Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board
Knee replacement exercises are a vital part of the recovery process to ensure you get the best results from your new knee.
Surgery is just one part of the treatment for knee arthritis - what you do before and afterwards will have a big impact on your recovery.
After a knee replacement, you can get up and about very quickly. As well as practising walking, it is also important to be doing knee replacement exercises to build up the strength of the new knee and get it moving properly.
Here you will find a whole range of knee replacement exercises that are really good to do in the early stages following surgery. They are also suitable to do beforehand in preparation for operation. All these exercises are suitable for both Total Knee Joint Replacements and Partial Knee Replacements (aka uni-knees).
Knee replacement exercises are a vital part of making a good recovery following a knee replacement.
Knee replacement exercises help to improve:
Knee replacement exercises can be started straight away after a knee replacement and will need to be continued for at least three months.
It can also really help to do the knee replacement exercises before you have your surgery, to make sure the muscles are in the best state possible. Starting early can make all the difference to the recovery process.
I have ordered the knee replacement exercises starting with those to do in bed, then in a chair and then the exercises to do standing up so you can progress through as you recover. Choose the ones you find work best for you – keep doing them until they become too easy.
I would also recommend checking out the Exercise Top Tips and Getting The Best Results pages to ensure you achieve the best results from your knee replacement exercises.
These knee replacement exercises are all done lying down so can be started almost immediately after surgery. They will help to loosen up the new knee and reduce the swelling.
Foot pumps are the best place to start with knee replacement exercises after surgery as they promote good circulation in your leg and prevent Deep Vein Thrombosis (blood clot).
You can stop doing this exercise once you are regularly walking around.
Ankle circles are another good exercise to promote good circulation in your leg to prevent Deep Vein Thrombosis.
Note: You can stop doing this exercise once you are regularly walking around
Quad clenches are a great way to maintain and strengthen the Quads without moving the knee and are one of the simplest knee replacement exercises to help you achieve full straightening of the knee.
Variations: If you are struggling to get your knee to straighten fully, place a rolled up towel underneath the ankle so that your leg is lifted slightly on the bed. Then do the exercise as described. Lifting the knee up slightly lets gravity help the knee to straighten
Heel slides are a really good knee replacement exercise to do in the early stages to loosen your knee up without needing much strength.
Progression: Carry out the exercise as above but when you’ve bent your knee as much as you can hook a towel over the ankle and pull it towards you to help the knee bend further – you can achieve the same effect by hooking your opposite foot over the ankle and pushing with that leg to gain more knee bending.
Variations: Make the exercise easier by placing a board and/or a plastic bag underneath your foot so you have a slippery surface making it easier to move
Another good strengthening knee replacement exercise to start with as it doesn’t require much knee movement.
Progression: 1. Increase the size of the towel under the knee
2. Add a weight e.g. by wearing a shoe, or using a light ankle weight. Progress further by using a heavier weight
The straight leg raise is an excellent knee replacement exercise for strengthening the quads without having to bend the knee. It also makes getting in and out of bed easier.
NB Not appropriate if you have a history of back problems
Progression: Add a weight e.g. by wearing a shoe, or using an ankle weight
Top Tip: You might find that when you first start doing this knee replacement exercise that your knee bends slightly when you first lift the leg - this is due to weakness in the quads. Keep going - it will come!
You should be able to start these seated knee replacement exercises as soon as you are able to get out of bed.
Long arcs are a great way to strengthen the quads and increase knee mobility. They are a great knee replacement exercise to do anytime you are sitting for prolonged periods (30mins+) to stop the knee from getting stiff.
Progression: Strengthen further by adding a weight either by wearing a shoe or ankle weights.
Heel slides in a chair are one of the best knee replacement exercises for regaining knee flexion.
Progression: 1. Hook your other foot around the front of the ankle and push backwards with it to further bend your knee
2. Once you have slid your heel back as far as you can, raise yourself up on your chair using your arms and slide you bottom forwards keeping your foot still. You will find this makes your knee bend even more.
A simple, yet effective exercise to maintain and strengthen the Glutes (buttocks) without having to move the knee. If the glutes are weak, more force goes through the knee, so glutes strengthening should always form part of knee replacement exercises.
This is essentially four knee replacement exercises in one - it strengthens the quads, improves knee mobility, improves circulation and loosens up the legs after you’ve been sitting for a while.
Once you are feeling confident on your feet, you can start these standing knee replacement exercises. Hold onto something stable like a table or the wall for some balance.
Kick backs help strengthen the knee and also help improve flexibility – both vital components of knee replacement exercises rehabilitation.
Progression: Add a weight e.g. shoe or ankle weight
Top Tips: 1. Don’t bend forwards - keep your body upright
2. keep your knees in line with each other- don’t let your thigh come forwards.
Heel raises help to strengthen the calf muscles which provide support the knee. The calf muscles often get forgotten with knee replacement exercises.
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Once you can happily do all of these knee replacement exercises, you are ready to progress onto more advanced exercises.
If you want to know more about knee replacements, including information on knee replacement recovery and frequently asked questions, use the links.
Remember, you will need to continue with these exercises for a good few months to get the most benefit. You will gradually be able to reduce how often you do them, but don't stop your knee replacement exercises until you have regained full strength, movement and function in your knee.
Page Last Updated: 11/01/23
Next Review Due: 11/01/25
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1. BMC Musculoskeletal Disorders: What is the evidence to support early supervised exercise therapy after primary total knee replacement? A systematic review and meta-analysis. Sattler L, Hing W, Vertullo C. January 2019.
2. Ontario Health Technology Assessment Series: Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis. Medical Advisory Secretariat. June 2005
3. Guy's & St Thomas' NHS Foundation Trust: Physiotherapy advice following total knee replacement surgery. Guy's & St Thomas' UK. February 2013