Knee Arthritis and Knee Replacement Surgery with Exercise| Top 10 Tips To Improve Mobility

Knee Arthritis and Knee Replacement Surgery with Exercise, Did you know that by being an active participant in the management of your arthritis, you can improve your overall mobility, decrease pain, and maintain a better quality of life?  Now, the stiffness and pain you feel in your knee joint may actually tell you otherwise and make you feel you should rest, do less, and avoid exercise.  Well, the good news is that you have the ability through exercise to increase your range of motion, improve your strength, and gain functional ability; these will all allow you to perform daily activities with confidence and independence.  Through my years of experience as an exercise specialist training individuals with knee arthritis and knee replacements, I have learned what the most important exercise goals are to improve quality of life.  To assist you with what is best to focus on and what will help you with your knee arthritis or knee replacement, here is a list of exercises to improve your mobility.

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1. Lubricate and loosen your joints, with a range of motion exercises using the stationary bicycle or participating in an aquafit class.  The range of motion exercise form you select should be non-weight bearing if you have pain or experience pain and swelling with weight-bearing activities.  However, if you are posting knee replacement or do not have pain, then walking is a great choice to keep your joints lubricated.
2. Strengthen your muscles around your knee and in particular the quadriceps muscle.  The gluteus medius hip muscle and the adductor muscle group on the inside of your thigh are also important to keep strong.
3. Stretch your tight muscles and the muscles which may limit your range of motion at the knee and thereby your functional ability.  These muscles include the hamstring, quadriceps, calf, iliotibial band, and possibly your gluteal muscles as well.
4. Limit and monitor swelling and/or heat in your knee joint. Sometimes arthritis sufferers become so accustomed to swelling or the feeling of heat in their joint that they ignore it and persist through this.  If the activity you are doing is causing swelling or heat in your joint, it is either too much, too soon, or the wrong exercise.  Please use these symptoms as a gauge of what you should be doing and always ice.  Your first goal is to bring the swelling down and minimize heat in your joint.
5. Do specific exercises targeted to knee flexion and extension. A physiotherapist or exercise specialist will be able to identify for you whether you need to focus on flexion or extension exercises.  Having good flexion and extension at the knee is what gives you the ability to walk properly and perform daily tasks with ease such as climbing stairs.
6. Practice and be conscious of your gait mechanics. Pain, change of range of motion at the knee, and structural abnormalities caused by arthritis can alter your gait.  Have someone teach you how to walk with good technique and then implement this into your daily exercise regime.
7. Know the right volume of activity for you! Often my arthritic clients would be going along steadily progressing well and then they would get a flare-up of pain all of a sudden.  Upon further discussion, we would realize together that the activity they did over the weekend, on their holiday, or with their grandkids was too much.  The volume of activity relates to the accumulated amount of walking, exercising, and being on your feet that you do in one day.  A lot of arthritic participants find that they can walk for 30 to 60 minutes, but any amount above that threshold will set them into pain.
8. Keep your body weight healthy to reduce the load/stress on your joints. If you are overweight, you will want to focus on cardiovascular exercise for a minimum of 3 days a week, preferably 5 days so that you can lose weight and reduce a load of stress on your knee joints.  Nutrition and eating habits play a huge role if not the most important role in weight loss; therefore it is highly recommended to combine both diet modifications and exercise to maintain healthy body weight.
9. Seek out medical professionals who can help you. Physiotherapists are an excellent resource prior to surgery and immediately post-operation.  Massage therapists are terrific at all stages as they can help loosen all the tight muscles that form around your painful knee joint.  A registered dietician can assist everyone pre-surgery and also help individuals who need to lose weight.  Personal trainers and kinesiologists are fantastic at helping design a strength program for you both pre and post-surgery.
10. Rest! Make sure you have rest days from exercise and allow your body to recover. I cannot tell you how many people have been so dedicated to their exercise program and healing fast that they never take a day off and hence end out setting their recovery back.  You should never do more than two days of exercise in a row and ideally, it is best to do exercise every other day unless it is a very gentle form of exercise.
11. You are an integral player in the daily management of your arthritis and your recovery from surgery.  Exercise in the form of a range of motion, stretching, strength, and cardiovascular conditioning will hugely impact your independence, confidence, and overall feeling of well-being.  I wish you all the best in building strong, supple, well-functioning knee joints.

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2. What can you do pre-operation waiting for a knee replacement?

There is so much emphasis and education on post-operation knee replacement recovery that you may feel there is nothing you can do, but wait. Not only is there a lot you can do to relieve pain, maintain mobility, and recover stronger, but also you will improve how you feel and have a way more successful outcome post-surgery. Many of you may be experiencing so much pain around your knee joint that it feels counterintuitive to exercise which is why you feel it is safer to wait. Let us just take a look first of all at what happens when you decrease or stop exercise.

Here are the changes that occur in your body and muscles when you stop moving or decrease your activity:

1) Muscles tighten and tight muscles can increase pain
2) Range of Motion around your joints decreases which limits function
3) Muscle strength deteriorates causing weakness and inability
4) Your cardiovascular or heart health and stamina decrease
5) Lack of use reduces one's ability to balance and coordination
6) Everyday activities become difficult and independence is challenged

You can limit the impact your knee arthritis has on your overall health by engaging in some simple targeted exercises. It is important to select the right exercises that will not cause pain or increase inflammation. The good news is there are a lot of exercise options available to you that will benefit your pre-knee replacement surgery.

What are the benefits you will gain by exercising pre knee replacement surgery?

1) Maintain or increase range of motion around your knee

2) Maintain or gain strength in muscles that stabilize the knee

*Muscles can absorb shock lessening the stress of loads placed on the knee joint. Also, it is well documented that people who have good quadriceps strength will recover better post knee replacement surgery.

3) Exercise and stretching eases tight muscles which can lead to a
decrease in pain. It has been noted that a large portion of the pain
associated with knee arthritis can be attributed to tight muscles.

4) You will prevent a serious decline in cardiovascular health

5) You will boost energy, mood, and your confidence

6) You will limit the deterioration of your balance and coordination

7) You will drastically improve your ability to recover stronger and
faster than those who do not exercise pre operation

Now that you grasp the importance and benefits of why exercise is essential pre knee replacement surgery, where do you proceed from here? When selecting a type of exercise that is good for your knee having arthritis and possibly pain as well, follow these three guiding principles:

Non-Weight Bearing

Most likely you are at the stage where you experience pain upon walking or weight-bearing whether it is with every step or only after a specified time on your feet. If you fit into this category then you will want to select non-weight-bearing exercise options such as stationary cycling and swimming. Most importantly, you need to know that there are a lot of non-weight-bearing strength exercises you can choose from as well.

Range of Motion

The very nature of osteoarthritis is the deterioration of the range of motion in your joint. The deterioration occurs due to a breakdown in the cartilage between your bones leaving the point of friction at your joint bone on bone. This breakdown in the joint structure and the subsequent pain leads to a decrease in the range of motion at your knee. Therefore, it is extremely important to do knee range of motion exercises including flexion and extension pre-operation. There is a non-weight-bearing range of motion exercise you can do that will help you maintain flexibility in your knee joint.

Quadriceps Strength – Especially VMO Strength

Now do not go shying away from the mention of the word strength because it does not involve heavy weights or fancy equipment. There are simple at-home strength exercises you can do with little or minimal aids that will strengthen your quadriceps muscle. This muscle is the most important muscle you want to target to keep strong before you go in for surgery. Even just learning how to fire or contract this muscle and hold the contraction for a few seconds will help you recover strong post-knee replacement surgery.

Your VMO muscle or Vastus Medialis Obliques, thank goodness for abbreviations, is one of the four quadriceps muscles that sit on the medial or inside of your knee closest to the joint. Having the ability to strengthen and contract this muscle is extremely important for knee rehabilitation and it also aids in the extension of your knee. There are numerous exercises you can do at home to strengthen this muscle with little or no equipment.

These 3 guiding principles need to be the cornerstone of your exercise selection as you prepare for your new knee. If you could only see the results and know the comparisons I have witnessed by my clients who did exercise pre-surgery in relation to those who do not, you would begin exercising today. Often my clients would report less pain post-exercise, feel they loosened up, experience greater confidence in their physical ability, and also have a boost in mood and energy. Need I say more? The evidence is clear, the results are incredible, and now it is all up to you.