Ranging Exercises Improving your knee’s range of motion, or the ability to bend and straighten, is vitally important to restoring your knee function after surgery. Ranging exercises done in the first few days/weeks after surgery are an absolute necessity and are more effective than waiting one or two weeks to begin. Although some discomfort is to be expected, pain should not significantly increase with your exercise progression. Remember to maintain the position without bouncing. Flexion (bending) Maximum allowed is 90 degrees. Unlock brace hinges. The following are different methods of completing bending: Option #1: Sit on bed or chair. Place your operated-on leg on top of the opposite leg. Position lower legs off bed or chair. Use opposite leg to gently lower knee into a bend. Option #2: Sit on floor, couch or bed. Use hands under thigh (just above the knee) to help bend your knee and cause the heel to slide towards your buttocks. Option #3: Sit in a chair. Keep your foot on the floor while carefully scooting your buttocks closer to end of the chair. Duration: 5 minutes on the first day, increasing as tolerated to 10 minutes, then to 15 minutes. Frequency: 4 times per day. Extension (straightening) If you have had pre-operative instruction in brace placement/adjustment, you may temporarily loosen or undo the straps and the Velcro thigh/leg cuffs to allow hyperextension. Otherwise, wait to do this until after seeing your therapist. Sit or lie on your back. Elevate your heel on several pillows or a chair. Relax and allow the knee to flatten down straight. Reapply or tighten your brace once the stretch is completed. Duration: 5 minutes on the first day, increasing as tolerated to 10 minutes, then to 15 minutes. Frequency: Every hour. Kneecap Mobilizations Along with your knee joint, the kneecap must also be kept mobile after surgery. The primary motions are up toward the hip (needed for knee straightening) and toward the foot (needed for bending). The kneecap must also have side-to-side mobility. Sit with knee straight, muscles relaxed. Use the long inside borders of either hand’s thumb or index finger to move the kneecap. It will be difficult to feel the kneecap under the post-operative dressing, but you should try to estimate it’s position using the opposite knee as a guide – unless your physician advises you to wait to do these. Medial: Push kneecap towards other knee. Lateral: Push kneecap away from other knee. Superior: Use both index fingers under kneecap to pull up towards hip. Inferior: Push kneecap down towards foot. Duration: 30 second hold, rest 1 second. Repeat 3 times in all 4 directions. Frequency: Every hour. Ankle Pumping Moving the foot helps loosen the calf muscles, control swelling and improve circulation. Elevate the leg above your hips with your ankle supported on pillows. Pump your toes back up towards your hip and down away from you as in using the gas or brake pedal while driving. Use a 1-count pace in each direction. Duration: 30 times. Frequency: Every hour.