Orthopedics focuses on the musculoskeletal system. Learn about the diagnosis, treatment, and rehabilitation of bone, joint, ligament, and muscle conditions.
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Rehabilitation is the bridge between the surgery and the new life. The surgery fixes the mechanical problem, but rehabilitation restores the function. Muscles that have been weak for years due to arthritis must be retrained. Stiffness must be overcome to achieve a functional range of motion.
Rehab is a phased process. It starts with simple movements to pump fluid out of the limb and progresses to strengthening and balance training. Consistency is key; small efforts daily yield better results than sporadic intense sessions.
The timeline for full recovery is longer than most expect. While the incision heals in two weeks, the soft tissues continue to remodel and mature for up to a year. Patience and persistence are the patient’s best tools.
For knee replacements, regaining motion is the top priority in the first few weeks. Scar tissue begins to form immediately. Patients must work on extension (straightening) and flexion (bending) diligently to prevent a stiff knee.
Passive stretching, where the therapist or a machine moves the leg, helps. Active stretching, using the patient’s own muscles, is even better. Achieving a straight knee is critical for walking without a limp and reducing fatigue.
Swelling is the enemy of motion. A swollen joint is physically tight and painful to bend. “R.I.C.E.” (Rest, Ice, Compression, Elevation) is the mantra.
Elevation means having the joint above the level of the heart, which uses gravity to drain fluid back to the central circulation. Ice should be applied for 20 minutes at a time, several times a day, to constrict blood vessels and reduce inflammation.
After years of limping from arthritis, patients often have abnormal walking patterns ingrained in their brain. Physical therapy focuses on unlearning the limp.
Therapists use mirrors and verbal cues to teach proper heel strike and toe off mechanics. Using a walker or cane is encouraged until the patient can walk without a limp. Ditching the cane too early often reinforces bad habits.
Rehab isn’t just about the operated joint; it’s about the whole leg and core. Hip abductors (side muscles) stabilize the pelvis. Quadriceps extend the knee. Calves push off.
Strengthening the entire kinetic chain takes pressure off the new joint. Core stability exercises are also incorporated to improve balance and posture, which are often compromised after years of compensating for a painful joint.
Arthritis damages the nerve endings that tell the brain where the joint is in space (proprioception). An artificial joint needs to be “mapped” by the brain.
Balance exercises, such as standing on one leg or using a wobble board, retrain these neural pathways. This is critical for preventing falls, which are a major risk to the new implant.
Massage and soft tissue mobilization help keep the scar and surrounding tissues pliable. Therapists may use techniques to prevent the skin from adhering to the underlying bone.
Desensitization involves rubbing different textures over the sensitive incision area to retrain the nerves and reduce hypersensitivity. This helps the patient become comfortable touching the knee and kneeling (if allowed) in the future.
Once the incision is fully healed, pool therapy is excellent. The buoyancy of water supports the weight of the body, reducing stress on the joint while allowing for a full range of motion.
The resistance of the water provides a gentle strengthening workout. The hydrostatic pressure of the water also helps compress the tissues and reduce swelling. It is a safe environment to practice gait and balance.
Low impact activities are highly encouraged. Walking, swimming, cycling, golf, and doubles tennis are excellent for the longevity of the implant. They keep the bone interface strong and the muscles active.
High impact activities like running, jumping, or singles tennis are generally discouraged as they increase wear on the plastic liner and the risk of loosening. However, restrictions vary by surgeon and implant type.
Patients should see their surgeon periodically for the rest of their lives, typically every few years. X rays are taken to check for plastic wear or silent loosening.
Early detection of wear allows for a simple liner exchange. If ignored, wear can lead to metal on metal contact and massive bone loss, requiring a complex revision surgery. Routine monitoring is the best insurance policy for the implant.
Recovery is not linear. There will be good days and bad days. Overdoing it one day often leads to increased swelling and pain the next.
Patients are taught to respect the “tissue envelope.” If the joint is hot and swollen, it needs rest and ice, not aggressive exercise. Pushing through sharp pain is counterproductive. The goal is steady, sustainable progress.
Send us all your questions or requests, and our expert team will assist you.
Clicking is very common. It is the sound of the metal and plastic parts touching. Unlike natural cartilage which is soft and silent, artificial parts are hard. As long as it is not painful, the clicking is normal and often decreases as muscles get stronger and dampen the sound.
During the incision, tiny skin nerves are inevitably cut. This leaves a numb patch on the outside of the scar. This is permanent but usually becomes smaller over time. It does not affect the function of the joint.
Most patients take blood thinners for 2 to 6 weeks depending on their risk factors. This might be aspirin, a pill like Eliquis, or injections. It is crucial to finish the full course to prevent life threatening blood clots.
Mechanically, yes, the implant can handle it. However, many patients find it uncomfortable because the scar is sensitive and there is no fat pad to cushion the metal. Using a gel knee pad usually makes kneeling possible for gardening or household tasks.
For hips, patients often forget they have an artificial joint within 3 to 6 months because it feels so natural. Knees take longer. It can take 12 to 18 months for the soft tissues to fully settle and for the knee to feel truly “part of you” again.
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