• Q&A with Australian Health Experts

    How do I strengthen my knee after surgery?

    I'm 24 and had a Fulkersons Osteotomy with lateral release about 13 weeks ago. I was on crutches for a month, but am walking almost totally normally now, but I'm really wanting to start jogging and cycling again to get my fitness back. I've tried to go jogging a few times but once I start I find I limp quite badly and my knee partially collapses every now and then, I don't fall but it can be close. I know I need the strength back in my knee, but what is the quickest safest way to do this? Ive put on weight since the surgery even though I do eat quite well and I just want to start moving again. Please help.

  • Image of Dr Alasdair Dempsey

    Dr Alasdair Dempsey

    Exercise Scientist
    University biomechanist focussing on mechanisms and prevention of sports injury and musculoskeltal disease. View Profile
    Firstly the best thing to do would be to vist a professional who specilises in rehabilitation such as and Acredited Exercise Physiologist (www.essa.org.au) or a physiotherapist.

    Outside of that though it is not just about strenghening.  You also need to include balance exercises such as wobble board training, or even just balancing on one foot and having people pass balls to either side of you.  This will increase the co-contraction of the muscles around you knee, which inturn will increase your stability.  Try including this in your program and see how you go. 
  • Image of Mark Barrett

    Mark Barrett

    Physiotherapist
    Mark graduated from Sydney University in 1993 and is one of Physiologic’s practice partners. Since completing his studies, Mark has furthered his skills through extra ... View Profile
    I think this is probably a common mistake with people is, ‘I feel like I can walk normally so I should be able to run.’ there is a lot more to running. You need to make sure you have thoroughly strengthened your knee, when you have that layoff after knee surgery; you lose strength in other areas like around your hip and around your ankles.

    While you can focus on just your knee, I think it is better to look at strength, holistically. With regards to the weight, exercise bike or riding a bike is a really good way to shed some kilos and not put a lot of stress through your knee, and can be a really good strengthener of the knee in those early stages, when you cannot do a lot of high-intensity stuff.

    In terms of running, something we see a lot is a lot of issues with running technique. The way I like to put it is the best runners in the world practice their technique day in and day out, and the rest of us seem to think that we can just go out for a run and it is going to be OK. I think people, particularly after surgery need to spend a lot of time working on their running technique before they go out and do some serious running.
  • Image of Dr Nicholas Miller

    Dr Nicholas Miller

    Chiropractor
    Special interest include; Wellnes,nutrition, physical exercise, headaches and sports injuries. My aim is to improve the wellness and health of all my clients. View Profile
    Hi, totally agree with both answers. It's not until we have that we appreciate the bodies ability to co-ordinate and move. Any exercise or movement  requires boh spinal stability and joint stability to move with balance and injury free. Movements like running that are very repetitive in nature, require great technique, balance and coordination to ensure injuries do not occur. People will get coaches for just about any other activity Except running. 

    My advice would be to seek advice from a exercise physiologist. They should be able to prescribe a exercise routine to improve both knee and spinal, strength as well as balance. They should also be able to advise you'll  low impact activities to help not only shed the weight but reduce the strain on the knee once you progress to more complex and higher impact activities.
  • Image of Jonathan Harris

    Jonathan Harris

    Physiotherapist
    Jonathan Harris is a Titled Sports and Musculoskeletal Physiotherapist having achieved Master Degrees in both fields. As well as his undergraduate Physiotherapy degree he also ... View Profile
    You have had significant knee surgery for, what I imagine was a re-occuring dislocating knee cap.  Generally, return to running is recommended at 4-6 months.  This allows time for the lower limb fracture you have been given (re-attachment of the tibial tuberosity) to be properly knitted.  It sounds like you are doing well if you are walking about and not noticing a limp etc.  However, it really is difficult to provide a complete answer to this question without actually assessing the knee.  The fact you have also had a lateral release means you might have developed scar tissue in the lateral retinculum (the tissue on the outside of the knee) and this might need some manual work to release it.  I would suggest going to see a sports physiotherapist.  This is the kind of thing we are trained to treat.  We can provide advise on progressing strength training about the lower limb and also do some manual work on scar tissue if required.  Good luck…..jono
  • Image of Suzen Meagher

    Suzen Meagher

    Physiotherapist
    Experienced Physiotherapist with special interest in Orthopaedic Rehabilitation following joint replacement surgery (at home following discharge). Treatments are focused on increasing strength, mobility and function. ... View Profile
    Lots of valuable advice here, you have had a major reconstruction of your leg so supervision would be safer than taking risks on your own. Even on a stationary bike you need someone to guide you on alignment - if you're cycling in traffic it would be harder to maintain this. An Experienced Physiotherapist local to you would liaise with your surgeon and ensure the optimal strenghtening programme to help you shed those unwanted kilos while ensure the best possible results from your surgery. You do need to be a patient patient - not easy when you've been out of action for months already.  Good Luck :)
  • Image of Irene Siew

    Irene Siew

    Physiotherapist
    After surgery, the muscles around your knee will be noticeably weaker. The best way to start strengthening your knee would be to start with a hydrotherapy program (water based exercises) and hopping on an exercise bike starting with gentle resistance and gradually increasing the resistance and time spent on the bike as you get stronger. A physiotherapist will be able to correctly assess what stage of your rehabilitation you are at, and put together an appropriate strengthening and proprioception program. Strengthening through specific muscle groups around your hip and knee will be very important considering the type of surgery you have had and your physiotherapist will be able to show you how to correctly perform and progress these exercises to get you moving again.

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