Knee Replacement Exercises to Avoid

While appropriate exercise is vital to successful recovery after knee replacement surgery, certain movements and activities can potentially harm your new joint, impede healing, or unnecessarily increase discomfort. For the thousands of patients who undergo knee replacement surgery in the UK each year, understanding which exercises to avoid is just as important as knowing which ones to perform.

This guide explores the exercises and activities that orthopaedic specialists typically recommend avoiding after knee replacement surgery, explains why they can be problematic, and offers safer alternatives to achieve your rehabilitation goals.

After surgery, your new knee needs specific considerations:

• Your prosthesis needs time to become securely integrated with your bone
• Muscles, ligaments, and other tissues are recovering from surgical trauma
• Excessive loading can increase inflammation and pain
• Artificial joints have different biomechanical properties than natural knees

Several types of movement can be particularly problematic:

• High impact: Creates jarring forces that stress the implant-bone interface
• Deep flexion: Extreme bending beyond 90 degrees places high pressure on the artificial joint
• Torsional (twisting) forces: Rotational movements can stress the implant components
• Excessive compression: Very heavy loads compress the joint surfaces and surrounding tissues

High-impact activities create jarring forces that can be harmful:

Running and Jogging

Why it's problematic:

• Creates forces up to 3-4 times your body weight through the knee
• Increases wear on the artificial joint components
• Can lead to earlier implant loosening or failure

Safer alternatives:

• Walking on even surfaces with appropriate footwear
• Elliptical training (when cleared by your physiotherapist)
• Stationary cycling with proper seat height
• Water walking in a swimming pool

Jumping Activities

Why they're problematic:

• Landing creates extreme impact forces through the knee
• Difficult to control landing mechanics during recovery
• Places stress on the implant-bone interface

Safer alternatives:

• Step-up exercises with controlled movements
• Heel raises for calf strengthening
• Modified squats to appropriate depth
• Water aerobics with non-jumping movements

Excessive bending places extreme pressure on your knee replacement:

Deep Squats and Lunges

Why they're problematic:

• Create extremely high pressure between the kneecap and femoral component
• May contribute to premature wear or instability
• Can exceed the designed range of motion for many implants

Safer alternatives:

• Partial squats (no deeper than 90 degrees)
• Split squats with limited depth
• Supported mini-lunges with controlled range
• Seated leg extensions (when approved)

Kneeling on the Operated Knee

Why it's problematic:

• Places direct pressure on the healing incision site
• Creates extreme flexion combined with compression
• Can be uncomfortable even in well-healed replacements

Safer alternatives:

• Using a kneeling pad when kneeling becomes necessary
• Kneeling on the non-operated knee when possible
• Using long-handled tools to avoid kneeling
• Practicing half-kneeling with support on the non-operated side

Rotational forces can be particularly stressful for knee replacements:

Pivoting Activities

Why they're problematic:

• Create rotational forces that artificial knees aren't designed to withstand
• Increase risk of component wear or loosening
• Can lead to instability sensations

Safer alternatives:

• Step turns instead of pivot turns when changing direction
• Controlled rotational movements within pain-free range
• Dancing styles with predictable, controlled movements

Sports with Sudden Direction Changes

Activities to reconsider include:

• Football, rugby, and hockey
• Squash and badminton
• Basketball and netball

Safer alternatives:

• Swimming with focus on freestyle or backstroke
• Cycling on predictable terrain
• Walking on even paths with gradual turns

While strength training is beneficial, certain approaches can place harmful loads on your new knee:

Heavy Leg Press

Why it's problematic:

• Places extreme compression forces through the knee
• Often encourages deeper knee flexion than recommended
• May contribute to implant loosening with very heavy weights

Safer alternatives:

• Seated leg extensions with appropriate weight
• Standing hip strengthening with resistance bands
• Partial wall slides with body weight

Weighted Deep Squats

Why they're problematic:

• Combine deep flexion with high compressive forces
• Increase pressure on the anterior portion of the implant
• May exceed the design limitations of the prosthesis

Safer alternatives:

• Mini-squats (45-60 degrees) with light or no weights
• Sit-to-stand exercises from appropriate height
• Leg extensions with controlled resistance

Many restrictions evolve throughout your recovery:

Early Recovery (0-6 Weeks)

• Strictest adherence to avoiding problematic exercises
• Focus on prescribed rehabilitation programme
• Emphasis on regaining basic range of motion

Intermediate Recovery (6-12 Weeks)

• Continued avoidance of high-impact and deep flexion activities
• Gradual introduction of more challenging exercises under guidance
• Increasing resistance within appropriate ranges

Long-Term Considerations (Beyond 6 Months)

• High-impact activities generally remain discouraged indefinitely
• Deep flexion activities typically remain limited
• Individual assessment and guidance remains essential

While this article has focused on exercises to avoid, appropriate, consistent exercise remains essential for successful recovery. By understanding why certain movements can be problematic and learning appropriate alternatives, you can maintain fitness while protecting your new knee.

Remember that recommendations may evolve throughout your recovery, and individual factors significantly influence what activities are appropriate for your specific situation. Working closely with your surgical team and physiotherapists ensures you receive personalised guidance tailored to your circumstances, goals, and implant type.