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Strengthening Perform reps of each exercise, twice daily. Increase to reps Ankle Pumps: With leg resting on bed and knee straight, slowly pump ankle up and down as far as possible. Quad sets: Tighten thigh muscle and straighten knee as much as possible. Hold 5 seconds. Glut sets: Tighten buttocks, hold 5 seconds. Short arc quads: Place a firmly rolled blanket under knee, with foot resting on bed. Straighten knee and hold 5 seconds, Heel Slides: Slowly bend your knee by sliding your foot as close to your buttocks as able.

Strengthening Increase to reps. Long arc quads: Sit with knees bent. Slowly straighten knee. Hold 5 seconds. Straight leg raise: Lie on your back with opposite knee bent. Slowly raise leg, keeping knee straight. Hold 2 seconds. Straight leg raise, sidelying: Bend bottom leg. Keep top leg in line with shoulder and knee straight. Lift slowly. Hold 2 seconds. Straight leg raise, prone: Lift leg, keeping knee straight. Hold 2 seconds. Optional: place pillow under hips.

Strengthening Increase to reps. Hamstring curls: Slowly bend knee, bringing foot towards buttocks, until you feel a stretch. Hold 5 seconds. Standing hip flexion: Stand with hand on a support. Lift leg forward, keeping knee straight. Standing hip abduction: Stand with hand on a support. Tighten outer thigh and lift leg to the side, keeping knee straight and trunk upright. Standing hip extension: Stand with hand on a support. Tighten buttocks and lift leg behind you, keeping knee straight and trunk upright.

Stretching Heelcord Stretch: Pull heelbone AWAY from patient while pushing ball of foot TOWARDS patient. Hold 20 seconds. Heelcord Stretch 2: Loop towel or elastic band around ball of foot. Pull towards you until stretch is felt on back of calf. Hold 20 seconds. Knee extension stretch: Gently push down on top of thigh (just above the knee) while lifting calf upward, to straighten knee. Hold 20 seconds. Knee flexion stretch: Lying on stomach, Stabilize hip while gently bending knee. Do not allow bottom to rise from bed. Hold 20 seconds.

Stretching Hip extension stretch: Stabilize buttocks with one hand while lifting thigh upward with other hand. Hold 20 seconds. Alternate: perform in sidelying. Hip abduction stretch: Take leg out to side until a stretch is felt on inner thigh. Keep knee straight and avoid leg rolling outward. Hold 20 seconds. Hamstring stretch: Begin with hip and knee bent in a chair position. Keeping thigh in place, gently straighten knee until stretch is felt on back of thigh. Hold 20 seconds. Patellar Mobility: Locate the top of the knee cap with one hand, and the bottom of the knee cap with the other hand. Gently guide the kneecap downward, towards the toes. Hold seconds. Gently guide the kneecap upward, towards the hip. Hold seconds.

General Guidelines Activity: 1. Non-weightbearing (no walking, standing, or kneeling) on surgical leg. 2. Home exercise program twice daily. 3. May use ankle weights with mat exercises under PT guidance. 4. May pedal stationary bike with no resistance. Note: Do not begin weightbearing on your surgical leg until your doctor advises you to do so, even after you are finished lengthening. Pic of crutch amb Positioning/Bracewear: 1. Wear knee brace as instructed. 2. Lie on flat on stomach at least once daily for 30 minutes. 3. No compression garments or devices. May elevate and ice as needed for swelling. Note: Do not modify your bracewear schedule or adjust your brace settings except as instructed to do so by your doctor. Pic of prone or knee brace.