Total Knee Replacement Surgery
Muscle Strengthening Before a TKR
Exercises you perform prior to surgery can help strengthen your knee, improve flexibility, and help you recover faster. There are numerous exercises you can do at home—however, it is important to speak to your surgeon and physical therapist before you start any new exercise regimen.
Jamie Nelson, PT, DPT, at UCSF, offers insights into how you can rehab more quickly and effectively by strengthening your muscles before surgery with these common exercises. Begin with 5 to 10 repetitions of each exercise twice a day the first week, then increase to 10 to 15 repetitions by week two, and finally move up to 15 to 20 repetitions by week three.
Click “next” to learn about these knee-strengthening exercises.
1. Thigh Squeezes / Quad Sets
While lying on your back, tighten the muscles in the front of your thigh by pushing the back of your knee down toward the floor or bed. Hold for five seconds and then release. This helps build the quadriceps muscle that attaches to the knee.
2. Side-lying Straight Leg Raises
While lying on your side, lift your leg straight toward the ceiling to a distance of about 1.5 to 2 feet from your other leg. Perform up to 3 sets of 10. This exercise is crucial in building your hip abductor muscles located in the buttocks. These muscles stabilize your pelvis while you are standing and walking.
3. Straight Leg Raises
Lie on your back and place your problem leg flat on the floor or bed while bending the other leg. Raise your sore leg up to about 12 inches and hold it there for five seconds. Then slowly lower your leg. This will help build your quadriceps and hip flexor muscles. This is especially important for regaining movement after surgery.
4. Clamshells
Lie on your side with the damaged knee positioned toward the ceiling. Keeping your heels together, open and close your legs like a clamshell. This works the external rotators and part of your abductors. Both are important for early ambulation and balance.
5. Knee Bending
Sit in a stable chair and bend your knee back as far as possible. Hold it for five seconds and then return it to the resting position. This helps maintain your range of motion prior to your surgery.
6. Sitting Kicks
Sit in a stable chair and raise your leg until it is straight. Hold the position for five seconds and then slowly lower your leg. This helps strengthen the quadriceps muscle through its full range of motion.
7. Chair Push Up
Sit in a sturdy chair with arms. Grasp the arms of the chair and push down on them while raising your body and straightening your arms and elbows. Then slowly lower yourself back onto the chair. This will help strengthen your triceps so they can hold you up when you don’t have the use of both legs after surgery.
8. Lying Kicks
Lie on the floor or a bed and place a rolled blanket or large coffee can under your problematic knee. Straighten your leg and the knee and hold the position for five seconds. Slowly lower your leg down and rest. Make sure the back of your knee stays in contact with the object the entire time and the small of your back remains on the floor. This exercise also helps strengthen the quadriceps muscle.
9. Stomach Kickbacks
Lie on your stomach with your leg straight and then slowly bring your whole leg towards the ceiling. Hold for 2-3 seconds then slowly lower it. This helps strengthen your hamstrings and the gluteal muscles in your butt. These muscles are important for getting in and out of chairs and cars.
10. Standing on One Leg With Support
Place yourself in front of a countertop or waist level bar. Hold on to the bar and stand on your affected leg for 30 seconds. Make sure to squeeze your gluteal muscles (in your butt) together to engage your abductors. This exercise is crucial for maintaining balance and reducing the risk of falls. Perform this exercise as many times as you can per day.
Set Goals and Exercise Regularly
Spend 10 to 15 minutes at least twice a day doing these exercises. Your ability to build up strength in the muscles around your knee prior to the surgery will greatly impact the speed and quality of your recovery.
