Todd Kuslikis

Todd Kuslikis

MMT, MPA
Knee Pain Specialist and Injury Prevention Expert

Natural-minded TKR Prehabilitation Guide (PLUS Gentle Exercises Before Knee Surgery)

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Learn how you can decrease physical therapy post-op visits and improve the outcome of your TKR with these natural-minded tips and gentle exercises before knee surgery. 

Written by: Coach Todd

 

Your surgery is scheduled. The decision is final. You feel a cocktail of emotions stir inside.

Hope that the knee pain will disappear.

Worry that the rehabilitation process will take forever.

Fear that the surgeon might make a mistake and you’ll lose your independence. 

Total knee replacement is a very serious decision. It’s a decision you and your doctor have to make together after you have researched all the options. And even though our team at Feel Good Life believes in natural medicine, if you decide to move forward with TKR, we won’t toss you out of the family like some estranged prodigal son or daughter. We’ll walk with you no matter what you decide.

Today, you’ll find some of our best natural tips and exercises before knee surgery to help ensure your knee is as healthy as possible before the big day. 

 

Why Might Some People Opt For Knee Surgery? 

There are many reasons. Really, surgery is a last resort. It should rarely be discussed without exhausting other options.

But it’s helpful to understand the full picture of why some people make decisions to choose knee surgery, so you and your doctor can make the best decision for you. 

Here are a few reasons people choose knee surgery:

Exercises Before Knee Surgery | Feel Good Life with Coach Todd

I am the master of my fate: I am the captain of my soul.” – William Ernest Henley

Remember, you make the decisions for your life. You are the captain of your ship.

Get as much information as possible. Weigh the pros and cons and the likelihood of each possible scenario. Then make an informed, careful decision. And if you decide to move forward with knee surgery, understand that the actions you take beforehand can have a big impact on how you feel after the surgery. 

This is called a prehabilitation

Think of it this way. If the surgery is the “big game”, then prehabilitation is the practice that leads up to the big game. The more layups and free throws you shoot, the better chance you’ll win the game.

The more effective the exercises before surgery, the better chance your knee surgery will work. 

 

3 Foundational Tips for Natural-minded Prehabilitation Before Knee Replacement Surgery 

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Begin pre-hab at least six weeks prior to your surgery

It takes time for your muscles, ligaments, and tendons to get stronger and healthier. Start the process early. 

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Start slowly

Your knees are probably in bad shape if you’re about to have knee surgery. So start the prehab process slowly. 

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Strengthen the muscles indirectly

You should strengthen your muscles indirectly. In a moment, I’ll teach you some very gentle exercises for your knees that are ideal for prehabbing before surgery. They indirectly strengthen the muscles around the knee so you improve your overall knee health, without aggravating the pain or causing more damage. 

What do I mean by “indirect” knee prehab strengthening exercises? 

There are many muscles that affect the functioning of your knee. Your glutes, hip flexors, hip abductors, hamstrings, quads, and calves among others, all work in harmony with even a single step. 

You can use exercises that directly strengthen the muscle. For example, a leg extension directly strengthens your quad because you are using that muscle to perform the movement. But that same exercise indirectly strengthens the ankle because you are using the muscles in the ankle to stabilize. 

Exercises that are “indirect” are often safer and gentler on your knees. The prehab knee exercises below all strengthen the knee indirectly so you improve your knee health and protect against further damage or injury. 

 

Why You Should Undergo Prehabiliation Exercises Before Knee Surgery

Over 50 million Americans undergo surgery each year. And according to Vonda Wright, MD, assistant professor of orthopedic surgery at the University of Pittsburgh’s Center for Sports Medicine….  

Fifty percent of the outcome depends on the surgeon’s skills. The other 50 percent – you determine…. A patient’s commitment to recover, even before the surgery takes place, is a large factor in a successful recovery.” 

Pretty stunning right? 

So surgery is not a magic button that is guaranteed to make the pain go away. There is still work to be done beforehand (and after hand for that matter). 

Here are some of the benefits to prehab with exercises before knee surgery:

Exercises Before Knee Surgery | Feel Good Life with Coach Todd

5 Gentle Prehab Exercises Before Knee Surgery 

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Heel To Toe Rocks 

Exercises Before Knee Surgery | Feel Good Life with Coach Todd

Sit in a chair with your spine upright. Place your feet shoulder-width apart. Begin to rock your feet by shifting the weight of your legs forward onto your toes. This will engage your calf muscle. Hold for just a moment, then rock the weight of your legs backward onto your heels while lifting your feet up. This will engage the front of your leg muscles called the anterior tibialis. Hold this position for just a moment. 

With a controlled, slow rhythm, continue to rock back and forth. Repeat 10X. 

Why Is This Exercise Good for Knee Surgery Prehab? 

In order to perform the rocking motion, you are mostly using your calf muscle and anterior tibialis (front of the leg). Both muscles connect to the knee so you’re improving your knee health without directly focusing on the larger muscles of the knee. This exercise provides a gentle amount of weight-bearing which is great if you have bone-on-bone osteoarthritis. 

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Buns Squeeze

Exercises Before Knee Surgery | Feel Good Life with Coach ToddSit in a chair with your feet shoulder-width. Make sure you are sitting upright. Your knees will be at a 90-degree angle. Squeeze your glutes, aka butt muscles, at about 50-75% of your maximum effort. You don’t need to squeeze super hard. Just enough to get a good squeeze. Pretend your spouse was about to give you a love slap on your rump. That’s the right amount of pressure. 

Hold for 5 seconds, then release. Repeat 10 times. 

Why Is This Exercise Good for Knee Surgery Prehab? 

Your glutes stabilize your hip. Your hips stabilize your knee. When your glutes are healthy and strong, it can relieve pressure on your knee joint. 

Also, your butt muscle is designed to extend your leg backward as you walk. When this muscle is strong, walking becomes less painful. 

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Heel Digs

Exercises Before Knee Surgery | Feel Good Life with Coach ToddSit in a chair with your spine upright and feet shoulder-width apart. Gently push both heels into the ground as if you were about to stand up. Use about 50% of your max effort without actually moving.  

It’s important to keep your knees from collapsing inward. Think of driving your knees outward just a bit. You should be able to wiggle your toes since your weight is on your heels. 

Hold the seated heel push for 3 seconds then release. Repeat 5 times. 

Why Is This Exercise Good for Knee Surgery Prehab? 

This exercise is called an isometric contraction. It means that you are tightening your muscles without actually moving your joint. Heels pushes are a gentle way to strengthen the quads and hamstrings without having to bend your knee, which is normally painful when you are heading towards surgery.  

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Forward Wall Kick

Exercises Before Knee Surgery | Feel Good Life with Coach ToddStand facing a wall and place your hands on the wall for balance. Place one foot forward until your toes are touching the wall. It’s helpful to wear tennis shoes to provide greater support for your toes. Press your foot into the wall at about 40-50% of your max effort. As with all the prehab exercises, you don’t need to apply a lot of force. You’ll still get benefits even with low effort. Hold for 3 seconds then release.

Repeat 5 times. 

Why Is This Exercise Good for Knee Surgery Prehab? 

Here is another isometric exercise, but this time you are targeting your hip flexor and quads. Again, traditional exercises that force you to bend and straighten your knee repeatedly can be pretty painful when you’re nearing surgery. This exercise avoids that movement but still always for ample strengthening that will set you up for success after surgery. 

Also, this exercise is great to improve knee alignment if you have bowed knees or patella misalignment. 

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Side Wall Kick

Exercises Before Knee Surgery | Feel Good Life with Coach ToddNow turn and stand next to the wall. Make sure your back is straight and place one hand on the wall for balance. Gently, press the leg nearest to the wall into the wall as if you as trying to kick your leg out to the side. Hold for about 3 seconds. Then release.

Repeat 5 times. 

Why Is This Exercise Good for Knee Surgery Prehab? 

This final exercise strengthens your hip abductors which lay on the outside of your hips. As we already covered, your hips help stabilize your knee. By doing this isometric strengthening exercise, you are indirectly strengthening your knee.

Alrighty, the above exercises should have you well on your way to improving the outcome of your knee surgery! 

For rehabilitation after surgery, your doctor or PT will give you exercises to perform. 

If you are looking for additional support and exercises to speed up recovery, many Feel Good Lifers have found tremendous success with our 5-minute Feel Good Knees system. Check it out to set yourself up for pain-free knees following surgery. 

Bonus Prehab Tips When Planning for Total Knee Replacement Surgery

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Thoroughly investigate rehab options, hospitals and surgeons. Always get a second opinion and read all you can. 

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Ask your doctor questions. Here are a few examples…

  • How long will the surgery take? 
  • Is it possible to have the surgery as an outpatient and not stay in the hospital?
  • What type of anesthesia will I be getting (research the actual medications)
  • What does rehab look like after surgery? 
  • Will I need any assistive devices at home after surgery?
  • Should I store blood before the surgery?
  • How long will I be off work or need to rest from any physical activity? 

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Carry a notebook to jot things down

  • Your current medications and supplements
  • Any health conditions
  • Insurance policy and membership numbers
  • Your doctors’ names and phone numbers
  • Family/friends to contact in case of an emergency

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Plan for help. Surgery is a big deal. You’ll need help afterward.

  • If you live by yourself, recruit a friend or family member to stay with you for a while.
  • Ask a neighbor to take out the garbage or bring in the mail.
  • Freeze extra meals and stock your pantry before you head to the hospital

Feel Good Life with Coach ToddGet your home ready

  • Organize the furniture in your house so it’s easier to get around
  • You might need to move your bedroom to the first floor if it’s not already there
  • Consider installing safety rails in your bathroom
  • Make sure everything is within reach (phone, coffee maker, etc)
  • Here’s a handy checklist you can print off to help you get ready before your knee surgery 

Feel Good Life with Coach ToddUse your calendar. It can be hard to remember all the dates of appointments before surgery. Make sure you have a refrigerator calendar or planner to mark important appts. 

Feel Good Life with Coach Todd

Follow orders. Of course, your doctor will have specific instructions to follow before surgery. They might tell you to stop certain medications, especially ones that can cause you to bleed more during surgery like blood thinners. 

As mentioned, surgery is a big deal. My hope is that this prehabilitation guide before knee surgery will help ease your nerves and empower you to start these exercises which can improve the outcome of the surgery. 

To your health! 

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