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How to Increase Flexion After Total Knee Replacement

By Rebecca Boardman ; Updated July 27, 2017

Total knee replacement surgery is a huge operation. It takes a tremendous toll on the body and the mind. In most cases, however, dramatic improvement of quality of life will occur when recovery is complete. With some physical therapy exercises you can regain flexion in the replaced knee, making the best possible recovery.

Begin the day after surgery. More than likely, the staff will begin physical therapy on you the same day of your surgery. Begin by rolling your ankles in circles and pointing your toes to the ceiling and then pointing your toes towards your chin.

Move on to heel slides as soon as you are cleared by the doctor. Place your heel on the bed and slide it toward your rear end as far as you can. The first few days this will likely not be far, as the pain and pressure will be excruciating. Increase the heel slide pull every day, trying always for just a bit more. When you have received clearance from your physician and physical therapist, you may add the elastic band to this exercise to increase resistance and improve strength.

Start with quad sets with your leg flat, tightening the quadriceps muscle in your leg. But do not move any other part or muscle, such as your hamstrings or your rear end muscles. If you do quad sets properly, you will see the incision move. It will hurt, but you must work your way through the initial pain. Your physical therapist will guide you through this. Strengthening your quadriceps is the most important thing you can do to recover from any knee surgery.

Move onto straight leg lifts. These are accomplished lying prone, then tightening the quadriceps muscle and locking the joint. Then raise the leg at least 10 inches into the air. Lower and relax the leg. Repeat.

Within a couple of weeks, add bridges into your exercise regime. Place your feet and ankles on top of the exercise ball and lift your pelvis to make a "bridge" between the ball and your body. Add repetitions to all of these exercises until you reach the point of fatigue. Finally, roll the ball toward your rear end, using your feet and bending your knees as far as you are able.


By following these simple steps, and always aiming to improve your flexion, you will dramatically improve your recovery.


Always follow your doctors orders, and consult with a physical therapist before beginning any exercise program.

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