Throughout my career as a personal trainer, I have interacted with many seniors who have had knee replacements. Some have even been my clients. For these active seniors, having pain so severe that it was preventing them from an active life or enjoying their grandchildren was not an option they could accept.
Statistics show a majority of adults seeking a knee replacement are between the ages of 65 and 74. Slightly more women than men will have the surgery. It’s estimated in the U.S. alone, there will be more than 1 million knee and hip replacements performed this year. At the present time, over 7 million Americans are already living with a knee or hip replacement.
While the popularity of knee replacements is growing, it’s still good to remember this is a major surgery. That being said, the experts at orthoinfo.org consider it to be “one of the most successful procedures in all of medicine.”
The first months after surgery are the most critical for knee rehabilitation. To guarantee optimal recovery, it’s important to work on knee flexibility. It’s common to be prescribed physical therapy after surgery for this very reason. If you’re looking for full use of the knee after your surgery, this step is extremely beneficial.
It’s important to remember that recovery time can vary for each person, but most people will be up on the new knee the same day. There are plenty of estimates to show that many patients are back to their regular daily activities within 4 to 6 weeks.
Because knee replacements (and hip replacements) are becoming so common, medical facilities are continually trying to figure out how to help patients reach more optimal outcomes. Many have started “prehab” for their prospective patients, doing a sort of rehabilitation program before the surgery. This has led to better outcomes in recovery times and overall healing.
Related Reading: Why In-Home Physical Therapy Is A Game Changer
The main objective of prehab is to strengthen the muscles in the leg that will be receiving the knee replacement, and improve the range of motion prior to surgery. It is recommended that prehab begin at least 6 weeks before the planned procedure.
Here are five strength exercises I use with my clients to help them build leg and muscle strength before a joint replacement.
Exercise #1: Seated Leg Lift
This exercise helps to strengthen the front thigh muscles, also known as the quadriceps. The quadriceps are the muscles that support the knee joint and stabilize it as it’s bending and straightening.
- Choose a chair that allows both feet to rest on the floor, knees bent with legs at a comfortable 90-degree angle.
- Sit closer to the front of the chair seat for this exercise.
- Extend one leg out straight, heel resting on the floor.
- Pretend you’re reaching for something at the end of your toes and slowly raise the straight leg to a 3 count — one and two and three.
- Lower the straight leg slowly to a 3 count — one and two and three.
- Repeat the leg lift up and down for a total of 15 times or repetitions.
Exercise #2: Standing Leg Curls
This exercise helps improve the range of motion of the knee so it can bend properly after surgery. It also helps to strengthen the back of the leg or the hamstring muscles which go from the hip to the knee.
- Stand tall, feet about shoulder width apart and your knees slightly bent.
- Make sure to hold onto a solid chair, desk, or countertop.
- Keeping knees inline, curl one leg up behind you with a flexed foot, bringing the heel of the flexed foot as close to the hamstring as possible. Do this to a 3 count — one and two and three.
- Lower the foot slowly back to the floor with a 3 count — one and two and three.
- Repeat the leg curl up and down for a total of 15 times or repetitions.
Exercise #3: Standing Calf Raises
This exercise helps strengthen the calf muscles. The calf muscles go from the back of the knee to the heel and help stabilize the leg during walking and squatting.
- Stand tall, feet about shoulder width apart and your knees slightly bent.
- Make sure to hold onto a solid chair, desk, or countertop.
- Slowly lift both heels off the floor, transferring your weight to the ball of your foot.
- Hold this for a full second.
- Slowly lower your heels so they are touching the floor in the starting position.
- Repeat the calf raise up and down for a total of 15 times or repetitions.
Exercise #4: Standing Side Leg lifts
This exercise helps strengthen the inside and outside muscles of the legs, the abductors and the adductors. These muscles are critical for keeping the body and hips stabilized especially while standing on one leg.
- Stand tall, feet about shoulder width apart and your knees slightly bent.
- Stand to the side of a solid chair, desk, or countertop to hold for balance.
- Flex the foot on the leg furthest from the chair, desk, or counter.
- Lift the leg to the side as high as feels comfortable for you, making sure to keep the hips level and the torso straight, trying not to lean with the lift.
- Bring the leg back and cross slightly over the standing leg.
- Repeat the side leg lifts for a total of 15 times or repetitions.
- Be sure to deliberately lift the leg instead of swinging it.
Exercise #5: Counter Push-Ups
This exercise helps strengthen the upper body. On the first few days after surgery, you will likely use some sort of walker, crutches, or poles for assistance. If your upper body isn’t strong, you will become tired before you can give your new knee a good workout.
- Stand facing a heavy desk or kitchen counter.
- Securely grab the edge of the counter or desk with your hands so your arms will be about shoulder width apart.
- Pull tall, keeping your torso tight and not allowing your bum to stick up in the air.
- Bend your elbows out to the side and slowly lower yourself to the counter or desk, allowing your heels to come off the floor as you lower.
- Go only as low as you can go and still push yourself back to the starting position.
- Repeat the pushups for a total of 15 times or repetitions.
Pro Tip: Be sure to work both legs with these exercises. After surgery, the “good” knee will need to be strong enough to support you while your new knee heals. If you feel like the leg that will receive the new knee is significantly weaker, you may find it beneficial to do more exercises with the weaker leg. You might do two sets on the weaker side and just one set on the stronger side.
How To Begin Using Knee Replacement Exercises
These exercises should be started 6 to 12 weeks before the planned surgery. If you have not been active because of the pain, please begin slowly.
Start your prehab with 4 to 6 repetitions (reps), or what you feel like you can do with a mild amount of exertion.
Do those 4 to 6 reps every other day for 1 week. Add 1 or 2 reps the next week, again using a mild amount of exertion. Keep adding 1 or 2 reps until you are doing 15 reps on each leg.
If you start 3 months before surgery, at 4 weeks before surgery, do these exercises every day instead of every other day.
Pro Tip: When 15 reps become easy, start doing two sets of each exercise. Do two sets of 8 reps and begin to increase the reps of each set by adding 1 or 2 reps each week. One set is equal to performing an exercise for a set number of repetitions, and 15 reps is recommended for each set of these prehab exercises.
From my experience working with seniors, the most common remark I heard after a knee replacement was, “I wish I had done it sooner.” For that reason, I suggest you don’t wait until the pain is so severe it significantly interferes with your quality of life. The research is there: The stronger you are going into surgery, the faster the recovery. Here are some additional insights if you’re a candidate for surgery:
- Start 3 months before surgery to focus on improving leg strength. This is always a huge boost for my clients.
- Incorporating healthier eating habits can also help. It can help take off a few extra pounds, but mainly it helps you feel more energized.
- If you are offered physical therapy before or after surgery, it’s good to accept it.
- A personal trainer can help you stay current with the prescribed program you receive from your medical team.
- It’s important to have your home organized so you can get to things easily once you get home.
- And please, don’t be afraid to ask for help so you can concentrate on making a full and successful recovery.
For more inspiration, consider reading At 70 I’m Healthier And Fitter Than I Was At 20 — Here’s How plus Seniors Matter’s advice on how caregivers can prevent opioid addiction in older adults.
