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Arthroscopic knee surgery is most commonly performed for cartilage
problems although a number of other knee conditions can also be treated
in this way.
Rehabilitation is an important part of the healing process regardless
of diagnosis and preferably should be done under the supervision of
a chartered physiotherapist.
- decrease pain and swelling
- restore normal range of movement (ROM)
- restore normal muscle tone and strength
- progress to a return to normal daily activities
Most simple arthroscopic surgery is carried out as a day case which
means you will be allowed home on the same day. You will usually be
able to fully weight bear without the use of crutches.
It is common to experience some pain in the knee which is usually
caused by swelling within the joint and the arthroscopic treatment
itself. Swelling causes pressure on the surrounding structures which
can impair muscle function and restrict ROM. Early mobilisation of
the knee helps to activate the muscles thus helping to increase the
circulation to the knee. Exercises performed with the leg raised will
also aid in the reduction of swelling whilst you begin to move the
joint and strengthen the knee muscles.
The exercises below should be used as a guideline to aid in your recovery
remembering there is no recipe for rehabilitation as every case is
different. It is important to follow the advice of your physiotherapist
in this early phase and be guided by them.
Sit with your legs out in front of you, preferably resting your heels
on a sliding surface. Put a sling (towel, sheet etc.) around your
foot then bend your knee using the sling, as far as it will comfortably
go.
Hold it there for a few seconds before straightening the leg. Repeat
20 times.
Sit with your legs straight out in front of you and pull you toes
upwards. Tense the thigh muscles to try and push the back of your
knee against the underlying surface.
Hold for 10 seconds and repeat 10 times.
If you find this difficult try it first on the other leg as often
a reminder of the feeling prompts a better response when you try it
again on the injured leg.
Sitting with your legs out in front of you place a rolled up towel
under your knee.
Push your knee down onto the towel whilst digging your heel into the
surface below. You should feel the muscles at the front and back of
the thigh working together.
Hold that position for 10 seconds and repeat 10 times.
To progress this, repeat the whole process over two, then three rolls
to increase the degree of bend at the knee.
Sit on a chair and straighten the injured knee pulling your toes up
towards you.
Tense your thigh holding that position for 10 seconds and repeat 10
times.
Sit with your legs straight out in front of you and tense the thigh
muscle on the injured leg. Turn your foot out slightly and then lift
the straight leg up about 3 inches off the bed.
Hold for a few seconds before lowering - repeating the exercise 10
times.
As this gets easier to do you should not need to rest the leg down
in between repetitions. If you are unable to keep the knee straight
during the whole of the exercise it means you are not ready to do
this one yet.
All of these exercises should be done in moderation (little and often)
in the first few days after knee cartilage surgery.
Where possible, elevate the limb when sitting or when applying ice.
Ice is used to help minimise swelling in your knee and is often good
for pain relief (your physiotherapist will be able to give you all
the correct information for this regarding application and timing).
After this initial stage, your exercise programme will be devised
according to your individual needs. The aims are to encourage normal
walking and to progress to a more functional strengthening programme.
This may include exercises such as ski squats, lunges, knee dips,
balance exercises and progression onto mini trampoline, mat work,
weights etc..
Rehabilitation following arthroscopy usually takes from four to six
weeks.
These rehabilitation guidelines
have been prepared with the help of Gill Cannon and Rachel Galley
(Physio Action Ltd. – at David Lloyd Centre, Leeds and Cannons
Gym, Harrogate)
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