Being stuck in a boot or cast after surgery is no excuse to not move. While it is imperative to protect the integrity of the surgical site and allow for proper tissue healing, we can still maintain the STRENGTH and RANGE OF MOTION of other more proximal and distal joints. This article will cover some of our favorite lower extremity exercises to do while “immobilized” or “non-weight bearing” and keep you staying strong after surgery. As always, check with your orthopedic surgeon and/or physical therapist to determine which motions and exercise are the right ones for you!
Staying STRONG After Surgery – Strength Exercises
You loose 350g of msucle tissue (~10%) and a reduction of 30% of muscle protein synthesis for every 2 weeks you’re immobilized after surgery.
350g of muscle tissue is the size of your heart!! How crazy is that?! Immobilization, bedrest, and being non-weight bearing (not allowed to bear any weight on a given limb) are an absolute recipe for disaster to your bone, joint, and muscle integrity. Typically with many foot/ankle surgeries, surgical precautions include a period of non-weight bearing for as long as 8 weeks. Even worse, some surgeons don’t even send their patients to physical therapy until 4-6 weeks after surgery. That’s over a month in which you’re losing precious muscle mass and your joints are getting stiffer.
Shown in this video above are a host of different strength and conditioning exercises as well as basic stretches to keep your affected limb in check while you are immobilized. These exercises will keep your glutes and quads strong and your lower extremity mobile. Do these exercises (+more) on the unaffected side as well!
Exercises/stretches in order are: Side-lying hip abduction, clams, evil clams, sideplanks, sideplank clams, hip extension, fire hydrants, hip hinges, long arc quads, straight leg raise, hamstring curl, hamstring stretch, hip flexor stretches. You can find detailed explanations and follow along tutorials of all these exercises in our exercise library.
Regaining Range of Motion After Surgery
There are numerous way to regain knee range of motion prior to or after surgery. When it comes to ACL reconstruction in particular, one of the best indicators for good post-operative outcomes is normalizing range of motion prior to surgery itself. This is why, in addition to allowing swelling to decrease, surgery is usually held off for a bit after someone tears their ACL. Shown in the video below are just some of the many ways we like to gain back knee ROM. In general, we can classify the exercises as either passive, active-assisted, or active range of motion exercises.
- Passive exercises rely simply on gravity to do the ‘stretching’ work. Exercises like supine knee props, bag hands, or seated knee flexion all rely on gravity to stretch the knee.
- Active-assisted exercises incorporate active movement into the exercise, in addition to an external force like gravity, your other leg, or even another person’s body. An example of this is the supine knee flexion against wall exercise. Gravity is pushing Craig’s knee into flexion, while he contracts his hamstring at the same time to add a further stretch to the quads. Note that this exercise and others can easily be made passive if Craig doesn’t contract!
- Active range of motion exercises use the agonist muscle to move into the range. Examples of this are the long arc quad to achieve full knee extension (using quadriceps) or supine heel slide to achieve full knee flexion (hamstrings).
We hope this article has been helpful to you as you are preparing for your surgery/casting, or if you just got out of the surgery room/cast! Even if you aren’t injured, share this article with a friend or loved one who will be getting surgery/casting as it will dramatically affect their outcome for the better.
We wanted to help out you, and we created a FREE exercise program for anyone with lower extremity knee injury using our Exercise Library database. This program will work for a host of different knee surgeries like ACL reconstruction, meniscectomy, total knee replacements, you name it! It’ll help you stay mobile and strong after surgery. As always, consult with your surgeon/physical therapist to find the best and safest combination of exercises for YOU!
Early Post-Op Knee Surgery Exercise Program