Post-Surgery Knee Rehabilitation: Safe Exercises for Recovery

Postoperative Issues Following Knee Joint Debridement Surgery

Hello, Doctor.
At the beginning of January this year, I underwent an MRI which confirmed that my left knee's lateral meniscus was severely damaged and had to be removed.
It has now been two months post-surgery, and I have stopped using crutches.
During this time, I have been doing rehabilitation, but I still experience issues with my legs being uneven in size.
Additionally, I have bone spurs in my knee, and the cartilage is worn down; during the surgery, holes were drilled into the cartilage.
Could you please advise me on which exercises would be beneficial for my recovery at this stage? Is it safe for me to swim, use an elliptical machine, or ride a stationary bike? Since I have only recently stopped using crutches, I am still hesitant to walk without support.
Thank you for your help.

A-Zhi, 30~39 year old female. Ask Date: 2016/03/24

Dr. Shi Guozheng reply Orthopedics

The condition of the thighs and calves is due to muscle atrophy caused by lack of exercise on the affected side.
Gradually engaging in physical activity can lead to some recovery.
Suitable exercises include walking, swimming, and cycling at a slow pace.

Reply Date: 2016/03/24

More Info

Post-surgery knee rehabilitation is a critical phase in the recovery process, especially after significant procedures like meniscectomy or cartilage repair. Given your situation, where you've had a severe lateral meniscus tear and subsequent surgery, it's essential to approach rehabilitation with caution and a structured plan.

Safe Exercises for Recovery
1. Range of Motion Exercises: Initially, focus on gentle range of motion exercises. These can include:
- Heel Slides: While lying down, slide your heel towards your buttocks and then back out. This helps improve flexibility without putting too much strain on the knee.

- Quadriceps Sets: Tighten your thigh muscle (quadriceps) while keeping your leg straight. Hold for a few seconds and then relax. This helps maintain muscle strength.

2. Strengthening Exercises: As you progress, you can incorporate strengthening exercises, but they should be done gradually:
- Straight Leg Raises: While lying down, keep one leg straight and lift it to the height of the opposite knee. This strengthens the quadriceps without stressing the knee joint.

- Wall Sits: Stand with your back against a wall and slide down into a sitting position, holding for a few seconds. This helps build strength in your quadriceps and glutes.

3. Low-Impact Aerobic Exercises: Once you feel more comfortable and your range of motion improves, you can start incorporating low-impact aerobic exercises:
- Swimming: This is an excellent option as it provides resistance without putting weight on your knee. The buoyancy of water supports your body, allowing you to move freely.

- Stationary Biking: Using a stationary bike can help improve your knee's range of motion and strength. Start with low resistance and gradually increase as tolerated.

- Elliptical Machine: This is another low-impact option that can help with cardiovascular fitness and leg strength without the harsh impact of running.

Precautions
- Listen to Your Body: Pay attention to any pain or discomfort during exercises. If you experience significant pain, especially sharp or worsening pain, stop the activity and consult your physician or physical therapist.

- Avoid High-Impact Activities: Activities such as running, jumping, or any high-impact sports should be avoided until you have fully recovered and received clearance from your healthcare provider.

- Gradual Progression: Increase the intensity and duration of your exercises gradually. This will help prevent re-injury and ensure that your knee is adapting well to the increased demands.

Rehabilitation Timeline
Typically, the rehabilitation process can take several months, depending on the severity of the injury and the surgery performed. It's essential to have regular follow-ups with your orthopedic surgeon and physical therapist to monitor your progress and adjust your rehabilitation plan as needed.

Conclusion
In summary, your rehabilitation should focus on gentle range of motion and strengthening exercises initially, progressing to low-impact aerobic activities like swimming and biking as your knee allows. Always consult with your healthcare provider before starting any new exercise regimen, especially after surgery, to ensure that you are on the right track for a safe and effective recovery. Remember, patience and consistency are key in your rehabilitation journey.

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