AFTER ACL RECONSTRUCTION

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STRAIGHT LEG RAISES

Lie on bed straight, relax your body, bend one of your knees as in the figure, tighten the thigh muscles in front with the knee straight on the other side, lift it to about foot from the bed. Do: Keep your upper body relaxed and tighten your stomach muscles to keep your low back flat against the floor.

Do not: Arch your back. Do not lift your leg too high with a jerking motion.

Hold this positon for 10 seconds, relax then repeat on other side and repeat as you like.

STEP UPS

You should feel this exercise in the front and back of your thigh, your hip, and buttocks.

Use a 6-inch high stool or platform. Step one foot onto the platform. Lift your other foot off the floor, letting it hang loosely off the platform. Try to hold for 3 to 5 seconds. Slowly lower your hanging foot to the floor, then bring your stepping foot down. Repeat and switch sides.

Do: Make sure when you step up that your whole foot is on the platform.

Do not: Lock the knee that is stepping on the platform.

Wall HALF Squats

You should feel this exercise mostly in the front of your thighs.

Stand with your head, back, and hips against a wall. Step your feet out about 2 feet from the wall, hipwidth apart. Slowly slide down the wall until you are almost in a sitting position. Hold for 5 to 10 seconds, then slowly slide up. Repeat.

Do: Keep your abdominal muscles tight. Hold the position longer as you get stronger.

Do not: Slide your hips down lower than your knees. Do not let your knees move forward over your toes.

QUADRICEPS TIGHTENING

Just sit on the bed with your legs straight, put a folded towel under the knees and press it with the knees. You will feel the tightening of the front thigh muscles and hold it for ten seconds.

EXERCISES AFTER TOTAL KNEE

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Quadriceps Setting

This is a good beginning exercise as it not only initiates the needed muscle contraction but also is helpful in increasing extension of the knee. It is optimal for both legs as both legs will be in a weakened state postoperatively. Try to do this exercise several times every hour. However, the amount of discomfort will determine how many each individual can perform.

While lying in bed with legs straight and together and arms at the side, try the following:

Tighten the quadriceps muscles while pushing the back of the knee downward into the bed.
Hold this muscle contraction for four to five seconds, relax for a short period of time and repeat 10-20 times for each leg.

Terminal Knee Extension

This exercise also helps promote muscle activity and increases knee extension. This exercise is to be repeated 10-20 times.

While lying in bed place a pillow or towel rolled up into a bolster under the operated knee to position the knee joint at approximately 40 degrees from full extension.

Tighten the quadriceps muscle and straighten the knee by lifting the heel off the bed.
Hold this muscle contraction for 5-10 seconds, then to slowly lower the heel to the bed.

Heel Slides (Knee Flexion)

This exercise will promote muscle activity of the hamstrings as well as help increase the amount of knee flexion. The physical therapist will record the amount of flexion and extension for a daily report on the patient\\\\\\\\\\\\\\\'s progress to be reviewed by the physician.

While lying in bed on the back, keep legs straight and together and arms at the side.

Slide the foot of the surgical limb toward the buttock to a point where a mild stretch is felt.
Hold this position to a count of ten then slowly returns to the starting position

Straight Leg Raising

This is another excellent exercise to promote strength to the quadriceps and the flexor muscles important in ambulating . Once the individual can perform 20 repetitions without any difficulty, gradual resistance at the ankle (such as the use of ankle weights) can be utilized to further strengthen the muscles. The amount of weight used should be increased in no more than one pound increments.

Bend the uninvolved leg by raising the knee and keeping the foot flat on the bed. (This will help decrease or avoid unwanted strain on the low back region).

While keeping the involved leg straight, raise the straightened leg about six to ten inches off the bed.

Hold this position for 5-10 seconds, then lower the leg slowly to the bed and repeat 10-20 times.

Pillow Squeeze

This is a good exercise to help strengthen the hip adductors or groin muscles.

Place a pillow between the knees (or slightly above the knee joint line if pressure at this area is uncomfortable).

Next squeeze the pillow and hold for a count of ten.

Relax for a short period of time and repeat this exercise 10-20 times

Exercises are essential part of the rehab after knee replacement. Exercises are to be done regularly after the surgery in both bilateral knee replacements as well as unilateral knee replacements. The emphasis of the exercises are on knee bending and regaining muscle strength.

The patients stand up within two days of surgery and start walking by the same day with a walker.Normally sitting in the toilet starts by fourth or fifth day and climbing a few steps start by tenth day.

Recovery may be slightly faster in those patients in which one knee is done at a time. Knee scores are available for the functional assessment of patients. The commonly used knee scores include the oxford knee score.

Proper walking is the best way to help your knee recover. At first, you will walk with a walker or crutches. Your surgeon or therapist will tell you how much weight to put on your leg.

Stand comfortably and erect with your weight evenly balanced on your walker or crutches. Advance your walker or crutches a short distance; then reach forward with your operated leg with your knee straightened so the heel of your foot touches the floor first. As you move forward, your knee and ankle will bend and your entire foot will rest evenly on the floor. As you complete the step, your toe will lift off the floor and your knee and hip will bend so that you can reach forward for your next step. Remember, touch your heel first, then flatten your foot, then lift your toes off the floor.

Walk as rhythmically and smooth as you can. Don\\\\\\\\\\\\\\\'t hurry. Adjust the length of your step and speed as necessary to walk with an even pattern. As your muscle strength and endurance improve, you may spend more time walking. You will gradually put more weight on your leg. You may use a cane in the hand opposite your surgery and eventually walk without an aid.

When you can walk and stand for more than 10 minutes and your knee is strong enough so that you are not carrying any weight on your walker or crutches (often about two to three weeks after your surgery), you can begin using a single crutch or cane. Hold the aid in the hand opposite the side of your surgery. You should not limp or lean away from your operated knee.

Stair Climbing and Descending

The ability to go up and down stairs requires strength and flexibility. At first, you will need a handrail for support and will be able to go only one step at a time. Always lead up the stairs with your good knee and down the stairs with your operated knee. Remember, \\\\\\\\\\\\\\\"up with the good\\\\\\\\\\\\\\\" and \\\\\\\\\\\\\\\"down with the bad.\\\\\\\\\\\\\\\" You may want to have someone help you until you have regained most of your strength and mobility.

Stair climbing is an excellent strengthening and endurance activity. Do not try to climb steps higher than the standard height (7 inches) and always use a handrail for balance. As you become stronger and more mobile, you can begin to climb stairs foot over foot.

Climbing up and down the stairs normally starts two weks after surgery

EXERCISES AFTER STICH REMOVAL

We make the knee movement exercises more vigourous after stich removal. Normally we provide our patients with knee exercise videos for self guidance.

KNEE EXERCISES SHOULD NOT BE DONE IN PAINFUL PERIOD