Dear Sherwood blog readers,
Couple of months back, we discussed the benefits of total knee replacement ( TKR) for arthritis sufferers. In this blog we would like to present case studies of three clients who were recently treated by us at The Sherwood Clinic, each with a unique story of their own challenges, struggles and fighting spirit in order to achieve their desired outcome.
The story begins with a 67-year-old female Mrs PC, who underwent TKR following several years of struggle with an arthritic knee.
Mrs. PC, an active determined individual who was very keen to get back to her job as a health professional in a hospital post her TKR. It is generally seen that the real work begins from the very first phase and peaks during the second phase.
During her first phase, Mrs. PC cleared her first hurdle successfully, which involved learning to control pain and swelling, gently moving her knee for flexibility, strengthening key muscles like the quadriceps and hamstrings and re-learning how to walk safely with the walking aid. First phase also includes elevation, icing every 2 hourly and ankle-toe movements for managing the surgical wound and swelling. It is observed that post-TKR, most simple movements are exhausting. But Mrs. PC achieved the required range and muscle activation to move to the next step by the end of 4th week.
Week 4-8: Progress, But Not Without Challenges
A slow but noticeable progress was seen by the end of second month. Her knee flexion improved to 90 degrees, but complete knee extension was a challenge. She could walk for less than 10 minutes with mild to moderate discomfort using an elbow crutch. She also experienced nighttime knee stiffness and lateral knee pain making getting out of bed a struggle. These symptoms are sometimes observed post TKR. Hence it is important to understand the management of the same. The challenges for Mrs. PC in the second phase:
- Strength Deficit – Weak quadriceps and hamstrings making movements difficult.
- Uneven Walking Pattern – She relied heavily on her good leg, using an elbow crutch for support.
- Calf Pain & Stiffness – Walking caused discomfort in her knee, lower leg, and foot.
- Night Pain – Sleep remained a challenge due to stiffness and knee locking.
These symptoms were catered in face-to-face sessions (3 times a week-30 minutes sessions) with the physiotherapist and sports therapist. A great emphasis was placed on the combination therapies like manual therapy and exercises. Manual therapy to ease stiffness and enhance movement whereas resisted exercises to build strength and stretching exercises to improve flexibility. Another important goal was to train the gait, improve balance, and correct the walking pattern. Home exercise routine is said to play an important role in early recovery. Hence, Mrs. PC was taught self-mobilization techniques for pain relief and tailored exercises to achieve the strength goals. Despite a few hiccups, she started noticing real improvements—less pain while walking, increased range of motion, and renewed confidence.
Beyond 8 Weeks: A New Chapter
Now in the advanced rehab phase, the focuswas on full recovery. Goals included:
- Walking without assistance
- Restoring balance and confidence
- Achieving near-full knee flexibility
- Preventing future knee issues
Her journey hadn’t been apiece of cake, but her story is a proof that resilience, patience, and the right rehab plan can make all the difference. Recovery after knee replacement isn’t a sprint—it’s a marathon. And every step forward, no matter how small, is a victory.
Next, we share the journey of a 57-year-old lawyer MR BN, who underwent partial knee replacement surgery.
The patient initially began rehabilitation with home visit sessions and progressed to in-clinic physiotherapy sessions at The Sherwood Clinic.
After three weeks post operatively:
- The patient was able to walk short distances unaided and had started going to work twice a week.
- He reported no significant pain in his knee- a great sign.
- However, mild swelling was still present in his right knee, the surgical scar was healing well.
4-8 weeks following surgery:
- He had some difficulty fully straightening his knee and continued to struggle with free movement for about six weeks
- His leg muscles were weak, which affected his ability to walk smoothly.
- By end of eight weeks, he had achieved all the required milestones like range of motion, strength, and independence in activities of daily living.
His Rehabilitation Plan To help him regain strength and improve movement, the following exercises and treatments were introduced:
- Gentle knee movements to improve flexibility.
- Massage and soft tissue therapy to release tension and improve circulation.
- Kneecap movements to prevent stiffness.
- Specific muscle activation exercises to strengthen the front thigh muscles.
- Leg lifts and knee bends to improve mobility.
- Hip and ankle exercises to support overall leg function.
- Walking practice to improve balance and reduce limping.
Why Rehabilitation Matters?
There is a common misconception that patients automatically regain mobility following a knee replacement surgery. Physiotherapy is a critical component for recovery and aftercare; It is often started immediately after surgery. This case study highlights how a structured rehabilitation programme aided in improving range of motion, strength and flexibility for the patient; therefore, facilitating a gradual return to daily function and work life. Despite facing several challenges such as occasional swelling and an altered gait, Mr BN was able to make a steady progress with dedication and the right support.
Fear and apprehension of a knee replacement is common and often stems from the concerns of pain, lack of awareness, recovery time and the potential complications involved. If you or someone you know is considering knee surgery, it is important to recognise that you are not alone and it is natural to feel anxious prior to a surgery. However, with the appropriate rehabilitation, it is possible to restore mobility and strength which will ultimately enable a quicker return to normal activities.
It is important to seek expert guidance at an early stage if your daily activities are hampered due to knee pain. At The Sherwood Clinic, we are committed to helping our patients get back on their feet and enjoy life without pain.
Stay active, stay healthy!
Our third and final case study is a story of a female patient Mrs GS who underwent total knee replacement (TKR) after over a yearlong wait for it.
Mrs GS had been seeking physiotherapy for her right knee arthritis at The Sherwood Clinic, we actively supported her with maintaining flexibility, muscle strength and pain relief and had advised her to seek her GP’s help to be put on the waiting list for TKR. During this period, she had sustained fracture of femoral shaft on the same side which was fixed internally. This had further increased the need for intensive rehabilitation which focused to maintain joint mobility and muscle strength not allowing to compromise this which would affect a successful outcome of TKR. Most importantly, Mrs GS had developed excellent body awareness, her walking pattern, her muscle weakness around the hip and the knee area and flet educated and empowered to work on it.
Following the TKR surgery on her right knee, Mrs GS commenced her rehabilitation at the clinic in the second week. At this stage she was using elbow crutches to facilitate walking.
Within two weeks, she was able to walk around the house with minimal support.
She has no issues with day-to-day activities although experienced pain when bending her knee beyond 80 degrees in the first three weeks, This was taken care of by pain relief medications, co-codamol twice a day for the first two weeks, and then paracetamol as required.
She was able to extend the knee fully; there was a slight limp to the left due to hip muscle weakness. This was addressed very early on, and MRs GS actively and untiringly worked to build the strength around her hip.
Rehabilitation Plan for Mrs GS
- Soft tissue release to reduce stiffness and improve movement.
- Strengthening exercises for the thigh, hip, and leg muscles.
- Stretching routines to loosen tight muscles.
- Gait retraining with the goal of reducing crutch use over time.
- Leg length measurement to assess the need for corrective adjustments.
New Challenges and Adjustments
At a later follow-up, the patient reported pain in the back of her thigh while walking, along with difficulty taking longer steps and fear of falling. Further assessment showed:
- Increased arch in the lower back while standing.
- Limited movement in the right hip due to tight muscles.
- Short steps and reduced arm swing while walking.
- Weakness in key muscle groups, affecting balance and confidence.
To address these concerns, the rehabilitation plan was optimised to include:
- Stretching exercises to reduce muscle tightness and pain.
- Strength exercise plan for the hip and thigh muscles.
- Balance training to improve stability and reduce fall risk.
- Posture correction to help with walking efficiency and confidence.
- Education and emotional support to build confidence and reduce fear of falling.
Following ten weeks of intensive rehabilitation, Mrs GS was walking independently, managed to do all her daily chores and was able to use the public transport confidently.
Despite some challenges, Mrs GS followed an ideal recovery pathway following TKR. Her previous experience of physiotherapy, with understanding and awareness of her joint flexibility, muscle strength and its overall impact on her body made it easier for her to carry out the rehabilitation and feel confident and empowered to actively take charge of her recovery.
Why Rehabilitation is Crucial Recovering from knee replacement surgery?
Life after surgery involves more than just healing. It is about reigniting confidence and resuming an active lifestyle. Through this patient’s recovery, we see the value of a rehab approach that supports the whole body – not just the knee, but also balance, posture, and fluid movement.
Final Thoughts
Having knee replacement surgery is a big step, but getting better takes time, effort, and the right support. If you or someone you love is going through this, remember—recovery can be slow, but every small improvement is a step toward feeling better and getting your life back.
At The Sherwood Clinic, we are here to help you through the healing process. Our team offers expert care to help you move better and feel more independent. If you are recovering from knee surgery, do not go through it alone – getting the right help can make a big difference.
Stay strong, stay mobile!
If you or someone you know is going through TKR recovery, remember progress takes time. Celebrate small wins, stay consistent, and trust the process.
Your new knee is just the beginning of a more mobile, pain-free future!
