How to Cope With a Delayed Elective Surgery

Medically Reviewed by: Clint McCullough, ATC, OTC

Non-Essential Surgery Delays

If you had an elective surgery scheduled in 2020, chances are you are having to postpone due to the outbreak of COVID-19.  Patients across the nation are anxiously awaiting the treatment for their elective, or “non-essential” surgeries, which may be more critical than the term implies. The Center for Disease Control issued framework on providing clinical care to non-COVID-19 patients, which depending on the state and local communities level of COVID-19 transmission, gives the green light for resuming elective surgeries. While hospitals and surgery centers are reopening, patients are still experiencing extreme delays in their surgery date due to the tens of thousands of surgeries that had to be rescheduled.

Waiting for an Elective Surgery Procedure

Often patients wait to have knee replacement surgery during a time of the year when they are not working, have personal time off, or have help readily available from friends and family members. Other times, they wait until the summer months to ensure they will have nice weather and footing as they resume walking, while others prefer the winter months to hunker down inside and break up the cold weather. Even if a patient is ready for surgery, they sometimes must wait several months before there is availability in the surgeon’s schedule – with elective procedures resuming after COVID-19, the wait may be longer than normal. If you are planning on having an elective knee replacement surgery, it’s likely you will have to wait several months before you get your new knee. While you wait, here are some exercises and resources that will help prepare you for surgery.

How Can I Prepare My Body?

The more range of motion and strength you can build in your knee before surgery, the better your outcomes will be. Even if you have extremely poor range of motion and lots of pain, doing knee exercises prior to surgery will help. Getting your knee back to full extension following surgery is essential and a good “pre-hab” protocol will kickstart your recovery. Check out these simple home exercises that will help get you back on your feet faster!

Quad Sets

Engaging your quadriceps (anterior thigh muscle) will help promote knee extension following surgery.

  • In a long sit position with your toes pointed up, contract your quadriceps muscle and imagine pushing the back side of your knee through the floor or table. Hold for 5 seconds and relax.
  • To prepare for surgery, we recommend doing 3 sets of 10 repetitions at least twice per day.

Heel Slides

This is an easy exercise to work on flexion and extension of your knee. Even if you have poor range of motion or it causes some discomfort, you’ll be happy you did them after surgery!

  • Lying flat on your back, slowly bend your knee and slide your heel as close to your buttock as you can get. Hold this position for 3-5 seconds and then slowly straighten your leg back to the starting position. 3 sets of 10 repetitions at least twice per day.
  • It is important that you perform this exercises in a slow and controlled manner.
  • To get a few more degrees of flexion, try using your hand to pull your lower leg closer to your buttock once you feel you cannot go any further. Every little bit helps!
  • Our Zero Degree Knee – Slider is the perfect tool to allow you to perform these exercises comfortably and safely on any surface.

Short Arc Kicks

This exercise will again focus on engaging your quadriceps and build strength as you lift your lower leg off the ground.

  • In a short sit position, start by placing a rolled-up towel or bump behind your knee. This will place your knee in a slightly flexed position. Then engage your quadriceps muscle and straighten your leg.
  • Hold straightened position for 3-5 seconds. Slowly lower your leg down to the starting position. 3 sets of 10 repetitions at least twice per day.
  • Do not just let your leg quickly fall back to the starting position. It is important to slowly control the descent back to the table or floor.

Long Arc Kicks

Seated knee extension will help improve your strength, motion, and endurance.

  • In seated position with your knees at 90 degrees of flexion, gradually straighten your knee and focus on fully contracting your quadriceps muscle. Slowly lower your leg down the starting position while maintaining control. 3 sets of 10 repetitions at least twice per day.
  • You can work on flexing your knee past the starting position to maximize range of motion.
  • As your strength improves, gradually increase the number of repetitions, and add a 5 second hold with the knee straight.

Straight Leg Raises

Great for knee, hip, and core strength. All of these are important after a total knee replacement.

  • In a supine position (lying flat on your back) with your toes pointed straight up, lift your heel approximately 12 inches off the floor or table. Slowly lower the leg back down to the table in a controlled fashion. 3 sets of 10 repetitions at least twice per day.
  • Its important to keep your toes pointed up and your knee straight throughout the exercise.
  • Make sure the descent is slow and controlled.

Gravity Assisted Knee Extension

You might notice a theme here – knee extension is essential following knee replacement. This is a static exercise that will help with that!

  • In a supine (lying flat on your back) or a long sit position, prop your ankle up so it at least 4-6 inches off the ground. This will free up space behind your knee.
  • With nothing supporting your posterior knee or calf, let gravity pull your knee into full extension. Try to hold this position for 20 minutes. Adding light weight to the front of your knee will help promote full extension.
  • Our Zero Degree Knee positioner is the perfect tool to help you before and after your knee surgery. It protects your heel, keeps toes pointed up, and controls rotation at your hip. The Zero Degree Knee has helped over 100,000 patients nationwide!

Wall Slides

Another great way to promote knee range of motion while using gravity to assist you.

  • Start by lying flat on your back with your feet up on a wall. Your knees will start in a slightly flexed position (30 degrees) and your buttocks should be about 12 inches away from the wall.
  • Trying to keep your feet flat on the wall, slowly flex your knee using gravity to help pull your lower leg down. Hold the maximum knee flexion for 5 seconds and then straighten your knee back to the starting position. 3 sets of 10 at least twice per day.
  • You can use your hand to help maximize flexion at the bottom of the exercise.

Preparing your Home for Surgery Recovery

Preparing your home for your recovery after surgery is one of the most important steps to ensure safety and efficiency during the rehabilitation process. Follow these steps to turn your home into a safe space for healing and strengthening!

  • Declutter– You will need as much space as possible following surgery. Boxing up and storing non-essential items as well as removing throw rugs and other items you can trip on will be helpful. Hide or cover electrical cords so you do not trip and fall!
  • Re-arrange Furniture– Arrange your furniture so you have easy access to your couch or chair while navigating with a cane or walker. Try to arrange the furniture in a way that limits the amount of twisting, bending, or turning you have to do.
  • Install Fall Prevention Equipment – Though you may be weak and have a loss of balance following surgery, walking is inevitable and you will need to walk to complete activities of daily living (toileting, bed to chair transfers, home exercises). Here a couple tips to help prevent falling:
    • Install handrail next to bathtub/shower and toilet
    • Consider using a raised toilet seat
    • Use a bathmat to prevent slipping
    • Wear socks or footwear with good grips
    • Make sure walkways are well lit (nightlights)
  • Prepare a Sleeping Area– Plan on sleeping and living on one level. If your bedroom is upstairs and living quarters is downstairs, prepare an area in the living quarters where you can have a bed. Sleep is important to the healing process and stairs may be difficult to navigate.
  • Stock up on Nutrient Dense Food – Proper nutrition is vital to healing after knee surgery. Make sure your freezer is stocked with nutritious pre-made meals that just need to be heated up. It also might help to make sure you have access to online grocery delivery.
  • Make Sure You Have Help – Always make sure you have friends or family close by that can offer help when you need it. Even though you’ll be prepared, things always come up that you may need help with.

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