Knee Injections: Post-Procedure Care, Recovery, and Rehabilitation

What Can You Do After Knee Injection?

After a knee injection, the immediate post-procedure period typically involves rest, ice, and reduced activity, followed by a gradual return to movement and structured rehabilitation tailored to the specific type of injection and your individual needs.

Understanding Knee Injections: A Brief Overview

Knee injections are a common therapeutic intervention used to manage pain, inflammation, and improve function in various knee conditions, most notably osteoarthritis, but also tendinitis, bursitis, and other inflammatory states. The type of injection dictates, in part, the post-procedure recommendations. Common types include:

• Corticosteroid Injections: Aim to reduce inflammation and pain rapidly. The effects are typically temporary.
• Hyaluronic Acid (Viscosupplementation) Injections: Designed to supplement the knee's natural synovial fluid, improving lubrication and shock absorption. These are often given in a series.
• Platelet-Rich Plasma (PRP) Injections: Utilize components from your own blood to promote healing and reduce inflammation, often for chronic tendon issues or early-stage arthritis.
• Other Biologics (e.g., Stem Cells): Less common and often experimental, aiming for tissue regeneration.

Regardless of the type, the primary goal is to create an environment conducive to healing, pain reduction, and improved mobility.

Immediate Post-Injection Protocol (First 24-48 Hours)

The initial period following a knee injection is crucial for optimizing its effectiveness and minimizing potential side effects.

• Rest and Reduced Activity:
  • Avoid strenuous activities: Refrain from heavy lifting, deep squats, prolonged standing, running, jumping, or any high-impact movements. This allows the injected substance to settle and begin its work without undue stress on the joint.
  • Gentle Movement: Light, non-weight-bearing movements, such as gentle knee flexion and extension while seated, can help circulate the fluid and prevent stiffness.
• Ice Application:
  • Apply an ice pack to the injection site for 15-20 minutes at a time, several times a day. This helps to reduce swelling, discomfort, and inflammation. Ensure a barrier (towel) is between the ice and your skin.
• Elevation:
  • If you experience swelling, elevating your leg above heart level when resting can aid in fluid drainage.
• Pain Management:
  • Over-the-counter pain relievers like acetaminophen (Tylenol) can be used for discomfort.
  • Avoid NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen or naproxen immediately after some injections (e.g., PRP) unless advised by your doctor, as they can interfere with the inflammatory process critical for healing.
• Monitoring for Complications:
  • Keep an eye on the injection site for signs of infection, such as increased redness, warmth, severe pain, swelling, fever, or pus. While rare, these symptoms warrant immediate medical attention.

Gradual Return to Activity: The Progression

The timeline for returning to full activity varies significantly based on the type of injection, the underlying condition, and your individual response. Always follow your physician's specific instructions.

• Listen to Your Body: This is the paramount rule. Pain is your body's signal that you may be overdoing it.
• Gentle Movement and Mobility (Days 2-7):
  • Light Walking: Gradually increase the duration and intensity of walking on flat, even surfaces.
  • Range of Motion Exercises: Gentle knee bends, heel slides, and quad sets can help maintain flexibility without stressing the joint.
• Avoiding High-Impact Activities:
  • Continue to avoid activities that put significant stress on the knee joint, such as running, jumping, pivoting sports, or heavy squatting/lifting, for at least 1-2 weeks, and often longer for hyaluronic acid or biologic injections.
• Specific Considerations by Injection Type:
  • Corticosteroids: While pain relief can be rapid, resist the urge to immediately return to full activity. The underlying issue is still present, and overexertion can lead to re-injury or further joint damage once the pain-masking effect wears off. A gradual return over several days is typically recommended.
  • Hyaluronic Acid: Many physicians recommend limiting strenuous activity for 24-48 hours, and avoiding high-impact activities for up to a week, to allow the viscous fluid to integrate properly into the joint.
  • PRP and Biologics: These injections aim for tissue healing and regeneration, which is a slower process. A more conservative approach is often advised, with restricted activity for several days to weeks, followed by a carefully supervised rehabilitation program.

Incorporating Rehabilitation and Exercise

For long-term success, an injection should often be seen as a stepping stone to facilitate rehabilitation, not a standalone cure.

• Physical Therapy:
  • A structured physical therapy program is highly recommended after an injection. A physical therapist can design exercises to strengthen the muscles supporting the knee, improve flexibility, balance, and proprioception (your body's awareness in space).
• Low-Impact Strengthening:
  • Focus on exercises that strengthen the quadriceps, hamstrings, glutes, and calf muscles without excessive joint stress. Examples include wall slides, leg raises, glute bridges, and gentle resistance band exercises.
• Mobility and Flexibility:
  • Gentle stretching of the hamstrings, quadriceps, and calf muscles can improve range of motion and reduce stiffness.
• Proprioception and Balance:
  • Exercises like single-leg stands, balance board drills, or tai chi can enhance knee stability and reduce the risk of future injury.
• Activity Modification:
  • Learn how to modify your exercise routine or sports activities to minimize stress on the knee. This might involve choosing cycling or swimming over running, or adjusting squat depth.

Long-Term Considerations and Lifestyle Factors

Beyond the immediate post-injection period, sustainable knee health involves broader lifestyle adjustments.

• Weight Management:
  • Maintaining a healthy body weight significantly reduces the load and stress on the knee joints, slowing the progression of conditions like osteoarthritis.
• Proper Footwear:
  • Wear supportive, well-cushioned shoes that provide adequate shock absorption, especially during activities.
• Nutritional Support:
  • A diet rich in anti-inflammatory foods (e.g., omega-3 fatty acids, fruits, vegetables) can support overall joint health.
• Consistency:
  • Adherence to your prescribed exercise program and physical therapy recommendations is key to maintaining the benefits of the injection and preventing symptom recurrence.

When to Seek Medical Attention

While knee injections are generally safe, it's important to be aware of potential complications. Contact your doctor immediately if you experience:

• Persistent or worsening pain that is not relieved by rest or over-the-counter medication.
• Signs of infection: Fever, chills, severe redness, warmth, or pus at the injection site.
• New numbness or weakness in the leg or foot.
• Significant swelling that doesn't subside with ice and elevation.
• Any other concerning symptoms or unexpected reactions.