Strengthening program: Knee exercises before total knee replacement surgery

You may have discovered that you've been less active because of your knee joint discomfort. When muscles aren't used, they become weak and don't perform well in supporting and moving your body.

Having your knee replacement surgery will correct the joint problem, but you will need a regular exercise program to strengthen your muscles and properly support your new joint.

Beginning an exercise program before your surgery can greatly enhance your recovery period. Follow your doctor's orders before your surgery.

Because everyone responds to exercise differently, you need to be the judge of how much exercise you can do each day. If an exercise causes an increase in joint discomfort, stop doing that exercise.

You should try to exercise one to two times a day, every day, before surgery. Do five repetitions of each exercise. If you are comfortable with the exercise, increase the repetitions by five each week until you reach 20 repetitions (week one: 5 to 10 repetitions, week two: 10 to 15 repetitions and week three: 15 to 20 repetitions).

For the most comfort, do the exercises lying down. Your bed is an excellent place to do your exercises.

Ankle pumps and circles

Bend both your ankles up, pulling your toes toward you, then bend both your ankles down, pointing your toes away from you. In addition, rotate your foot clockwise and counterclockwise, keeping your toes pointed toward the ceiling.

Thigh squeezes (quadriceps sets)

Tighten the muscles in front of your thigh by pushing the back of your knee down into the bed. Hold for 5 seconds and relax.

Heel slides (hip and knee flexion)

Bend your hip and knee by sliding your heel up toward your buttocks while keeping your heel on the bed. Slide your heel back down to the starting position. Keep your kneecap pointed up toward the ceiling during the exercise. You may want to use a cookie sheet under your heel to help it slide easier.

Leg slides (abduction/adduction)

Slide your involved leg out to the side, keeping your kneecap pointed up toward the ceiling. Slide your leg back to the starting position. You may want to use a cookie sheet under your heel to help it slide easier.

Lying kicks (short arc quadriceps)

Lie on your back with a 3-pound coffee can or rolled blanket under your involved knee. Straighten your involved knee. Hold for 5 seconds. Slowly lower your leg down and relax. The back of your knee should stay in contact with the can/blanket throughout the exercise.

Straight leg raises

Bend your uninvolved leg with foot flat on the bed. Raise your involved leg up (about 12 inches), keeping your knee straight. Hold for 5 seconds. Slowly lower your leg down and relax.

Bed mobility exercise

Lie flat on your back. Come up on both elbows. Straighten arms out behind you and come to a sitting position. Lower yourself down onto your elbows again, then down to lying flat.

Knee bending (sitting knee flexion)

Sit on a chair. Bend your knee back as much as you can. Hold for ________ seconds. Return to the starting position and relax. Repeat 5 times.

Sitting kicks (long arc quads)

Sit in a sturdy chair. Straighten your knee as much as possible. Hold for 5 seconds. Slowly lower your leg down and relax.

Chair push up

Sit on a sturdy chair with arms. Grasp the arms of the chair. Push down on the chair arms, straightening your elbows so that you raise your buttocks off the seat of the chair. Hold for 5 seconds. Lower yourself slowly back into the chair. If your arms are weak at first, use your legs to help raise your buttocks off the chair.

Optional: Hamstring sets (heel digs)

Bend your involved knee a little and tighten the muscle on the back of your thigh by digging your heel into the bed. Hold for 5 seconds.

Optional: Buttocks squeezes (gluteal sets)

Tighten your buttocks muscles by squeezing the muscles together. Hold for 5 seconds.