What does physiotherapy involve?

Physiotherapy, also referred to as physical therapy, is a treatment that uses exercises and equipment to restore and maintain the patient’s maximum mobility and functional ability. Joint replacement is a major operation that is usually considered a last resort when other treatments fail. Joint replacement is highly effective for reducing joint pain, correcting a deformity, or helping improve mobility; it is also performed for treating advanced arthritis. Joint replacements that are commonly performed are knee and hip replacements, but the surgery can be performed on other joints that include the wrist, elbow, shoulder, and ankle.

Physiotherapy treatment after joint replacement surgery helps to build strength, improve balance, reduce the risk of falls, and give the confidence required to return to work or even sport. Studies report that a combination of exercises for mobility, strengthening, and balance improves and speeds up recovery. Physiotherapy involves several forms of treatment that principally include massage therapy, electrotherapy, hydrotherapy, and exercises and movements that are practically essential to keeping your bones and joints healthy.

• Massage therapy: Massage therapy increases flexibility and range of motion. Massage is suitable for all patients, but the form and firmness of the therapy will depend on the particular case. Massage improves blood flow and involves movements that ease tension in the muscles and joints.
• Hydrotherapy: Hydrotherapy involves the use of a warm-water pool for exercises wherein the exercises are coupled with the pressure of water. Hydrotherapy helps relieve pain, increases the range of movement of your joints, and improves muscle
• strength. Water jets and massage as part of hydrotherapy are used to stimulate nerve activity.
• Electrotherapy: Electrotherapy involves nerve stimulation with the use of controlled electric shocks. Electrotherapy eases muscle pain and aids in muscle repair and regeneration
• Exercise and movement: improve the range of movement of joints and muscles, which is the fundamental concept of physiotherapy. Physiotherapists from the best hospital for knee replacement in Pune suggest exercises to reduce stiffness and improve flexibility.

After a joint replacement surgery, it is essential not to stop moving. Usually, six weeks of physiotherapy are recommended after a hip or knee replacement.

What are the benefits of physiotherapy?

Physiotherapy that involves a regular exercise regimen is a key part of recovery after joint replacement surgery.

Physiotherapy advantages will help to:

•  Restore normal joint movement
•  Build up strength in the muscles around the new joint
•  Reduce pain and swelling
•  Return to your normal activities
• Increase blood circulation, particularly right after surgery, to avoid problems with blood clots.

What are some physiotherapy exercises?

Soon after the joint replacement surgery, you will be referred to a physiotherapist to guide you on the exercise regimen. Exercises that involve contracting the muscles in your leg after a knee replacement or hip replacement will help your body function like normal again. These exercises increase blood flow through the legs, help decrease swelling, and improve recovery.  A few effective exercises for knee replacement surgery and hip replacement surgery include:

Arc Quad Exercise

• Lay flat on your back on the floor with your knees out straight, and place a towel roll beneath your heel.
• Press your heel down against the towel to straighten your knee by raising it slightly off the surface.
• Hold the straightened knee position for 5 seconds, and then relax your leg.
• Repeat this exercise 10 times.

Hamstring Contraction

Hamstring muscles include the three posterior thigh muscles between the hip and the knee.

• Lay flat on your back with your knees bent at an angle of 10–15 degrees and your feet placed on the floor.
• Without moving your legs, press your heels onto the floor. This motion will contract your hamstring muscles.
• Hold for 5 seconds and relax.
• Repeat the exercise 10 times.

Ankle Pumps

• Lay down on the floor, on your back.
• Pull your toes up so that they face your head, and then point them down.

This exercise will increase blood flow through your leg, which will reduce swelling and promote healing.

Walking

Walking is the best treatment for joint replacement surgery; you must walk right after surgery. It is important to put all your weight on the new joint. While using a walker or a cane, do not place all the weight on the support devices; they should be used only for stability and safety. You must walk independently as soon as possible, as it will help with body alignment and normal posture patterns. When you feel comfortable, slowly increase the distance you walk.

Climbing Stairs

Once you can walk comfortably, slowly start climbing the stairs. This movement of “stepping” is very beneficial, as it increases flexibility and strengthens your knee or hip joint following surgery. Initially, take only one step at a time and rely on a crutch or cane. Always
Use the strong leg for the first step, and then your recovering leg to follow behind. If you are comfortable, use the railing, and try to climb the stairs foot over foot slowly.

Strengthening Exercises

With the above exercises, your new joint regains its range of motion and functions normally. But your joints are still too weak to support your body completely; you must get into the next phase of exercises that will strengthen your joints. Strengthening exercises following joint replacement, be it knee or hip replacement, should be done every other day, with one set comprising 8 to 15 repetitions. As you become more comfortable, increase the number of sets, resting 1-2 minutes in between.

Knee Exercises

• Standing knee bends: Stand up straight, holding onto a railing or with hands resting on the back of a chair. Lift your leg upward and bend your knee until your lower leg is parallel to the floor. Hold this position for 5 to 10 seconds, then straighten your leg. Repeat 10 times or until you feel tired.
• Assisted knee bends: Lay down on your back and hold a folded towel around the ankle of your operated leg. Bend your knee and hold the towel by applying gentle pressure to increase the bend. Hold for 5 to 10 seconds and repeat until you feel tired.

Hip Exercises

• Standing hip abduction: Stand up straight, holding the back of a chair or resting your hands on a wall. Raise your operated leg and lift it out to the side slightly. Pause and then return to the starting position; repeat 10 times.
• Squat: Stand up straight and point your toes forward; bend your knees; and lower your bottom, as if you were sitting. Keep your knees in line with your toes to make sure you straighten your knees. Hold the position for a few seconds and return to the starting position; repeat 10 times.