Therapeutic physical training significantly speeds up the rehabilitation process after joint arthroscopy surgery in Moscow. Regular exercises allow you to restore joint mobility and normalize its functioning. In order for the exercises to be effective and beneficial, experts recommend following a few simple rules: Exercise regularly. Each workout should last from 20 to 30 minutes, preferably several times a day. Therapeutic physical training after arthroscopy of the knee joint should be carried out under the supervision of a specialist, at least at the initial stage. If you experience pain or discomfort while performing any exercises, be sure to tell your doctor. During the early rehabilitation period, training is carried out in fixing bandages (bandages). Even if you think that you are ready for increased stress, under no circumstances do it too abruptly. The load should be increased gradually so as not to provoke complications and unpleasant consequences. At the end of classes, a light leg massage is recommended to improve blood circulation. All exercises should be performed at a moderate pace. Remember that you are not competing or performing exercises against the clock. The workout should take place in a calm state at a moderate pace. Be sure to monitor your health. If your body temperature rises or severe pain occurs, consult a doctor immediately.
Rehabilitation after knee arthroscopy
The recovery period after arthroscopy varies in duration for each patient, as it depends on the general condition, correctness and intensity of rehabilitation actions.
The early recovery period is counted from the moment the operation is completed until the drainage is removed. Local cryotherapy is used - a cooling pack or ice container is applied for 30-40 minutes. Thus, the risk of complications is reduced. To prevent swelling and disruption of blood vessels, elastic bandaging of the knee is done. Compression stockings may be used. In some cases, the use of rigid splints or orthopedic orthoses is indicated. You should treat your foot carefully for several days. It is recommended to place a pillow under it.
Belousov Evgeniy Ivanovich
traumatologist-orthopedist, surgeon
After arthroscopy, rehabilitation is faster than after arthrotomy (open surgery). Due to its low invasiveness, it is possible to begin muscle mobilization earlier, restore the range of motion in the knee joint and the ability to support the limb. After surgery, immobilization is indicated for 12 hours. Then isometric exercises are performed. From 3-5 days, active movements in the joint are shown, and after 2 weeks, training begins in the pool and on exercise machines to restore muscle tone.
Main stages of exercise therapy
The patient after arthroscopy of the knee joint is shown a dosed load, which is gradually increased. During the recovery period, you need to perform exercises of varying complexity. Conventionally, physical therapy classes can be divided into four stages.
First stage
The first stage lasts from 1 to 3 days, depending on the patient’s condition. As a rule, at this time the person is in a hospital setting. This stage includes drug therapy with antibacterial and anti-inflammatory drugs. A rigid bandage is fixed on the leg. Any stress will provoke pain, so complete rest is indicated. During the first 24 hours after surgery, only flexion and extension of the leg in a supine position is allowed: this can only be done under the supervision of a specialist! Even if it seems to you that nothing hurts, you should not perform any physical activity on your own.
Second phase
If no complications are observed, the patient is discharged home on 2-3 days. At this stage you need to start developing the knee joint. Easy exercises with low amplitude are shown. Let's look at an example of training at the second stage: You need to lie on the bed on your back and remove the pillow from under your head. In this position, you need to bend your legs at the knee (the permissible amplitude is determined by the doctor). Lie down for 10-20 seconds and straighten your leg again. You need to repeat this exercise 5-10 times. Starting position: lying on your back, on a flat surface, arms along your body. Raise your straight leg 30-40 degrees and fix it in the air for 10-20 seconds. The exercise is performed alternately on each leg for 5-10 approaches. Lying on your back, bend your knees without lifting your feet off the floor. Try to slowly raise and lower your pelvis. 10-12 approaches. Stand at the back of a chair and hold it with your hands. Try to move your leg to the side as much as possible, holding it in the air for a few seconds. 5 approaches for each leg. Please note that everything is purely individual. The training plan depends on the patient's condition and the extent of the surgical procedure. Exercises at this stage must be performed under the supervision of a specialist. In case of severe pain, it is better to stop this or that exercise and inform your doctor.
Third stage
The third stage begins approximately 3-4 weeks after arthroscopic surgery on the knee joint. Compared to the previous ones, here the load is significantly increased and the training time is increased. You can do physical therapy at the third stage at home, but first you need to discuss a training plan and acceptable exercises with a specialist. Let's consider a sample training plan: Starting position - lying on your back, you need to place a small cushion under your knees. Please note that it is localized under both legs at once - the healthy one and the operated one. Press down on it, straightening your leg as much as possible. This exercise must be performed 10 times in 3 sets. Place a chair with a backrest in front of you. Grasp it with your hands and try to sit down. There is no need to perform a deep squat, a small amplitude is enough. Repeat 5-10 times until your legs become tired. Stand on the floor with your feet shoulder-width apart. Try to touch the floor with your palm without bending your knees. Hold this position for 30 seconds. This will not happen right away, after a certain time of regular training - you must place your palm completely on the floor. Stand straight, hands on your waist. Do a hip raise with each leg in turn. 10 times on each leg. Sit on the floor on your buttocks, legs straight, back straight. Try to reach your foot, repeat this several times.
Fourth stage
The fourth stage begins 7-8 weeks after knee surgery. Now the range of motion and intensity of training increases significantly. The exercises are aimed at the final restoration and normalization of the functioning of the knee joint. At this stage it is recommended to: Walk as much as possible at a moderate pace. Exercise on an exercise bike and step platform. Climbing stairs. Perform strength training with minimal weight.
Therapeutic exercises for the leg
Physical therapy allows you to restore flexibility and mobility to the operated joint:
- At the first stage, the exercises should be performed while lying on your back with a fixed knee. The loads are minimal. You can exercise already on the first day after surgery. It is recommended to make smooth movements of the ankle joint, as well as strain and contract the muscles of the thigh and buttocks, and slightly extend the leg at the knee. As a result, correct coordination of the joint is restored.
- With the permission of the doctor, the patient can move on crutches, which not only provide support, but also develop a sense of balance. Physical exercises are shown in a sitting position with legs raised parallel to the floor. As a rule, exercises are performed under the supervision of a physician on an outpatient basis after discharge from the hospital. Typically takes four days.
- After stopping crutches, you need to do stretching exercises. To increase the load, shin weights can be used. Sometimes the doctor prescribes exercise bike classes. It is recommended to carry out up to 20 days.
- At the final stage of rehabilitation, physical therapy is used to warm up muscles and joints. Exercises are performed with increased load on the knee joint. Walking and cycling are also useful, 10-15 minutes a day. The stage can last up to six weeks.
If you neglect the doctor’s recommendations, there is a high probability of complications, including the appearance of adhesions, contractures, infection, hemorrhages in the joint, tissue swelling, and inflammation of the scar.
What complications may arise after surgery?
- severe pain;
- bleeding and minor abrasions;
- thrombosis;
- damage to nerve canals;
- limited activity;
- relapse;
- slight discomfort.
In order to avoid deterioration, it is very important to closely monitor your condition and visit your treating surgeon from time to time.
How soon will you recover after surgery?
After the operation, you will remain in the hospital for some time under the supervision of doctors, after which you will be discharged home. You should walk on crutches for some time. After the wounds have healed, your stitches will be removed. Then you need to wear the bandages for quite a long time to protect yourself from relapse. The graft takes about 12 weeks to heal after surgery, depending on your body and the rehabilitation process.
Thus, cruciate ligament surgery is the path to health, an active way of life without discomfort.
What is the duration of treatment after arthroscopy?
The duration of rehabilitation following arthroscopy depends on several characteristics. For example, how serious were the disorders in the joint or how the operation was performed. It is important to remember that a patient may have a variety of diagnoses associated with arthroscopy after the procedure. Arthroscopic surgery is performed differently for each patient.
We must not forget that after surgery, vigorous physical activity such as exercise, walking, can cause severe pain and swelling or even provoke a relapse. It takes at least one week to start driving a car. After surgery, activity should be increased gradually, depending on the condition of the joint. You need to carefully monitor your well-being. As a rule, light activity and small loads can be started after seven days, and the patient can return to normal life after two or three months. You can determine your readiness for activity by pain (if any) and swelling of the joint.
What complications may arise?
As a result of arthroscopy, complications may occur in rare cases (1% of all operations). There are cases when blood accumulates in the joints, thrombosis or thromboembolism occurs.
You should immediately consult a doctor if you observe the following symptoms:
- heat;
- chills;
- redness around the joint;
- swelling of the joint;
- severe pain;
- hard breath.
If you see a doctor in time, you can avoid many postoperative complications!
How should rehabilitation proceed after arthroscopy?
After surgery, small wounds up to 6 mm in diameter remain on the knee joint. As a rule, they heal within two weeks, after which the stitches need to be removed by a surgeon. After the sutures are removed, slight swelling and pain may occur.
During rehabilitation, you need to make 2-3 visits to your doctor to change bandages, remove stitches and check-ups for a speedy recovery. After just 7 days, you can gradually return to household work, drive a car or go swimming. If you work in an office, you can return to your duties after 3 weeks, start moderate physical activity after 6 weeks, and after 15 weeks you can actively engage in sports.
After a week of rehabilitation, you need to adhere to the following recommendations:
- calm down, after surgery it is necessary to limit the activity of the operated joint for 4 days;
- cold - you need to apply ice to the sore knee for 10 minutes several times a day;
- tight bandaging. It is imperative to bandage the sore joint, removing the bandage several times a day for at least 15 minutes;
- high position of the sore knee. The joint should be kept at a higher position than the heart.
To resume muscle activity in the operated knee, you need to do light exercises after two weeks. But if the load is very strong, you will feel pain and swelling will increase, so it is better to draw up a set of exercises with your doctor. They need to be done at home for at least 20 minutes 3 times a day.
A set of exercises in the first days after arthroscopy
Exercise 1. Activity of the posterior muscles of the hip joint.
Lying on the floor with your back, raise your knees until slight pain occurs. Press your heels into the floor and tighten your glutes. Hold this position for a few seconds, then relax your muscles. Repeat the exercise 6 times.
Exercise 2. Activity of the anterior muscles of the hip joint.
Lie on your shoulder blades, roll a towel into a tube and place it under your heels. Press down on the towel with each foot in turn, engaging the front muscles as you release them. Repeat up to 10 times.
Exercise 3. Raising a straight joint.
Lie on your shoulder blades and bend your healthy knee. Raise the other leg on which surgery was performed slowly, but so that it does not cause pain. Repeat the exercise up to 7 times.
Exercise 4.
Stay on your shoulder blades, bend and lift your knees. Raise the muscles of the gluteal part a few centimeters and hold for a couple of seconds. Then lower yourself and repeat for 20 minutes.
Exercise 5. Raising a straight knee.
Place your hand on a wall or comfortable support. The main weight is on a normal leg. Slowly lift the sore leg until pain appears and then lower it. Repeat up to 5 times.
A set of exercises for the second and third weeks after arthroscopy
Exercise 1.
Take a lying position on your shoulder blades, place a hard pillow under the joint. Rest against the bolster and straighten your knee as much as possible. Hold for a few minutes and fold back. Keep repeating until fatigue sets in.
Exercise 2.
Lying on the floor, bend your healthy leg. Level the patient and slowly lift her to 90°, hold and lower. Repeat several times.
Exercise 3. Support on a chair.
Place both arms on the back of the chair and slowly squat until you feel a slight tingling sensation in your knee. Then stand up. Continue repeating for 20 minutes. At the same time, try to keep your posture straight.
Exercise 4. Stretching the front of the thigh.
The stance is the same as in the previous lesson. Support on a normal leg. Bend the patient and slowly stretch your heel towards the buttocks. Straighten your leg and repeat 10 times.
Exercise 5. Squat.
The body remains in the same position. The sore knee is slightly forward and squat in this state. When a feeling of pain arises, stop.
Exercise 6. Walking up the steps.
Stand on a short stepladder or ladder. Place your bad foot on the step and climb up. Do these steps for 10 minutes. But no more!
Exercise 7. Straightening the joint.
Sit in a place that is comfortable for you. And place your other leg directly on a solid stand. Place a weight of no more than one kilogram on the operated joint. Stay in this state for 5 seconds, remove the weight and wait 2 minutes. Repeat several times.
Exercise 8. Exercise with an exercise bike.
You can try using an exercise bike, but first make sure it doesn't cause pain. Start with 5 minutes a day, if your leg doesn’t bother you, increase the training time by a minute a day.
Exercise 9. Walking.
You can walk as usual every day for 15 minutes, no more.
Personal classes and training with patients are conducted by instructors from our clinic. To do this, consult your doctor and make a schedule of classes.
Physiotherapy after arthroscopy
Most patients undergo physical therapy while recovering from surgery. Various methods are used, among which the most common are massage, ultrasound therapy, UHF therapy, magnetic laser treatment, lidase electrophoresis, and magnetotherapy.
But physiotherapy has contraindications, including pregnancy, fever, exacerbation of chronic diseases, bleeding, and neoplasms.
When preparing for knee arthroscopy, you need to remember the need for rehabilitation, which will take some time. If you strictly follow all the doctor’s recommendations and prescriptions, then each stage will pass without complications, after which you will be able to quickly return to your normal life.
Features of the operation.
Arthroscopic intervention is represented by several fundamental stages:
- First of all, at a doctor’s appointment, the patient is examined, the specialist collects an anamnesis, and sometimes it is necessary to take additional urine and blood tests, undergo an x-ray, and an electrocardiogram. The result of collecting information and determining the clinical picture is a referral for arthroscopy.
- The patient is given local anesthesia, placed on the operating table and the damaged limb is fixed so that the doctor has the most convenient access to the affected area.
- Next, the doctor makes two small holes (unlike traditional surgery, where the joint cavity is completely opened). An arthroscope with a camera is inserted through one incision (a high-resolution image is broadcast on the screen in real time), and through another, instruments are inserted, with the help of which the cavity is washed, and all other manipulations are performed.
You can read more about joint arthroscopy here -
Frequently asked questions (FAQ)
What kind of orthosis is needed after knee arthroscopy?
To achieve the optimal effect from wearing the product, you need to know how to choose an orthosis for the knee joint. It is necessary to understand that these products are prescribed by a doctor after a thorough examination of the joint. To choose the right knee orthosis, you must strictly follow your doctor’s recommendations. Certain product characteristics must also be taken into account.
After knee arthroscopy, when can you walk?
You are allowed to stand up, but walk only with walkers or crutches. It is necessary to protect the leg from full load for at least one week.
After knee arthroscopy, fluid accumulates. What to do?
This may be associated with the development of tissue inflammation.