double knee replacement in March 2007. Please advise what core and quad strenghthening exercises I can do to help with my surgery and my overall health.

Thank you.

Marg, Hamilton, ON

Dear Marg,

You are doing the right thing in planning for your surgery now by performing strengthening and flexibility exercises. The stronger you are when you go into surgery, the faster you will recover. The surgeon will most likely recommend a course of physiotherapy. Once this rehab program is finished, you should get right back into a regular exercise routine.

So, before surgery I would suggest you strengthen the muscles surrounding your knees (quadriceps, as you mentioned) and also the back of thigh (“hamstrings”), as well as both the front and back of calf. I’ve listed common exercises (with alternate names in brackets) for each muscle group.

1. Quadriceps: Knee (or Leg) extension exercises.

2. Hamstrings: Knee (or Leg) curls.

3. Front of calf: Toe Lifts (or dorsi-flexion).

4. Back of calf: Heel raises (or plantar flexion).

I suggest you use resistance bands or tubing for these exercises unless you have access to a leg curl/leg extension machine to do exercises 1 and 2. Regardless I suggest you choose enough weight (or resistance) that you fatigue the muscle after 15 – 20 repetitions. This means choosing a lower weight or resistance level than you would for muscle building. Depending on your current fitness level and the extent of arthritis in your knees, you may be able to start with a blue band but more likely a green or red(lighter resistance) one, assuming you are using Theraband brand. If you purchase this brand of tubing or bands, they often have exercise brochures at the place of purchase. Alternatively, there are good exercises on their website. They even haveexercises specifically for knee osteoarthritis.

Be sure to follow these exercises with stretching. I would suggest you perform the stretches every day, not just on your muscle strengthening days. Be sure to stretch the area for at least 20 seconds. Go into the stretch until you feel a tug or some tension but no pain. Hold the stretch but continue to breathe.

You also mentioned core work. Choosing the most effective core exercises will depend on whether or not you can get up and down from the floor. Many traditional abdominal and lower back strengthening exercises can be done on a chair. Since I don’t know your situation, I cannot safely recommend the best ones to do.

To your health

Chris


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