Knee Replacement Exercises

Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board

Knee replacement exercises are really important to regain full strength, flexibility and function in your new knee. Find out which exercises work best at each stage of recovery

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).

Why Do Knee Replacement Exercises?

These knee replacement exercises will help to improve:

1) Flexibility: exercises will loosen up the knee helping it to bend, straighten and rotate more 

2) Strength: exercises help to improve the strength, endurance and control of the knee

3) Function: as the strength and flexibility of your knee improve, you will find it  gets gradually easier to do daily activities e.g. walking and stairs.

Knee 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. 

Knee Replacement Exercises: Lying

These knee replacement exercises can be started almost immediately after surgery.  They will help to loosen up the new knee and reduce the swelling.

1) Foot Pumps

Purpose: Promote good circulation in your leg and prevent Deep Vein Thrombosis (blood clot).  This is one of the best knee replacement exercises to start with

Foot pumps are a great knee replacement exercise to start with after surgery.

Starting position: Lying flat on your back or sitting up. Leg and knee straight

Action: Pull your foot up towards you, keeping the rest of your leg straight. Hold for 3 secs. Then point your toes down away from you. Hold for 3 secs

Repetition: Repeat for about 1 minute every 2-3 hours

Note: You can stop doing this exercise once you are regularly walking around

2) Ankle Circles

Purpose: Promote good circulation in your leg to prevent Deep Vein Thrombosis (blood clot)

Ankle circles can be done lying down or sitting up after a knee replacement to help improve circulation and reduce the risk of blood clots

Starting Position:  Lying flat on your back or sitting up. Leg and knee straight

Action: Move your ankles as if you were drawing circles with your feet. Do this for about 1 minute and then repeat in the opposite direction

Repetition: 1 minute in each direction every 2-3 hours

Note: You can stop doing this exercise once you are regularly walking around

3) Quad Clenches

Purpose: Maintain and strengthen the Quads without moving the knee, enable full straightening of the knee

Starting position: Lying flat on your back or sitting up. Leg and knee straight

Action: Tighten the muscle on the front of the thigh by pushing your knee down. You should feel your thigh muscles clench. Hold for 3 secs

Repetition: Repeat 10-20x every 3-4 hours

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

4) Heel Slides - Lying

Intro: This is really good knee replacement exercise to do in the early stages to loosen your knee up without needing much strength

Starting Position: Lying flat on your back or sitting up. Leg and knee straight out on a bed or along the floor.

Action: Slide your heel towards your bottom as far as you comfortably can, bending your hip and knee. Keep your heel on the bed/floor. Hold for 3-5 secs and slowly return to starting position

Repetition: Repeat 10-30 times, 2-3x daily. Gradually aim to bend your knee a little more each time

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

5) Short Arcs

Intro: Good strengthening knee replacement exercise to start with as it doesn’t require much knee movement

Starting position: Lying flat on your back or sitting up with your leg horizontal on a flat surface such as a bed. Place a rolled up towel (approx 10cm diameter) under the knee

Action: Pull your toes towards you and clench you thigh muscles. Slowly lift your foot up off the bed until your knee is straight (keep your knee resting on the towel). Hold for 3-5 secs and slowly lower

Repetition: repeat 10-30 times, 2-3x daily

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

6) Straight Leg Raise

Intro: Excellent knee replacement exercise for strengthening the quads without having to bend the knee. Also makes getting in and out of bed easier NB Not appropriate if you have a history of back problems

Starting position: Lying flat on your back. Leg and knee straight

Action: Pull your toes towards you and tighten/clench the muscle on the front of the thigh, locking your knee straight. Lift your foot up about 6 inches off the bed. Hold for 3-5 secs and slowly lower. Ensure your knee stays straight the whole time

Repetition: repeat 10-20 times, 2x daily

Progression: 1) Add a weight e.g. by wearing a shoe, or using an ankle weight

Knee Replacement Exercises: Sitting

You should be able to start these knee replacement exercises as soon as you are able to get out of bed.

1) Long Arcs

Purpose: Strengthen quads, increase knee mobility, great to do anytime sitting for prolonged periods (30mins+) to stop the knee getting stiff

Starting position: Sitting on a firm chair with your knee bent and your foot on the floor

Action: Lift your foot up and straighten your knee as much as possible. Hold for 3-5 secs and slowly lower

Repetition: 5-20 times, 3xdaily

Progression: Strengthen further by adding a weight either by wearing a shoe or ankle weights.

2) Heel Slides - Sitting

Purpose: Increase knee mobility and aid circulation

Starting Position: Sitting on a dining chair with your knee bent and your foot on the floor

Action: Slide your foot backwards on the floor as far as comfortable so you are bending the knee more. Hold for 3-5 secs

Repetition: Repeat 10-25x 3x daily

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.

3) Buttock Clenches

Purpose: Maintain and strengthen the Glutes (buttocks) without the knee moving. If the glutes are weak, more force goes through the knee.

Starting position: Lying down or sitting up.

Action: Clench your buttocks together and hold for 3 seconds. You should feel yourself rise up slightly

Repetition: Repeat 10-20x every 3-4 hours

4) Knee Marching

Intro: Four exercises in one - Strengthens quads, improves knee mobility, improves circulation and loosen up the legs when you’ve been sitting for a while

Starting Position: Sit in a chair with your feet on the floor

Action: March your legs up and down one at a time. Lifting your knee and foot up and then back down

Repetition: Repeat for about 1 minute, 2x daily and any time you are sitting for more than 20 mins to stop your knee getting stiff

Standing Knee Replacement Exercises

Once you are feeling confident on your feet, you can start these standing knee replacement exercises.  Hold onto something stable like a table for some balance.

1) Kick Backs

Intro: This helps strengthen the knee and also helps improve flexibility – both vital components of knee replacement exercises rehabilitation

Starting Position: Stand up straight holding on to something stable e.g. chair or table

Action: Lift your foot up as far as you can towards your bottom, bending the knee. Hold for 3-5 secs

Repetition: Repeat 5-25 times, 2x daily

Progression: Add a weight e.g. shoe or ankle weight

Note: 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

2) Heel Raises

Purpose: Strengthen the calf muscles to help support the knee

Starting position: Stand with your feet slightly apart, weight equally distributed, holding onto something solid for balance e.g. kitchen work surface or wall.

Action: Rise up onto your toes lifting your heels as high as possible. Keep your body upright (don’t bend forwards). Hold for 3-5 secs and slowly lower

Repetition: Repeat 10-30 times, 2x daily

What Next?

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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, click 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 and movement.

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Page Last Updated: 02/05/19
Next Review Due: 02/05/21


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

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