Experience

Since knee operations are relatively common, especially for athletes, the operation and aftercare usually goes well. If loading is applied too early and insufficient care is taken, deficiencies in healing and knee stability may occur. However, sparing does not mean complete immobilization – those who do not actively participate in the therapy run the risk of the tissue sticking together and later causing a loss of range of motion and general function. The general state of health also has an effect on healing – healthy nutrition and avoidance of stress can always be recommended additionally.

Rehabilitation

For the first few weeks after the operation, crutches and an orthosis are prescribed in order not to put too much strain on the healing tissue too early and to stabilize the joint from the outside. Passive mobilization is started early on, especially of the patella, to keep it mobile and protect it from sticking together. Lymphatic drainage is used to remove the swelling.

At the end of the inflammatory phase, more and more active movement is performed to provide the newly formed fibers with stimuli for alignment, so that the knee is given both stability and flexibility again. Isometric exercises can already strengthen surrounding muscles without great strain. In a gait school, a partially straining gait is first learned with the help of the supports – depending on the doctor’s instructions.

The load is continuously increased as the healing process progresses. In the final phase, a physiological gait is learned again, actively strengthened and stretched, and depth sensitivity and coordination are trained. Exercises are presented in the following (physiotherapeutic intervention).

Physiotherapeutic intervention: Contents/exercises

1.) A good exercise to move the knee without a lot of load is to use a bicycle ergometer. If the weight is turned down completely, this can be practiced early on.

2.) For isometric exercises in early stages, for example, the long seat is suitable for training the front thigh muscle. Imagine you want to pull your kneecap up without moving your leg.Practice tensing and relaxing first, and then holding the tension longer.

3.) Training in water is good because of the weight loss of the body. For example, you can keep yourself fit with aqua jogging and other exercises.

4.) In the later course, equipment such as the leg press can be used to train especially the decreasing, eccentric strength. 5.)

Stretches are performed to keep the structures flexible. Stretches are held for at least 30 seconds to achieve an effect in the tissue. Stretch and train both sides, including the healthy side, to avoid muscular imbalance in the body.

6.) To further train stability, knee bends, lunges and the wall seat are suitable. To make it more difficult and to additionally train the outside of the legs, a Thera band can be wrapped around the knees, which should be kept under tension.

Muscle chains can be trained in physiological patterns and special sequences such as the shot in soccer. For example, the PNF concept (Proprioceptive Neuromuscular Facilitation) is suitable for this, which should be carried out by an experienced therapist. To regain depth sensitivity and inter-muscular coordination, it is best to use wobble cushions, jogging over different surfaces, one-legged standing on the trampoline, tiptoeing with eyes closed, etc.

The exercises depend on the individual training condition. You can find exercises for this in the article Coordination/Balancing Exercises If you still feel pain during exercises or movements, which is made worse by the exercise, leave it aside and give the body a little more time so as not to disturb the healing process. The articles might also be of interest to you.

To stretch the front chain, stand, place the lower leg of the affected leg backwards on a chair or stool and push the pelvis forward until a stretch is felt.
For the rear chain, either let your upper body sink forward from a standing position with stretched knees and try to reach the floor with your fingertips, or lead your leg stretched to the ceiling from a supine position with your toes pulled up towards the tip of your nose.

Physiotherapy after knee surgery
Physiotherapy after cruciate ligament rupture
Exercises for a cruciate ligament rupture
Exercises for a meniscus lesion
Exercises for an injury of the inner and outer ligaments