Exercise After Joint Replacement

Hip, knee or shoulder replacement surgery can be life-changing. The joint replacement procedure and after care can help you start to return to normal daily activities that you had to stop because of pain. Activities of daily living such as dressing, walking, performing household chores, and hobbies can be performed with good outcomes following a well-balanced rehabilitation program.

With joint replacement, surgery is just part of the journey. Exercise can help relieve post-operative pain, reduce swelling, help restore your range of motion, strength and joint movement. It also lets you recover as quickly and comfortably as possible - and get the best outcome with your new hip, knee or shoulder.

"Exercise is an integral part of a successful joint replacement surgery. It ensures you have full motion and strength to return to the activities you enjoy," said Trisha Gearld, PT, a physical therapist with Franciscan Health Mooresville.

When To Begin Exercise After Joint Replacement

Exercise is so important for recovery that you will likely see a physical therapist even before joint replacement surgery.

"At your presurgical visit, we go over the exercises you'll do three to four times a day after surgery, and we have you start them right away," Gearld said. "Practicing lets your brain and muscles get in sync. Like any skill you do so often, it becomes automatic."

After hip or knee replacement surgery, you will begin therapy that same day. A physical therapist will help you walk and complete your exercises.

"You walk about 40 feet using a walker, and we review the exercises you'll do at home," Gearld said. "By the time you are discharged, you may walk about 120 feet, and you'll gradually increase this distance during recovery."

"After you return home, it's encouraged to continue your home exercises four times a day. Most patients continue with therapy through outpatient PT or PT in their home, depending on their personal situation. This ensures continued progress towards your goals," Gearld continued.

The shoulder joint has a greater range of motion than your hip or knee joints, so exercise after shoulder replacement surgery begins more gradually and carefully.

What Exercises Are Recommended After Joint Surgery?

The kinds of recommended exercises after surgery depends on the joint you had replaced.

Exercise After Hip Or Knee Replacement

After total hip and knee replacements, exercises will focus on regaining range motion of the replaced joint. It will be important to move your lower body, including the calf, quadriceps (thigh) and buttocks muscles. Exercises like ankle flexes, leg lifts and glute squeezes focus on these areas.

The surgeon may implement some movement restrictions for the first 8-weeks after a total hip replacement. The physical therapist will educate you on these. Exercises after a hip replacement are focused on gentle range of motion and strength, along with balance.

After a knee replacement, bending and straightening the knee are crucial. Early range of motion is very important.

"We want a bend as close to 90 degrees as possible by 1-week post-surgery to ensure a full range of motion," Gerald said. "We do this with gentle bending and straightening. Then, as your strength increases, you do more advanced exercises - from walking with a walker, to using a cane, to walking independently."

Physical therapy makes sure a patient regains their knee bending and straightening ability, along with balance and strength. The physical therapist will make sure to create a plan to stay on track to success.

Functional activities such as moving in bed, transferring from bed to a chair, using the bathroom, and gradual increasing safe walking distance are also very important. Helping a patient advance from using a walker, to using a cane, and then walking independently is an important part of the rehabilitation process.

Exercise After Shoulder Replacement

"For shoulders, we begin with passive exercises (the physical therapist moves the joint). These start a few days after surgery," Gearld said. "We gradually move to assisted exercise - where we help you move the joint. Once you can move on your own, we start strength-building exercises."

Total shoulder replacement surgeries differ and there can be precautions or restrictions to follow early on to encourage healing of the soft tissue.

Tips For Exercise After Joint Surgery

Svendsen recommends you stay within your comfort level for the first few days after surgery. Exercise performance may feel challenging dur to post-operative pain and stiffness. You should have someone nearby when you exercise to encourage you and also keep you safe.

Although knowing your limit is important, Gearld said you shouldn't do too little.

"Movement prevents joint stiffening and reduces pain. When people are afraid to move because of pain, we help them work through that."

What To Avoid After Joint Replacement

Your physical therapist will tell you which movements are safe and appropriate and which to avoid. It's essential to follow their advice to avoid overstressing your new joint.

After a shoulder replacement, avoid reaching out to the side. If you have a reverse shoulder replacement - an approach surgeons use for a torn rotator cuff - don't reach behind you.

"If you've had a hip replacement, avoid excessive bending, such as picking something off the floor when seated," Gerald said. "After hip or knee replacement, don't cross your legs, twist your body, or do weight-bearing exercises within the first eight weeks of rehab."

While recovering from joint replacement, avoid these activities:

• Heavy lifting
• High-impact sports, such as team sports or skiing
• Repetitive or intensive motions, such as running or jumping
• Weight machines at the gym, such as the leg press

Choose a low-impact exercise, such as walking, biking or swimming. Doubles tennis and pickle ball are other recommended activities. Your physical therapist will let you know when you can resume more activities.

The Benefits of Exercise After Joint Replacement Surgery

Exercise isn't just beneficial for your new joint; it's also good for your heart and lungs. It increases circulation, which boosts healing, and prevents complications like blood clots in your lower legs.

Svendsen always finds out what activities mean the most to patients.

"An 80-year-old may want to stay as independent as they can," she said. "But a 60-year-old may be focused on going back to work. My role is to help each person achieve their goals."

And exercise makes achieving those goals more likely.

"The nice thing about rehab is that it makes exercise part of your daily routine," Gearld said. "I tell them they've worked so hard to enhance their health - keep it up."