Sleeping After Knee Replacement: Keeping it Simple

Sleeping After Knee Replacement: Keeping it Simple 

Sleeping after knee replacement surgery is an important aspect of your healing. Keep reading to learn how you can sleep comfortably and make the most out of your rehab.

Sleeping positions after knee replacement

The best sleeping position after a total knee replacement is on your back. However, you will want to avoid sleeping flat on your back for several reasons. First, sleeping flat on your back can cause muscle tension, soreness, or pain in your lower spine. Second, immediately after surgery, your knee will not be able to straighten all the way. This means you will not be able to lie completely flat and support your knee. Third, sleeping flat can allow fluid to build up in your leg overnight.

The other possible sleeping positions after knee replacement are on your stomach and on your side. Try to avoid sleeping on your stomach. Sleeping on your stomach puts a lot of stress and strain on your neck and upper back. In regards to side sleeping, its probably not going to be an option early on. Typically, sleeping on your side is pretty painful for the first couple of months after surgery.

Pillow placement after TKR

When sleeping after knee replacement surgery, try elevating your legs on a contoured leg elevation pillow. The contours will cradle your legs and calves for maximal comfort. They also support your legs in a way that avoids tender spots and pressure points.

Sleeping slightly elevated also uses gravity to reduce swelling in your leg. When swelling gets out of your leg faster, you recover faster. This position is also ideal for your back muscles and spine. Sleeping on your back with your legs supported ensures that your lumbar muscles and spine stay relaxed overnight instead of stiffening up.

Immediately after surgery, you may not be able to lie on a contoured leg wedge with your knee completely straight. That's okay! You can place a small pillow or towel under the bend of your knee. Over the next several weeks and months as your knee heals, remove the pillows or towels gradually until you can sleep comfortably with your legs elevated on the contoured leg wedge.

After a knee replacement, you do want to avoid lying for prolonged periods with your knee bent. However, if you are carefully following your physical therapist’s exercise program, you are getting plenty of movement throughout the day. If this is the case, sleeping with a small pillow under the back of your knee at night is generally okay if it is needed for you to sleep. Always check with your physical therapist to see if using an additional pillow on top of the wedge is okay for you, or if they want you to try to use only the contoured wedge.

Other sleeping positions after knee replacement surgery

As your knee continues to heal, you may want to venture back into side sleeping. To do this comfortably, you must have a leg separator pillow. Otherwise, the pain of your knees on top of each other is oftentimes unbearable.

Make sure that the leg separator pillow is supportive enough to keep your top leg parallel to the bed. This takes any tension off your low back and hips. You also want to make sure that it is long enough to run from your pubic bone to past your feet. This length makes sure your leg is getting the support it needs.

Sleeping after knee replacement surgery can be difficult at first, but as your body heals and your leg is supported correctly, you will be sleeping soundly before you know it!

-Hillary Blare, Doctor of Physical Therapy


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