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Exercise to strengthen knee muscles after surgery. What are the precautions to be taken?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15760 Questions

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Posted on Sat, 2 Feb 2013 in Bones, Muscles and Joints
Question: 1. I am able to walk now. I was doing cycling, elliptical trainer for first 6 months regularly and of-late I am doing squats around 5-10 everyday. I would like to know the exercises I need to do so that I can strengthen my knee and restore same level of strength as it was before surgery.

2. I am planning to climb a mountain after 2 weeks from now.. It involves around 1000-1500 regular steps (not an hike on irregular terrain).. Can I do this? Is there any harm in climbing up so many steps?

3. Any specific exercises that you can suggest to handling climbing so many steps.
Any other precautions that I need to take care?

4. What pain killers I can carry with me in case I need them.

Thanks,
-XXXXXXX
doctor
Answered by Dr. Michelle Gibson James 6 hours later
Hi, thanks for using healthcare magic

The strength of the quadriceps influences the return to activity. In addition to the squats that you are presently doing, you can consider adding lunges and leg extensions. The lunges and squats would not only work on the quadriceps but on the hamstrings as well.
If it is possible you can slowly increase the number of exercises done and the repetitions.
At 9 mths post surgery, most programs would have included running programs (drills , intervals, stops and starts, heel to buttocks, high skipping, hopping) checking agility and plylometrics.
In athletes, most return to unrestrictive competition by 9 to 12 mth, at 9 mths of physiotherapy you should also be able to return to unrestricted activity, including the hike that you are planning.

In terms of pain killers, the recommended ones would be the anti inflammatory ones such as ibuprofen, cataflam or voltaren.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James 11 hours later
Thanks Dr. XXXXXXX for your information/advice/prescription of exercises.
It really helps. Will include exercises you mentioned as part of regular list.

1) Is there any harm in trying to squat very low such that my buttocks can touch the heal like injuring the ACL that was reconstructed.. Basically if I try to acheive complete bending of my knee even if it pains, will it cause any harm to my ACL. At present I would say I can acheive atleast 150 degress flexion at my knee.

2) I tried running on treadmill. Whenever I try practicing running on threadmill, I see that I limp while running (kind of jogging) and also muscles at the back of knee starts paining and sometimes the pain persists for a day or two.

Is this expected?
How do I overcome this and also how I avoid limping and instead practice running normally?

Please advice.

Regards,
-XXXXXXX
doctor
Answered by Dr. Michelle Gibson James 8 hours later
HI,

Normally by 7 to 12 weeks after surgery the goal is to acheive full extension and partial flexion of the knee. Exercises are initiated to strengthen the quadriceps and hamstrings.
By 12 to 16 weeks post surgery, there should be full range of motion of the knee and increased amount of exercise is done.
By 4 to 6 mths, jogging, step ups, biking and agility drills are initiated by the physiotherapist.
You can try short periods of running to become accostumed to it, increase the amount of time gradually.
As you are 9 mths post surgery then you should be at full function. If you are having difficulty at this time then you need to consider re visiting your doctor for an assessment.

Feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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