Early-stage knee rehabilitation

After an operation, injury, or having a condition such as osteoarthritis, you may develop pain, swelling and stiffness in your knee joint.

Most knee pain does settle with time after an injury or operation, and even if you have a degenerative condition, pain levels at times can be very comfortable. However, it is normal for your knee to flare up from time to time.

Managing these flare ups is key, and our early-stage rehabilitation is designed to help you with this. If you are experiencing consistent pain that is difficult to manage, especially at night, and your knee feels unstable, you may need some help.

Please do not hesitate to contact your physiotherapist or GP for advice.

How much weight can I put through my foot?

Following your injury or surgery it is important to keep moving, but to do so in a safe way. You will be told how much weight you can put through the ankle.

 

Non weight bearing (NWB) 

No weight should go through the affected leg when walking – you will need crutches or a Zimmer Frame to help you to move about safely.


Touch weight bearing (TWB)

This is where a very small amount of weight is put through the toes of your affected limb as you place your foot to the ground. Pressure should be very light (10%), and most of your weight should be taken through your arms (using crutches or a Zimmer Frame) and your non-affected leg.


Partial weight bearing (PWB)

Partial weight bearing means putting some weight through your affected limb with help of crutches or Zimmer Frame, but not all your weight. You can try to walk normally but, when you have the affected foot on the ground, you need to have both crutches in contact with the floor; putting only 50% of your weight through your leg.


Full weight bearing (FWB)

You can put full weight through your affected leg. This means the fracture has healed well enough now to bear your full body weight as you walk, enough so you can stand fully on one leg while holding on. You may still be experiencing some pain or discomfort. You can discuss this with your healthcare professional, as this may be due to other factors such as muscle weakness.

How do I get up and down the stairs using my crutches?


Downstairs with elbow crutches

  1. Put your crutches onto the step below. 
  2. Lower your injured leg first onto the step.
  3. Take some weight through your arms and step down with your good leg so it is on the same step as your injured leg.
  4. Repeat, stepping down one at a time.
  5. If a handrail is available, use the rail and one crutch and follow the same instructions.


Upstairs with elbow crutches

  1. Keep the crutches on the same step as you are standing on.
  2. Step up with your good leg first (if not weight bearing then hop up with the good leg).
  3. Keep your crutches on the step below you while you bring your injured leg up so it is on the same step as your good leg.
  4. Finish by bringing your crutches up to the same step.
  5. If handrail is available, use the rail and one crutch and follow the same instructions.

Managing the swelling in your knee

If you have swelling in your knee, it is important to try and manage this as best you can.

Try and identify if there is something you are doing in your day-to-day life or exercises that could be making your knee swell. Your body may well be letting you know that your knee is not quite ready for the task.

Ice can be useful for the first few days after an injury, but after this, we think regular elevation and compression is more beneficial throughout the day.


Elevation

Sit with your leg up, supported with pillows to help drain the fluid out of your knee.
 

Compression

You can use a knee brace, or similar compression device to help with the swelling in the knee. In the early stages of your rehabilitation, it may help you regain your confidence back in your knee and help you to be more active.

How to get your knee straight

Improving the ability for you to straighten your knee is very important for the movement of your knee joint, we call this knee extension.

It is hard to walk without a limp if your knee does not fully straighten. This may happen for several reasons, for example, after surgery, after a knee injury, or it may happen as your knee develops age-related conditions such as osteoarthritis.

It is important to work on the exercises as much as your symptoms allow. We recommend 5-10 minutes every waking hour.

Regaining knee extension

How to improve the bend in your knee

Improving your knee bend allows you to get back to daily activities, and other interests such as cycling or gardening.

Your knee can stiffen up after surgery or an injury due to natural development of scar tissue.

It is important to work on the exercises as much as your symptoms allow. We recommend 5-10 minutes every waking hour.

Regaining knee bend

Early-stage knee strengthening exercises

The quadriceps (thigh) muscle can lose bulk rapidly following an injury or operation. The muscle is very important in stabilising your knee.

Below are some early strengthening and movement exercises which help to start strengthening your muscles around your knee. You can start these as soon you feel able.

You may experience some discomfort whilst performing the exercises, and this may persist for some time after finishing them. The pain you may experience does not mean you are damaging anything. How much and how long the pain lasts for is something you will discuss with your physiotherapist, but usually if the pain and the length of the time the pain lasts for is acceptable to you, then it’s fine.


Early knee strengthening exercises 


Early weight bearing exercises