by Giles on Tue Sep 24, 2019 11:11 am
Finger’s crossed for you there, Origami. Knees have been a theme of mine over the years, including some minor surgery although never anything on the scale you describe. On the basis of both my experience and understanding: the first phase of movement and (re)strengthening the muscles around the knee and your leg in general should be exercises where you are not supporting your body weight. In other words where you can move your knee/leg freely, usually in a lying or sitting position with (mostly) your leg stretched out. And then using a kind of feldenkrais-y or, wait for it, tai chi approach to the exercises. Slow, smooth, ‘gentle’, not forcing it, building up slowly. The most basic exercise is very low-threshold but also surprisingly effective. Can be done quite soon after surgery.
--> Sit or lie on a bed/mattress with your dodgy leg stretched out comfortably, quite relaxed. Then very slowly activate your quads to gently pull your kneecap towards you a little. And simultaneously lift your foot maybe an inch higher off the bed. Which is the same muscle action, just viewed differently. Go to the maximum straightness of knee/leg, at the end ‘tensing’ but not in a jerky manner. Hold for anything from 1 to 5 seconds, depending on your feeling, and then slowly (!) let the foot sink down again and your kneecap return to its original position. As long as this feels more or less OK, repeat as often as you like (100 times if it feels OK) with rest phases in between. Good while watching TV, listening to something etc. Do this several times a day for many days. In this way you not only strengthen the muscles but program into them a ‘healthy track’ for movements of the knee joint. Next phase is to place a rolled-up towel under the knee so that the foot needs lifting a little higher to fully straighten the knee. Next phase: when your leg is held fully straightened, lift your entire leg (not just your lower leg) a few inches from the floor or mattress and hold for a few seconds, or later make small circles in the air before putting down again. But this certainly not in the first few days.
Later again, sit on a sturdy but not excessively thick table or suchlike with the table edge under the hollow of your knee and your lower legs hanging down free. Place a towel under your knee(s) for comfort, start by swinging your feet a little (feels nice, being age 8 again), then use the same slow and smooth manner to lift your foot/lower leg up from vertical hanging to horizontal stretched out. Just one foot, not both! Hold for 1 to 5 seconds, then slowly and smoothly lower your foot again. Repeat as required.
Only when you feel you have built up smoothness and strength in and around your knee through these exercises should you progress to exercises where the knee is bearing any body weight. That’s because these latter exercises involve a greater risk of something going wrong, collapsing etc. Even if it just happens for a moment, this can put you back weeks or worse.
Also do these exercises before surgery. Even if only the first one. Your body will remember them later and find its way easier.
Good luck, keep us posted!
PS. Don't forget to cool the joint regularly in the first 48 hours or so to reduce swelling, but I guess the hospital will give you all this kind of info.
Do not make the mistake of giving up the near in order to seek the far.