Do I need physical therapy, and if so, for how long?

Rehab after a Knee or Hip Replacement is one of the most important aspects in order to gain the full benefit of the joint replacement surgery. Most people who have had a total knee/hip replacement require physical therapy following surgery. A skilled therapist can accelerate the rehabilitation as well as make the process more efficient with the use of dedicated machines and therapeutic modalities. Depending on the patient’s condition before surgery, physical therapy is beneficial for up to 1 to 2 months. The amount of therapy needed depends upon condition before surgery, motivation, and general health.

Patients will usually spend 2-3 days in the hospital after undergoing surgery. Most patients start rehabilitation while in the hospital and after leaving the hospital if facilities are available, then they undergo outpatient therapy while living at home. Physiotherapy before surgery can also be considered in order to maximize strength, stamina, and overall health. This way, being more prepared going into the procedure helps minimize pain and boost function, and it may even improve outcomes, cut costs, and reduce the risk of post-operative complications.

Regaining strength and motion

After a knee replacement, exercising to regain strength and range of motion is crucial. Most patients begin to stand and walk using a walker within 3 hours after surgery. The physical therapy program starts with gentle exercises to help bear weight on the new joint. Performing range of motion exercises after surgery is especially important to prevent scar tissue from limiting the flexibility of the new joint. Some pain during exercises after a knee replacement should be expected.

Most rehabilitation programs for knee replacements usually include a range of motion exercises, quadriceps strengthening, gait training, and daily life training exercises. It’s important to avoid straining or overworking the knee during your recovery period. Healing takes time and you shouldn’t try to rush your rehabilitation.

Making progress

Depending on the muscle tone and general strength of muscles, there is a plan to gradually resume normal activities within the next few weeks. This starts with progression from using a walker to a cane and gradually walking on your own. Within 4 weeks after surgery, patients start climbing stairs. By 3 days post-surgery, when ready to return home, patients are able to safely get out of bed, walk up to 100 feet with crutches or a stick, use the bathroom, and get in and out of chair or sofa. Physical therapy sessions should ideally continue when back at home. The therapist should visit at least once at home to ensure that patients can safely get around. After home visits have ended, physical therapy is started by self as per instructions given.

The therapist will guide through an exercise program that includes a range of motion, strengthening, balance, and endurance exercises as well as functional activities. As therapy progresses, confidence increases for day-to-day activities, such as going up and down steps, bending over, and squatting.

Returning to normal activities

Approximately six weeks after surgery, patients are mostly permitted to drive and return to work depending on the demands of the job. If the job requires heavy lifting or other manual labor, then the plan might change as per guidance from a doctor or physical therapist.

Remember that rehabilitative therapy is a vital part of recovery and hard work during this stage will keep recovery on track and help enjoy all the benefits knee replacement surgery provides.