Knee Injury and Surgery Rehab | Weeks 03-04

Knee Injury and Surgery Rehab | Weeks 03-04

Knee Injury and Surgery Rehab | Weeks 03-04

KNEE INJURY AND SURGERY REHAB | WEEKS 03-04

Stage Pre-requisites
Before progressing into Stage 2, you should meet the following criteria: Maintain improving knee extension and flexion range of movement Demonstrate improving quadriceps activation and lower limb control Walk with improving gait mechanics and confidence Have been reviewed by your Surgeon and/or Physiotherapist if required Have no signs of infection or significant post-operative complications Have swelling that is reasonably controlled and not significantly increasing following exercises or walking If you have fracture fixation, meniscal repair or ligament bracing restrictions, continue following your Surgeon’s or Physiotherapist’s movement and weight-bearing guidelines throughout this stage.

Physio Check-In
This stage is an important progression point in your rehabilitation, as exercises become more weight-bearing and movement based. Your Physiotherapist can assist with: Assessing walking mechanics and limping Monitoring swelling and knee joint stiffness Progressing weight-bearing exercises safely Improving quadriceps activation and lower limb control Assessing squat and balance technique Improving hip and pelvic control Progressing bike, walking and pool rehabilitation appropriately Hands-on treatment may still assist with: Soft tissue tightness around the knee and thigh Patella mobility Scar tissue mobility Swelling reduction Muscle tightness and stiffness This is also an important time to assess movement quality and reduce compensation patterns before progressing into later strengthening stages.

Goals
Range of Movement Goals Continue maintaining: 0° active knee extension Aim to progressively improve knee flexion throughout this stage: Week 3: approximately 100° flexion Week 4: approximately 110° flexion For post-operative patients, aim to progressively improve knee flexion throughout this stage while maintaining extension quality and minimising swelling response.

Recommended Equipment

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Power Band - Red (Medium)

Power Band - Red (Medium)

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WEEKS 3-4: Functional Loading and Movement Control
WEEKLY INSTRUCTIONS Welcome to Stage 2 of your rehabilitation program. During this stage, the focus shifts toward: Improving walking mechanics Building confidence with weight bearing Progressing quadriceps and glute strength Improving balance and neuromuscular control Restoring functional movement patterns By now, you should be moving more comfortably with improving range of movement and reduced swelling compared to the early stages of rehabilitation. Continue focusing on controlled movement quality and avoid progressing too quickly simply because pain levels are improving. Weekly Structure This stage consists of three sections. Session 1: Mobility and Stretches: DAILY Session 2: Muscle Activation and Control: 1-2 times per day Session 3: Functional Strength and Movement: 1 x per day, 4-5 x per week As exercise load increases, allow time for recovery and swelling management between higher-loading sessions. Focus on movement quality and symptom response rather than simply increasing exercise volume. Session 1: morning or midday Session 3: afternoon or evening Mobility and Stretching The mobility exercises remain important during this stage, however they no longer need to dominate the entire day as they did during the early phase of rehabilitation. Move only within tolerable limits and avoid aggressively pushing into pain or swelling. Continue focusing on: Improving knee mobility Reducing stiffness Improving soft tissue flexibility Restoring movement confidence Improving walking mechanics Strength and Functional Movement This stage introduces more functional loading and movement-based rehabilitation exercises, concentrating on: Improving squat mechanics Improving balance and proprioception Improving hip and pelvic control Restoring lower limb strength Improving movement confidence Restoring functional movement patterns Every exercise during this stage is designed to prepare you for more advanced strengthening and athletic rehabilitation in the later stages of the program. Focus on: Controlled movement quality Maintaining good knee alignment Controlled weight shifting Balanced movement between both legs Smooth and confident movement patterns Walking and Weight Bearing Focus on: Heel strike during walking Controlled knee extension during stance phase Reducing limping Improving walking symmetry Improving confidence during standing tasks Avoid excessive walking volume if it significantly increases swelling or pain later in the day. Bike, Rower, Pool and Cardio Bike The bike becomes an important part of rehabilitation during this stage. Aim to use the bike: 4–5 times per week 20–30 minutes maximum Low to moderate intensity only If the recumbent bike is comfortable, you may begin progressing toward a standard stationary bike during Week 4. Pool Pool walking may begin once cleared by your Surgeon or Physiotherapist: 1–2 sessions per week 20–30 minutes maximum Shallow water walking only No kicking or swimming yet
SPECIAL NOTES Continue using compression stockings during the day if swelling persists Ice after exercises or at the end of the day if the knee becomes reactive Progress exercises gradually based on swelling response and movement quality Do not rush walking progression if limping remains significant If you have fracture or surgical restrictions, continue following all weight-bearing and brace guidelines Do not swim in the ocean during this stage due to instability and unpredictable wave forces

Session 1: Mobility and Stretching

Session 1:

PER DAY

2

PER WEEK

7

1

KS | Knee Flexion ROM (Supine)

KS | Knee Flexion ROM (Supine)

3 sets x 10 reps (Evening only)

2

KS | Quadriceps (Prone) - Band Assisted

KS | Quadriceps (Prone) - Band Assisted

10sec x 20 reps (Evening Only)

3

KS | Knee Extension (Prone) - Off Bed

KS | Knee Extension (Prone) - Off Bed

4 sets x 1min (Evening Only)

4

HS | Hip Flexors (Thomas Test)

HS | Hip Flexors (Thomas Test)

5

KS | Hamstrings (Wall)

KS | Hamstrings (Wall)

6

AS | Gastrocs (Step)

AS | Gastrocs (Step)

Session 2: Muscle Activation and Control

Session 2:

PER DAY

1

PER WEEK

5

1

K1 | TKE - Heel Raise

K1 | TKE - Heel Raise

10sec holds x 10 sets

2

H1 | Glute Side Raise

H1 | Glute Side Raise

2 sets x 10 reps

3

H1 | Clams

2 sets x 10 reps

4

H2 | Prone Glute Leg Lifts

H2 | Prone Glute Leg Lifts

2 sets x 10 reps

5

H2 | Glute Bridge

H2 | Glute Bridge

3 sets x 10 reps

6

H3 | Hip Extension (Bent Knee)

H3 | Hip Extension (Bent Knee)

3 sets x 10 reps - CAREFUL WITH HAMSTRINGS

7

K1 | Hamstring Holds (Isometric) - Standing

K1 | Hamstring Holds (Isometric) - Standing

Session 3: Functional Strength and Movement

Session 3:

PER DAY

1

PER WEEK

5

1

A1 | One Leg Balance (Floor)

A1 | One Leg Balance (Floor)

2

A2 | Calf Raises - Step

A2 | Calf Raises - Step

3 sets x 10 reps

3

K2 | Swiss Ball Squat

K2 | Swiss Ball Squat

30sec ISOMETRIC HOLDS x 4 sets

4

K1 | Bench Squats

K1 | Bench Squats

3 sets x 10 reps

5

K2 | Hamstring Drops

K2 | Hamstring Drops

3 sets x 10 drops

6

K2 | Hamstring Flicks

K2 | Hamstring Flicks

3 sets x 30 reps - LOW INTENSITY

7

L2 | Hip Hinge - Band

L2 | Hip Hinge - Band

3 sets x 10 reps

Videos to Watch

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