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Physiotherapy below the knee - exercises before surgery

  • To stretch the calf muscle

    Standing stretch: Keep the back knee straight with the heel on the floor and the toes pointing forward. Lean into the wall until a stretch is felt in the calf. Hold 30 secs x 2. (figure 1)



    Figure 1

    OR

    Towel Stretch: With the knee straight, use a towel to gently pull the foot towards face until a stretch is felt in calf. Hold 30 secs x 2. (figure 2)



    Figure 2

    OR

    Assisted Stretch for young child: With the knee straight, gently pull the foot towards face. The child should feel a comfortable stretch in calf. Hold 30 secs x 2. (figure 3)


    Figure 3

    To stretch the toe flexors

    Stretch toes gently back towards the face. Hold for 30 secs. Repeat. (figure 4)


    Figure 4

    To stretch the hamstrings

    Tuck right / left heel near groin with the opposite leg straight. Reach down until a stretch is felt in back of thigh. Hold 30 seconds x 2. (figure 5)



    Figure 5

    OR

    Long sitting: The young child may long sit for 5-10 minutes or as tolerated (keep knees and back straight). (figure 6)


    Figure 6

    The placement of pins or wires through the muscles can lead to restriction of mobility. Some simple strengthening exercises which will be taught after

    surgery should be introduced now for familiarity and to help the child cope with lifting the leg with the added weight of the frame after surgery.

     

    To mobilise and strengthen the ankle

     

    Foot up / down. x 10. (figure 7)


    Figure 7

    Foot circles. x 10. (figure 8)


    Figure 8

    To strengthen hip and knee

    Tighten muscle on front of thigh, then lift leg from the floor keeping knee straight. x 10. (figure 9)


    Figure 9