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Physical therapy for below knee tumor surgery


After diagnosis

  • Your child may be fitted with a Bledsoe™ knee brace that he should use when walking and sleeping. This will help keep his leg from fracturing.
  • When your child is diagnosed, he may be fitted and trained with forearm crutches to help with walking. If he cannot use crutches, he may be given a walker with wheels.
  • If possible and suggested by the doctor or therapist, your child should be walking before surgery. This will keep him strong.
  • Your child may not feel well during chemo, but he should not just stay in bed. He should walk and move around as much as possible.
  • If it is hard for your child to keep up strength, a physical therapist may do exercises with him several times during the week.

Before surgery

  • A physical therapist will see your child before the surgery date to make sure he has all the equipment needed and that it fits well. Your child will be trained on how to walk safely with crutches.
  • The doctor or therapist will tell you if your child should not be walking before surgery.
  • Your child may be at risk for fracturing his leg, which would make surgery harder. To keep this from happening, your child may be fitted for a brace to wear on his leg before surgery.

Precautions (depending on doctor)

  • Toe-touch weight-bearing: Your child's foot or toes may touch the floor but should not bear weight when walking or standing.
  • The Bledsoe ™ brace should be locked at 0 degrees until the doctor says it should be changed.
  • The muscle flap will cover the exposed area and a wound vacuum will be in place.
  • There should be a bandage over the skin graft area, typically on the thigh.
  • Your child might have nerve damage in the affected foot and ankle, called peripheral neuropathy. This damage can cause pain and loss of feeling, and it can make your child unable to control those muscles. The area must be held in a temporary brace until swelling goes down. This will keep the foot in a 90-degree position. Your child should wear the foot brace at all times when up.
  • Foot and heel should be floating (not touching anything) at all times to keep from getting pressure sores on the affected leg. Too much pressure on the leg can cause skin to break down.

Day of surgery

  • Bring all equipment to surgery and have it in your child’s room. This includes knee braces, crutches and anything else the physical therapist gave him.
  • Bring your child shorts that are easy to slip over the bulky dressing and the brace.
  • Bring comfortable shoes like tennis shoes that are easy to get on and off. Please do not bring house shoes, flip flops, or Crocs®.
  • Your child will be given a nerve block for pain after surgery. This may make it hard for your child to feel his leg.
  • Sometimes, it may be hard to find your child’s heart pulse in the ankle after surgery. This may delay therapy, because he may need to keep the leg bent for a whole day to improve blood flow.

Day +1 after surgery

  • Parents or guardians must be present for the first days of physical therapy to learn how to help your child out of bed and how to use braces and other needed items.
  • Your child should be ready to get out of the bed the morning after surgery with the help of the physical therapist.
  • Your child will walk with the therapist in the afternoon the day after surgery.
  • Moving is very important for your child after surgery. We may need to encourage your child to do more than he feels like doing.
  • It might be hard for your child to move his foot up and down after surgery. If so, he will have a brace to keep the foot in proper position.
  • In therapy, your child will work on getting out of bed, walking around, moving the leg, and other activities.
  • Because movement can increase pain, you might want to ask the nurse for pain medicine before therapy even if your child is not hurting then.


  • After being released from the hospital, your child will return for regular physical therapy visits.
  • After the swelling has gone down, a more solid custom brace will be ordered for your child’s foot.
  • Your child should be walking and not need a wheelchair except for occasional fatigue after he is released from the hospital.


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

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