Anybody who has gone through the rehabilitation process after a knee surgery, can commiserate on the initial physical therapy goal of being able to get the knee straight as soon as possible. It’s often painful, takes significant dedication, and is the focus of attention of your physical therapy task master. Achieving full knee extension, i.e. getting the knee “straight”, is a critical first goal of the rehab process and has a large impact on the functional outcome of the surgery. When a knee lacks full extension, a person’s gait pattern is altered in such a way that he or she is effectively limping on that leg, which requires increased effort and can lead to pain in other parts of the body. So, to avoid having a limp, it’s critical to be able to get to zero degrees of extension on the surgical knee as quickly as possible.
But why can it be so hard to get it straight?
One of the most common reasons why achieving full post-op knee extension can be difficult is due to the presence of edema, or swelling. It’s entirely normal for there to be a certain amount of post-operative swelling at a knee joint, but unfortunately this swelling can inhibit the action of the quadriceps muscle, the key-mover for knee extension. Likewise, resting with the knee in slight flexion, such as with pillows under the knee, can make getting extension difficult.
Thus, one thing that is always emphasized after surgery is the importance of resting with the knee in an ideal position, that is: elevated (to decrease edema) and with the leg totally straight. It’s generally okay to support the leg with pillows under the calf, but not directly under the knee. Another critical piece of the puzzle is to manage pain and swelling with frequent icing, 20 minutes at a time through-out the day. Finally, doing specific physical therapy exercises to master a strong contraction of the quadriceps is essential for being able to stabilize the knee in full extension when walking.
This is a nice illustration of one of the common post-op exercises that can facilitate full extension.
PLEASE NOTE: It is essential to speak with your surgeon and physical therapist prior to adding any new exercises to your rehabilitation process. Each surgery is unique and the different phases of healing must determine the progression of exercises that you perform.
If you’re planning on doing your knee surgery rehabilitation in the Portland Metro area, contact Beyond the Clinic for your post-op needs. We’d be glad to help!