Ankle pumps
Pump the feet up and down to keep the blood moving.
- 10 times
- Every hour
Should feel: The calf working Should not feel: Calf pain or swelling — tell us
Home / Patient library / Exercise sheets / Sheet 71
Thigh bone in a rail (LRS) or external fixator
Hip & knee · After surgery on a broken bone
Count the weeks from the day of your operation. The date is on your discharge card.
If your doctor wrote a different plan on your prescription, follow that instead of this page.
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First 2 weeks with the frame
Let the wound and pin sites settle, and start the knee moving.
Weight bearing As we tell you, with a walker.
Quad sets
Sit with the leg straight. Press the back of the knee down and tighten the thigh.
- Hold 5 seconds
- 10 times
- 3 times a day
Should feel: The thigh muscle tightening Should not feel: Knee pain
Buttock squeeze
Lie on your back with the legs straight. Squeeze the buttocks together, hold, then relax.
- Hold 10 seconds
- 10 times
- 3 times a day
Should feel: The buttocks tightening Should not feel: Back pain
Heel slides
Lie down and slide the heel up towards the buttock, bending the knee as far as you can.
- 10 times
- 3 times a day
Should feel: A stretch as the knee bends Should not feel: Sharp pain at the wound
Straight leg raise
Lie down, one knee bent. Keep the other knee straight and lift the leg 20 cm.
- Hold 5 seconds
- 10 times
- 3 times a day
Should feel: The thigh working Should not feel: The knee bending or back pain
Terminal knee extension
Rest the heel on a rolled towel so the knee hangs free. Press the knee down straight.
- 5–10 minutes
- 3 times a day
Should feel: The back of the knee stretching Should not feel: Sharp pain
Not yet Pillows under the frame (they keep the knee bent), or hot water on the pins.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
While the frame is on
Keep the knee bending past a right angle and getting fully straight. Carry on with the earlier exercises.
Weight bearing It increases as the X-ray allows. We will tell you how much.
Sitting knee bend
Sit on a firm chair. Slide the foot back under the chair to bend the knee, hold, then bring it forward.
- 10 times
- 3 times a day
Should feel: A stretch as the knee bends Should not feel: Sharp pain
Standing hip abduction
Hold a chair. Lift the leg out to the side, keeping the body upright.
- 10 times
- Daily each side
Should feel: The side of the hip working Should not feel: Leaning over
Standing hip extension
Hold a chair. Take the leg backwards, keeping it straight.
- 10 times
- Daily each side
Should feel: The buttock working Should not feel: Arching the back
Lying on the front, buttock squeeze
Lie on your front with the legs straight. Squeeze the buttocks and press the hips into the bed, hold, then relax.
- Hold 10 seconds
- 10 times
- Daily
Should feel: The buttocks working and the front of the hip stretching Should not feel: Back pain
Not yet Bathing, swimming, or sea or river water.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
After the frame comes off
Build strength and walk without a limp.
Weight bearing As we tell you. It is often protected for a few weeks while the pin holes close.
Mini squat
Hold a support and bend the knees a little way.
- 10 times
- Daily
Should feel: The thighs working Should not feel: Knee pain
Stand up from a chair
Sit towards the front of a firm chair. Fold the arms across the chest, lean forward over the knees, and stand up without using your hands. Lower yourself back down slowly.
- 10 times
- 3 times a day
Should feel: The thighs working, and a slow controlled sit Should not feel: Dropping into the chair
Bridging
Lie on your back, knees bent. Lift your hips off the floor, hold, then lower.
- 10 times
- Daily
Should feel: The buttocks and back of thighs working Should not feel: Cramp, or back pain
Step-up
Hold a rail. Step up onto a low step with the operated leg, then step down with the other leg.
- 10 times
- Daily
Should feel: The thigh working Should not feel: The knee falling inwards
Step down
Stand on a low step and lower the other heel slowly towards the floor.
- 10 times
- Daily
Should feel: Controlled lowering Should not feel: The knee falling inwards
Single-leg balance
Stand on one leg beside a worktop.
- 30 seconds
- 3 times a day
Should feel: Working to stay steady Should not feel: Losing balance — hold on
Calf raises
Rise onto both toes and lower under control.
- 15 times
- Daily
Should feel: The calf working Should not feel: Sharp pain
Static cycling
Set the seat high, so the knee is almost straight at the bottom. Pedal gently with little resistance.
- 10 minutes
- Daily
Should feel: The knee moving freely Should not feel: Pain in the knee or hip
Not yet Running, until we clear you.
Caring for the pin sites
- Clean each pin site once a week, or more often if it is wet or leaking, with the chlorhexidine-in-alcohol solution we give you. Use non-fluffy gauze, never cotton wool.
- Keep each site covered with a clean dressing, gently pressed down.
- Leave the dry crust that seals a pin. Remove only loose dried fluid above it.
- No bath. Shower only on dressing day, then dry the frame and skin fully before the new dressing.
- A little clear, straw-coloured fluid is normal.
- Telephone us within a day if a pin site has more pain, spreading redness, more swelling, more discharge or pus. Telephone the same day if you also feel unwell or feverish.
- Take anti-inflammatory painkillers only as we prescribe; avoid long courses.
Living with the frame
- If the frame is lengthening the bone, turn it only as shown in clinic. Never start turning on your own.
- While the bone is being lengthened, come to clinic every week. Turning often aches for a while.
- Feeling low or frustrated during a long time in a frame is common. Tell us; help is available.
Stop and telephone us if
- Sudden breathlessness or chest pain — go to the nearest hospital
- The calf becomes swollen, tight or painful, away from the pins
- A pin site with more pain, spreading redness, pus or more discharge
- You feel unwell or feverish
- The foot becomes numb, cold, pale or blue
- A pin or the frame feels loose, or you fall onto the frame
Ready when you are.
Call either clinic during consulting hours, or send a WhatsApp message any time.