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exercise after joint replacement

The Importance of Exercise After Joint Replacement Surgery

Joint replacement surgeries, such as knee replacements and hip replacements, are common in those with end stage arthritis and can sometimes can also occur when younger from certain musculoskeletal conditions and/or significant injury.

The American Academy of Orthopaedic Surgeons (AAOS) explains that total joint replacements are usually recommended after non-surgical treatments such as medication, physical therapy and lifestyle changes do not relieve pain symptoms or limited function as a result of one’s condition.

They go on to describe how joint pain that may lead to surgery can, in many cases, come from damage or wearing away of the cartilage that lines the ends of the bones. The lack of cartilage can lead to bone impacting on bone, causing pain inside the joint.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) also describe how the purpose of joint replacements are to remove parts of joints that are damaged or diseased and replace them with artificial parts in order to allow for improved movement and stability of the joint and therefore better day to day function.

What’s also important to note, in addition, is that a joint replacement surgery in and of itself will not entirely fix the symptoms in every case. 

The reason being is that whilst joints are replaced, the surrounding structures i.e the muscles, ligaments, tendons and other soft tissue structures, need to also adapt and strengthen to be able to support the newly replaced joint.

Especially after a significant surgery such as this, it is always recommended to limit physically strenuous activity in order to prevent any negative side effects. Whilst this is advisable and entirely correct, it’s worth understanding how this impacts long term function, also.

This lack of activity reduces the muscle strength around the new joint and unless addressed can lead to a downward spiral where lack of strength leads to less activity, and less activity leads to increased lack of strength.

For example, the Journal of Bone and Joint Surgery published a study in 2005 showing that quadriceps (front area of the thigh) strength reduced by 62% following a total knee arthroplasty (replacement). This is a significant loss of strength but is quite expected, given the nature of the surgery.

The key is to be aware of this, so that if you are to have a surgery in the future you know the importance of strengthening the muscles after surgery (as approved by your medical progressional).

As a physiotherapist in Crawley I always stress to my patients that it’s important to remember bones move because muscles tell them to. Bones cannot move without the instruction of the muscle, which in tern is controlled by nerves from the brain. With improper muscular function, bones and joints lose their function.

Arthritis Research UK, a leading research organisation based here in England also noted on the importance of exercise after joint replacement. For example, when educating the public about care after knee replacement surgery, it noted the fact that exercises can be painful at first, given the adaptation the body has to undergo for the new joint, but as your strength improves and the healing of the joint completes, you’ll be able to see more functionality develop in the joint.

This is important to know, because the slight discomfort you may feel when trying to do gentle exercises after surgery may make you want to reduce the frequency or intensity of the program from what was prescribed by your medical professional. The key is to remember that with lack of use, muscles get weaker, and this will eventually make the joint less mobile and functional.

It goes without saying, any exercise programme or routine should always be confirmed first by your doctor.

It doesn’t just affect the knee, the case of muscle weakness results from any joint replacement surgery. The Public Library of Science in 2013 assessed the strength of 35 patients undergoing total hip arthroplasty.

The study found that hip muscle strength and leg press power was reduced from anywhere between 41% and 58% after day 2 and by day 8 anywhere between 23% and 31%. Therefore the need for safe exercise is essential when rehabilitated any joint that has undergone replacement.

In terms of which exercises to do, this will entirely be on the advice of your surgeon or appropriate medical practitioner.

As a guideline of what you may expect when having your exercise programme prescribed, the following organisations have released exercise sheets for your consideration:

The American Academy of Orthopaedic Surgeons: Total Hip Replacement Exercise Guide

Allina Health: Knee Replacement Home Exercise Program

Oxford University Hospital: Shoulder Replacement Information Guide (Exercise Sheet on Page 16)

Beacon Hospital: Total Ankle Replacement Guidelines and Exercise Program

Oxford University Hospital: Elbow Replacement Information Guide (Exercise Sheet on Page 13)

Sussex Hand Surgery: Total Wrist Replacement Exercise Program

Leila Walters
Leila Walters
1716317093
Would absolutely reccomend! The facilities are lovely, clean and with on site parking.Kulraj is very knowledgeable and has really helped to resolve my neck and shoulder problems which have been a problem for a long time. Thank you so much!
Adam Simpson
Adam Simpson
1716283352
Crawley Physiotherapy Clinic really got me back on track after some trouble with Sciatica. Kulraj was very knowledgeable and gave me a program to bring me back to normal and a plan to prevent this returning through a bespoke approach. I couldn’t recommend him more. Thank you
Max Bromfield
Max Bromfield
1715972408
Kulraj at Crawley Physiotherapy Clinic is a fantastic physio - he helped me with a painful chest injury. Very knowledgeable, a great physio and all round good guy. Would highly recommend!
Ross Bowditch
Ross Bowditch
1715081078
Crawley Physiotherapy Clinic is really my go to whenever I have any kind of issue with my shoulder and back. I like to exercise daily but sometimes get hit with a little injury that can stop me and whenever that happens, Kulraj is the one I call. He is always so easy to deal with, so approachable and friendly and he of course, really knows his stuff! Always gives sound advice and really helpful exercises and stretches to work on the issues that never fail to loosen things up and get me back to my regime ! Would highly recommend to anyone.
Helen Sinclair
Helen Sinclair
1715079742
I went to Crawley Physiotherapy Clinic for a shoulder pain that was impacting my daily life. Kulraj recommended weekly sessions (plus exercise). He did such a great job that I was able to successfully use my shoulder again (and take part in sporting activities). Kulraj is knowledgeable and friendly and I would definitely recommend.
Mark Dibben
Mark Dibben
1714672568
Being quite active and enjoying sports and gym sessions I was in need of some physio. Kulraj at Crawley Physiotherapy Clinic is brilliant! Like many others I was searching for a physio in/around the Crawley area to help with aches and pains as well as posture.Kulraj has helped me massively with exercise programmes to do at home as well as at the clinic.The clinic is easy to get to and everything you want/need.I will keep going to Crawley Physiotherapy Clinic for maintenance.
Charlie Moore
Charlie Moore
1714383474
Cannot recommend enough, fantastic service and extremely professional throughout!
Kanjana Ganeson
Kanjana Ganeson
1713986359
I was desperately looking for a Physiotherapist and was so glad I came across Crawley Physiotherapy Clinic. I have been suffering with my knees after my fall (2 yrs ago.).I have been so much in pain ,I thought it will never heal but Kulraj was so amazing and professional and helped me get better and heal in 6 weeks. We had lovely chats and is very approachable..I will not hesitate to go back again . Thank you again ..Kay
Koal Bhogal
Koal Bhogal
1713265210
Crawley Physiotherapy clinic were excellent in helping me recover and alleviate the pain of a hip joint problem I had suffered from for 2 years prior to their treatment plan. I had seen many physios about this problem with no joy, the holistic approach by Kulraj was the only treatment that worked for me. I would highly recommend their professional and friendly service.
anna woolford
anna woolford
1713263545
Crawley Physiotherapy Clinic offered a very friendly & professional service. Assisted with my lower back issues, giving great advice including exercises to continue at home. Symptoms have improved massively!
Garry Smith
Garry Smith
1712489402
Crawley Physiotherapy Clinic - Kulraj is a highly competent and professional therapist. On the two occasions I have needed to see him they were complex conditions, resulting from years of neglect and a very intensive sports life as a teenager. With both conditions he quickly assessed and analysed the issue, identified what needs to be done, building a programme to address the issue, and then guided me through the programme execution. If you have a condition that you believe physio will help/resolve then do not hesitate to reach out to him.
Amy
Amy
1712329791
I was looking for a physio to help with my increasingly painful shoulder - and I'm so pleased I contacted Kulraj.Within a couple of sessions the improvement was significant, and after 6 sessions of treatment combined with a structured home exercise plan, I'm pain free!Kulraj immediately identified and detailed the root cause of my issue, and with his expertise and guidance I can manage my posture/alignment going forward.He's friendly, professional and very knowledgeable. I'd highly recommend.
Holly Fuller
Holly Fuller
1712239102
Kulraj has been amazing in developing a plan to help with my concerns. The plan consisted of sports massage and different stretch combinations over the span of 6-8 weeks at the Crawley Physiotherapy Clinic. I now feel ready to complete my half marathon. Thank you for all your help!
Pam Graham
Pam Graham
1712232027
After injuring my back / Rt sacroiliac joint I could barely move and even after a month I was in constant pain with no relief resting. My family were concerned so I checked out Physio clinics and trusting the reviews of Crawley Physiotherapy Clinic I made an appointment to see Kulraj and after just one session there was a remarkable improvement - I was able to bear weight again through my Rt leg and managed a night’s sleep.Kulraj suggested an exercise regime to follow between treatment sessions. I am now pain free and able to enjoy walking, gardening and even shopping!
Daniel Eyre
Daniel Eyre
1712088965
Crawley physiotherapy clinic were so helpful with fixing my lower back.Kulraj was professional at all times. And the exercises he gave me along with massage really helped to get me moving again.Can't thank you enough !
Gracie-mai Carr
Gracie-mai Carr
1711368552
He was so understanding and his hands where gentle and soft
Kevin Bhimanah
Kevin Bhimanah
1710429775
Professional and very attentive on his job, I had a back pain for the last 6 months and in only 1 month he fixed it! Best physio I ever been!
Michael Holland
Michael Holland
1709916335
Kulraj has been great, treating tendonitis with a variety of practical treatments including massage and home exercises, with helpful links to videos to demonstrate the proper technique. Spotlessly clean facility and highly professional, yet personable approach. Highly recommend!
Max Talbot
Max Talbot
1709905333
I would highly recommend had a motobike accident and suffered from a bad back and after a few session's really made a difference.
Sadaf Khan
Sadaf Khan
1709659361
Kulraj helped me with the back pain. I feel much better after just five sessions. Hands on and suggested exercises. Very friendly person. Would definitely recommend him.
Mia Christensen
Mia Christensen
1709373550
100% recommend. Kulraj helped me after my car accident and gave great advice. It’s easy to get too, good parking and feels relaxing there. Definitely will go back for any other issues that may occur.
Stevie hillwood
Stevie hillwood
1709294879
Very knowledgeable and proffesional physio. After a free session Kulraj knew exactly what areas I had problems with and gave a detailed explanation of what the process will be moving forward.Also an all round great bloke. Would recommend for anyone!
Lou Oldfield
Lou Oldfield
1709048335
I had a very misaligned shoulder and trapped nerve . This was quickly sorted . Friendly and professional
Fatima Bello
Fatima Bello
1708982163
Kulraj helped me through a pain on my shoulder/neck/bicep after a car collision. He was very professional, kind and accommodating to my busy work schedule. After 8 sessions (8 weeks), I can now use my arm to its full availability thanks to him. Definitely recommend! 👏🏽
Brogan McFarlane
Brogan McFarlane
1708199638
Had a bad back and after a deep tissue massage the issue was resolved and the pain was gone!
Karen Young
Karen Young
1707587798
Short notice booking following chronic back.pain and immobility, got me in short notice, fantastic professional service and after care. Can't recommend enough.Stuart Young
Shiva Reddy
Shiva Reddy
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P Flynn
P Flynn
1706874691
Went to see Kulraj due to knee pain following torn ligaments. Excersises were very effective an dthe pain cleared quickly. Kulraj was very proffesional and explained what he was doing and why - would not hesitate to go back for other issues. Thank you Kulraj
Joe Carey
Joe Carey
1706873843
I came to Kulraj with an injury that needed sorting. Not only did he fix that, but also identified some underlying issues with my posture and fixed those too!Had me back playing sport quicker than originally thought. Couldn’t recommend him highly enough.
Marcus Chilcott
Marcus Chilcott
1705086998
Nice location, great guy! Really helped me with getting me back in action!
Jocelyn Dore
Jocelyn Dore
1703849199
I have been visiting Kulraj for knee and hip pain, these have improved considerably both with hands on treatment and with exercises. I would definitely recommend this knowledgeable and friendly physiotherapist.
Jane Gosden
Jane Gosden
1703786093
I was referred after an accident at work & was seen by Kulraj. Three sessions sorted out my neck pain. I couldn't believe how much better I felt in a short space of time. Would highly recommend the services of Crawley Physiotherapy!
Wesley Hayes
Wesley Hayes
1703246881
I saw Kulraj for knee and hamstring pain from an injury and he helped me to quickly recover. He is very knowledgeable and friendly. I would recommend highly!
clive skinner
clive skinner
1703178553
Went for help with a shoulder problem, was in tremendous pain and could hardly move my arm to the side at all.With a friendly & professional assessment, was given stretching exercises and massage and was quickly pain free again 👍
Colin Huckle
Colin Huckle
1702406184
Great service from initial consultation and then treatment for a sports injury would highly recommend
Alfie Brown
Alfie Brown
1702327082
Great care and attention to detail, not just with the local problem but other areas that needed correction and improvement. Very flexible and fast communication. Highly recommend and will definitely use again 👍
Chelsea-United
Chelsea-United
1701971161
I had pain on my back-shoulder. One of my colleague recommended him.He is a fantastic physiotherapist. Knowledgeable and talented. He caters to one's specific needs and explains in detail some of the possible causes for the issues. Teaches exercises that need to be done at home. I now feel that I am able to manage my issues with confidence.
Judith Cain
Judith Cain
1701791676
My elderly mother received treatment for prolonged lower back and leg pain. Two months of agony relieved after just one session, this far exceeded our expectations. I really like Kulraj, he is very social and personable but also professional. I would recommend him at any time!
Yogi Patel
Yogi Patel
1699897670
Started my Therapy due to a car accident which I suffered whip-lash would highly recommend for all your physio needs.
Emma Boakes
Emma Boakes
1699013874
I visited Kulraj after being involved in a car accident. He is very knowledgeable and has helped me with my back and hip.
Jackie Picton
Jackie Picton
1698335267
I visited Kulraj regarding a problem with my knee. Kulraj is very knowledgeable and compassionate. He is extremely good at listening and also at understanding the problem. He gave me a good set of exercises to do at the end of each session which, together with the hands on treatment, have helped considerably. I would not hesitate to recommend him.
Clare Grant
Clare Grant
1698149442
Friendly, professional service.Following a RTA Kulraj really helped with my neck and back pain. After a few sessions I could really feel the difference and the terrible headaches I was suffering as a result really improved.Together with treatment in clinic and exercises to follow at home I saw a huge improvement.Would highly recommend.
jason watts
jason watts
1696962002
Excellent advice and treatment, highly recommended. Kulraj was very flexible with appointments and resolved my issue within three weeks.
peter king
peter king
1695647236
I visited Kulraj at Crawley Osteopath after my son who also attends there suggested he might be able to help with my back pain. After a free consultation to understand what I had done Kulraj was able to get me up & running again after only a couple of treatments. I find Kulraj’s approach is very professional and he makes you feel very relaxed. The method of treatment he gave me was different from other osteopaths I have been to. The set of exercises he gave me helped me feel much better in only a short time. I have no hesitation in recommending Kulraj.
Chloe Adamou
Chloe Adamou
1694709659
Kulraj has been brilliant with my wrist injury. Very knowledgable and passionate about his work.
Shaz Cannonz
Shaz Cannonz
1694682752
Was looking for a local physio to deal with knee issues and pain. Kulraj was incredibly thorough in his assessment. His approach was a little different to other physios I’ve worked with but I feel like his method was far more effective and got me back to better movement & pain free much faster. He’s also been addressing my hip/knee alignment issues which has had flow on benefits for my back and hips. On top of that really lovely to work with. Highly recommended.
Ed Stimpson
Ed Stimpson
1692733170
Very pleased with the treatment I receive from Crawley Physiotherapy Clinic. Kulraj is very knowledgeable and has provided me with an effective rehab plan.
Kim Dean
Kim Dean
1691265053
Kulraj was very helpful, kind and knowledgeable when I tore my calf muscle and followed up by sending me some exercises to help in the future, thank you
Mike Kerezins
Mike Kerezins
1691061239
Was a bit sceptical of trying physiotherapy, however, after the spasm in my trapezius that I’ve managed to do at the gym, I started to look for one. I was recommended to visit Kulraj. After only 2 sessions the issue is almost gone (possibly would be gone gone if I would be more consistent with the suggested exercises)Very friendly, and straight to the point. I sure know where to call next time if I happen to have an issue. Thanks!
Robert McIntosh
Robert McIntosh
1678274090
Tavistock is a excellent place for physiotherapy, kulraj sorted my many different football injurys, would definitely recommend.
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