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Physiotherapy exercises following transtibial (below knee) amputation
Information for patientsMSK Mobility and Specialised Rehabilitation (Therapy)
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Introduction
• This sheet has been designed to help you remember the exercises that you have been taught by your physiotherapist. All of the exercises should be done slowly and smoothly. Only do what you are comfortable doing. Some discomfort is OK, but do not push so hard that it causes pain.
• You do not have to do all the exercises in one go. Stop when you feel you have done enough.
• After the exercises are complete, any increase in discomfort should settle down again (back to previous level within 15 minutes). If not, then you are pushing too hard.
• Do a few repetitions of each to start with.
• Build up the number of repetitions gradually once confident you are not experiencing too much discomfort.
• Remember you may not be able to do as much as the day before.
• Exercise helps to keep your strength and mobility as well as improve your blood flow.
• These exercises will help to keep you independent, either in a wheelchair or using an artificial leg (prosthesis).
• Try to keep doing these exercises, even after you have been discharged from treatment.
• If you have any questions, please speak to your physiotherapist.
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1. Static quadriceps
• Put your legs straight out in front of you
• Push the back of your knees into the bed and tighten the thigh muscles
• Hold for 5 seconds• Repeat this ____ times
2. Straight leg raise• Put your legs out in front of you• Tighten your thigh• Lift your leg off the bed• Hold for ___ seconds• Slowly lower• Repeat ____ times
• Repeat the above with the other leg.
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3. Inner range quads• Sit with both legs straight out in front of you• Place a rolled up towel, blanket or pillow under your knee• Straighten your knee• Hold for 5 seconds• Repeat _____ times
• Repeat the above with the other leg.
4. Hip Adduction with resistance• Sit with both legs out in front of you• Place a pillow or rolled up towel
between your thighs• Squeeze your legs together• Hold for 5 seconds• Repeat _____ times
NB. This exercise can also be performed when sitting in a wheelchair or at the edge of a bed.
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5. Outer range quadriceps• Sit on a chair or edge of the bed. Place your hands on your lap• Straighten one knee• Hold for 5 seconds• Now bend your knee• Repeat _____ times
• Repeat the above with the other leg.
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6. Static gluteal contractions• Lie on your back• Keep both legs straight and close together• Squeeze your buttocks as tightly as possible• Hold for 5 seconds• Repeat _____ times
7. Hip flexor stretch• Lie on your back, preferably without a pillow• Bend your knee towards your chest and hold with your hands• Push your opposite leg down flat on to the bed• Hold for 30 – 60 seconds, then relax• Repeat _____ times
• Repeat the above with the other leg.
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8. Bridging• Lie on your back with your arms at the side• Place a couple of firm pillows or rolled up blankets under your
thighs• Pull in your stomach, tighten your buttocks and lift your bottom
up off the bed• Hold for 5 seconds• Repeat _____ times
• To make this exercise more difficult, place your arms across your chest as shown in the picture.
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9. Hip flexion and extension in side lying• Lie on your side• Bend the bottom leg• Lift your top leg slightly• Bend your knee fully towards your chest• Straighten your knee and push your leg backwards• Repeat _____ times
NB. Try not to let your hips roll forwards or backwards.
• Repeat the above with the other leg.
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10. Hip abduction in side lying• Lie on your side• Bend the bottom leg• Keep hips and top leg in line with your body• Slowly lift your top leg up, keeping your knee straight,• Slowly lower• Repeat ____ times
NB. Try not to let your hips roll forwards or backwards.
• Repeat the above with the other leg
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11. Knee flexion in prone lying• Lie on your stomach• Place your arms in a comfortable position• Keeping your thigh on the bed, bend your knee as far as possible• Hold for 5 seconds.• Straighten your knee• Repeat _____ times• Repeat with the other leg
• Repeat the above with the other leg.
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Exercises for your sound limb
After an amputation it is important to maintain the strength of your sound limb. It will have extra work to do now and in the future.
Exercises for your hip and knee have already been covered in this booklet.
Ankle exercises
• Move your foot slowly up and down at the ankle.• Make circular movements with your foot first in one direction then
the other.
Do repetitions of each of these simple exercises ideally every hour.
PD8693-PIL3676 v2 Issue Date: June 2018. Review Date: June 2021
This exercise sheet has been produced by representatives of P.I.R.P.A.G.(Physiotherapy Inter Regional Prosthetic Audit Group). Copyright © PIRPAG 2004
Produced with support from Sheffield Hospitals Charity
Working together we can help local patients feel even better
To donate visitwww.sheffieldhospitalscharity.org.uk Registered Charity No 1169762
Alternative formats can be available on request.Please email: [email protected]© Sheffield Teaching Hospitals NHS Foundation Trust 2018Re-use of all or any part of this document is governed by copyright and the “Re-use of Public Sector Information Regulations 2005” SI 2005 No.1515. Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. Email [email protected]
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