Best Exercises After A Knee Replacement

By Robert D. Lim PTA

Knee Replacement  Exercises

Phase one of total knee replacement exercises will focus on regaining range of motion for both knee flexion and knee extension. Simultaneously, while trying to improve range of motion we will also try and decrease the post-op swelling and inflammation. Next, During Phase two the goal remains to improve range of motion while working toward full knee extension and knee flexion within a low grade pain scale. Subsequently, you may be able to begin using a stationary bike or floor bike. Additionally, in phase two we will add exercises that will include improving hip and glute strengthening. You will be instructed by your physician or therapist about RICE (Rest, Ice, Compression and Elevation). RICE is a great way to help manage your pain post surgery.

Image of a post op total knee replacement JOI Rehab

Image of Total Knee Replacement

Post Total Knee Replacement Exercises: Phase 1

1. Heel Slides:

First, start by lying on your back either on the bed or on the floor. Then, slowly extend the affected leg straight out if possible. Next, you will bend your knee towards you. Bend your knee as far as possible to your pain tolerance. As a consequence, you might find both motions (flexion and extension) might be difficult due to pain and swelling. Under those circumstances, the pain should never be more than a mild to moderate discomfort.

2. Supine Knee Extension Stretch:

Lie on your bed or on the floor with your affected leg straight and your heel resting on a pillow, towel or foam roller or anything that your can prop your heel on. Do not have any support under the knee. The purpose of this exercise is to help regain knee extension. Hold this position for at least 5 minutes at a time. Perform at least 3 times per day. You may place an ice bag or ankle weights to assist with pushing the knee down.

3. Quadriceps Set:

Lie on your back on the bed of floor with your affected leg as straight as possible. The other leg can be bent to help support your back. Keep your toes pointed straight up in the air with foot flexed towards you. Tighten your quadriceps muscle like you are attempting to straighten your knee. Hold this contraction for 5 to 10 seconds. Perform 2 sets of 10 repetitions, 1-3 times per day.

Post Total Knee Replacement Exercises: Phase 2

1. Heel Slides:

At this phase we will continue with heel slides but with the use of a towel or rope/exercise rope to assist with gaining more ROM. Again this motion should be pain free or low on the pain scale.

Image of Heel Slide Meniscus Tear Exercise JOI Rehab

Heel Slide Exercise


2. Hamstring Stretch:

With the use of a belt or strap/exercise band around your foot to help you perform a hamstring stretch on your affected side. Try to keep your knee as straight as possible and pull your leg upwards. You should feel the stretch behind your knee and upper thigh. Hold for 30 seconds. Perform 3 repetitions. Furthermore, repeat 1-3 times per day.  You can also do a hamstring stretch from a seated position.

3. Calf Stretch:

With the use of the same belt/strap or exercise band that you used for heel slides and hamstring stretch. Place loop behind the toes with your leg extended, pull your foot towards you. You will feel the stretch behind your calf. Hold this for about 30 seconds. Perform 3 repetitions. Repeat 1-3 times per day.  You can also do a standing calf stretch.

Image of Seated Gastroc Stretch Meniscus Tear Exercise JOI Rehab

Seated Calf Stretch Exercise

4. Straight Leg Raise:

Lie on your back with your affected leg straight. The other leg will be bent to help relieve pressure on your lower back. Keep your toes pointed straight up in the air. Then, raise your leg parallel to the bent leg. Use your opposite knee as a guideline.  Don’t arch your back and keep your abdominals engaged.   You could also add an ankle weight to increase the resistance. Do this only if you are able to perform about 30 reps without difficulty. Perform 2 sets of 10 repetitions, 3 times per day.

JOI Rehab Straight Leg Raise

Image of man doing a straight leg raise

5. Seated Knee Extension:

Sit on the edge of you bed or chair. Your affected leg will be in a bent position to start off. Next, you will kick your leg out into a straight position. When you maintain the straight position, you will hold this for 3-5 seconds and the same time contracting the quad. Perform 2 sets of 10 repetitions. Perform this 3 times per day.

6. Standing Knee Flexion (Hamstring Curls):

Stand behind a chair or next to a countertop. Keep your feet about hip or shoulder width apart. Then proceed to try to bend your knee and kick yourself in the buttock. Keep your thighs parallel to each other. Hold this for 3-5 seconds. Perform 2 sets of 10 repetitions, 1-2 times per day.

Image of Hamstring Curl knee replacement Exercise JOI Rehab

Hamstring Curl Exercise

7. Mini Squats:

The starting position will be with your hand or something that is stationary. Second, your feet will be approximately hip width apart. Slowly lower yourself towards a seated type position. Then, hold this position for 5 seconds. Perform 2 sets of 10, 1-2 times per day. The advanced exercise of the mini squat will be a full squat. Either, with or without assistance of your arm.

If you have already had your surgery, it is important to start physical therapy and be shown the correct way to do these exercises.

Related Links: Total Knee Replacement, Concentric vs Eccentric Exercises and Knee Replacement Rehab. 

By : Robert D. Lim PTA

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