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Post Knee Replacement Exercises

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Introduction

After undergoing knee replacement surgery, the exercises you perform during your recovery period are just as important as the operation itself. For patients in the UK, following a structured exercise programme is essential to regaining mobility, building strength, and ensuring the long-term success of your new joint.

Knee replacement surgery (arthroplasty) is one of the most common orthopaedic procedures in Britain, providing relief from chronic pain and improved function for those suffering from advanced arthritis or knee injuries. However, the surgery itself is only the beginning of your journey toward better mobility. The rehabilitation process—particularly the exercises you perform—largely determines how well you'll function with your new knee.

This guide will walk you through the essential post-knee replacement exercises, explaining when and how to perform them safely for optimal recovery.

The Importance of Post-Knee Replacement Exercises

Before diving into specific exercises, it's essential to understand why they're so critical to your recovery:

  • Restore range of motion: Without proper exercise, scar tissue can form and limit how far your knee can bend and straighten
  • Build surrounding muscle strength: Strong muscles support and stabilise your new joint
  • Improve circulation: Movement enhances blood flow, which reduces swelling and promotes healing
  • Prevent complications: Regular exercise helps prevent blood clots and improves overall recovery
  • Maximise implant life: Proper movement patterns and muscle support can extend the lifespan of your prosthesis

Early Stage Exercises (Days 1-14)

These initial exercises focus on gentle movement, activating muscles, and beginning to restore basic function. They should be performed as directed by your physiotherapist, typically several times daily.

Ankle Pumps

Purpose: Improves circulation and helps prevent blood clots

How to perform:

  1. Lie down with your leg extended
  2. Pull your foot up toward you, then push it away by pointing your toes
  3. Repeat 10-15 times, every hour while awake

Quadriceps Sets (Static Quads)

Purpose: Activates the main thigh muscle that stabilises the knee

How to perform:

  1. Lie on your back with your operated leg straight
  2. Tighten the muscle on top of your thigh by pushing the back of your knee down
  3. Hold for 5 seconds while breathing normally
  4. Repeat 10 times, 3-4 times daily

Gluteal Sets

Purpose: Activates buttock muscles that support hip and knee function

How to perform:

  1. Lie on your back
  2. Squeeze your buttock muscles together
  3. Hold for 5 seconds
  4. Repeat 10 times, 3-4 times daily

Straight Leg Raises

Purpose: Strengthens quadriceps while protecting the knee joint

How to perform:

  1. Lie on your back
  2. Tighten your thigh muscle and straighten your knee
  3. Keeping the knee straight, lift your leg about 30cm off the bed
  4. Hold for 5 seconds, then slowly lower
  5. Repeat 10 times, 3 times daily

Supported Knee Bends

Purpose: Begins to restore knee flexion (bending)

How to perform:

  1. Sit on a chair or bed edge
  2. Place your non-operated foot under your operated ankle for support
  3. Gently slide your operated foot backward, bending the knee
  4. Hold for 5 seconds, then return to starting position
  5. Repeat 10 times, 3 times daily

Intermediate Exercises (Weeks 2-6)

As your initial surgical pain decreases and basic movement improves, your physiotherapist will progress your exercises to focus more on building strength and increasing range of motion.

Standing Knee Bends

Purpose: Improves knee flexion and quadriceps control

How to perform:

  1. Stand facing a support (countertop or sturdy chair)
  2. Bend your operated knee, bringing your heel toward your buttock
  3. Hold for 5 seconds
  4. Slowly lower and straighten
  5. Repeat 10 times, 2-3 times daily

Step-Ups

Purpose: Builds strength for stair climbing and functional activities

How to perform:

  1. Stand facing a small step (start with 10-15cm height)
  2. Place your operated leg on the step
  3. Step up, bringing your other foot onto the step
  4. Step down with the non-operated leg first
  5. Repeat 10-15 times, 2-3 times daily

Knee Extensions

Purpose: Improves ability to fully straighten the knee

How to perform:

  1. Sit on a chair with a small towel roll under your ankle
  2. Tighten your thigh muscle and straighten your knee fully
  3. Hold for 5 seconds
  4. Slowly lower
  5. Repeat 10 times, 3 times daily

Standing Hip Abduction

Purpose: Strengthens hip muscles that support knee stability

How to perform:

  1. Stand holding onto a support
  2. Keeping your leg straight, lift it out to the side
  3. Keep your body upright (don't lean)
  4. Hold for 3 seconds
  5. Slowly return to starting position
  6. Repeat 10 times on each leg, 2-3 times daily

Seated Knee Flexion (Bending)

Purpose: Increases knee bending range of motion

How to perform:

  1. Sit on a chair with feet flat on floor
  2. Slide your operated foot back, bending your knee as far as comfortable
  3. Hold for 5-10 seconds
  4. Return to starting position
  5. Repeat 10 times, 3 times daily

Advanced Exercises (Weeks 6-12)

These exercises should only be started when approved by your surgeon or physiotherapist, typically around 6 weeks post-surgery.

Mini Squats

Purpose: Builds functional strength for daily activities

How to perform:

  1. Stand with feet shoulder-width apart, holding a stable support
  2. Bend both knees slightly, as if beginning to sit (no deeper than 45 degrees)
  3. Hold for 3 seconds
  4. Slowly straighten back up
  5. Repeat 10 times, 2-3 times daily

Single Leg Balance

Purpose: Improves stability and proprioception (position sense)

How to perform:

  1. Stand near a support but try not to hold it
  2. Shift weight to your operated leg
  3. Slightly lift your other foot off the ground
  4. Balance for 10-30 seconds
  5. Repeat 3-5 times, twice daily

Stationary Cycling

Purpose: Builds endurance and improves range of motion

How to perform:

  1. Start with the seat high and minimal resistance
  2. Pedal forward with smooth, controlled movements
  3. Begin with 5-10 minutes, gradually increasing to 20-30 minutes
  4. Lower the seat as knee flexion improves

Walking Programme

Purpose: Builds functional endurance and normalises gait pattern

How to perform:

  1. Walk on flat, even surfaces initially
  2. Start with 5-10 minutes, 2-3 times daily
  3. Gradually increase duration by 5 minutes per week
  4. Focus on heel-to-toe pattern and even weight distribution

Exercise Dos and Don'ts

Do:

  • Perform exercises as frequently as recommended by your physiotherapist
  • Use proper technique—quality matters more than quantity
  • Apply ice after exercising if you experience increased pain or swelling
  • Progress gradually rather than pushing too hard too soon
  • Take prescribed pain medication before exercise sessions if needed
  • Wear supportive footwear for standing exercises

Don't:

  • Continue exercises that cause sharp or severe pain
  • Skip sessions—consistency is key to recovery
  • Add extra repetitions or exercises without professional guidance
  • Perform high-impact activities (running, jumping) without medical clearance
  • Compare your progress to others—recovery rates vary significantly

Signs of Potential Problems

While some discomfort during exercises is normal, the following symptoms should be reported to your healthcare provider:

  • Sharp, severe pain during specific movements
  • Increasing rather than decreasing pain over time
  • Significant swelling that doesn't improve with rest and elevation
  • Redness, warmth, or drainage around the incision
  • Clicking or clunking sensations that are new or worsening
  • Inability to bear weight on your operated leg

Conclusion

A structured, consistent approach to post-knee replacement exercises is essential for achieving optimal results from your surgery. The exercises outlined in this guide represent the foundation of a typical rehabilitation programme, but your physiotherapist will tailor recommendations to your specific needs and progress.

Remember that recovery is not a race—progress happens at different rates for different people. Focus on quality of movement rather than rushing through repetitions, and communicate regularly with your healthcare team about your challenges and achievements.

Our healthcare provider marketplace can help you find specialist physiotherapists experienced in knee replacement rehabilitation, ensuring you receive expert guidance throughout your recovery journey. With the right support and commitment to your exercise programme, you can look forward to restored mobility and reduced pain with your new knee.

Common Questions About Post-Knee Replacement Exercises

Basic exercises typically begin the day after surgery while you're still in hospital. Your physiotherapist will introduce gentle movements that activate muscles without putting stress on your new joint. These early exercises are crucial for preventing complications and beginning the rehabilitation process, even though they may seem simple.

Most exercise programmes recommend performing the routine 2-3 times daily during early recovery. Some simple exercises, like ankle pumps and quadriceps sets, may be recommended more frequently (hourly while awake). Your physiotherapist will provide a personalised schedule based on your specific needs and progress.

Some discomfort during exercises is normal, but pain should be manageable. A good guideline is the 2-hour rule: if your pain is significantly worse two hours after exercising compared to before, you may be doing too much. Mild discomfort that subsides quickly after completing exercises is typically acceptable. Sharp, severe, or persistent pain should be reported to your healthcare provider.

Swimming is usually permitted once your surgical wound is completely healed, typically around 6 weeks post-surgery. Start with walking in water before progressing to swimming. Stationary cycling can often begin earlier (around 3-4 weeks) with the seat adjusted high to limit knee bending. Outdoor cycling is typically recommended after 8-12 weeks, depending on your balance, strength, and comfort level.

The formal rehabilitation period typically lasts 3-6 months, but many surgeons recommend continuing some form of exercise indefinitely to maintain strength and function in your replaced knee. The specific prescribed exercises will change throughout your recovery, gradually advancing from basic movements to more functional activities.