Total Knee Replacements and Post-Surgery Exercises: A Comprehensive Guide to Recovery 

Total knee replacement surgery (Total knee replacement, TKR or Total knee Arthroplasty, TKA) is a life-changing procedure that can bring relief to those grappling with chronic knee pain and limited mobility. While the surgery itself is a critical step, the journey to full recovery doesn’t end in the operating room. While this is a very common procedure, make no mistake that this is a big surgery and requires significant work after the operation for it to be effective. Post-surgery exercises play a crucial role in restoring strength, flexibility, and function to the knee joint. Without diligence to your exercise regime, the knee can get stiffer than prior to accident. However, if done correctly, you will have a painfree knee will be able to go back to your usual activities. In this comprehensive guide, we’ll explore the importance of exercises after a total knee replacement and provide a selection of effective exercises to support your recovery.  

The Importance of Post-Surgery Exercises: 

  1. Restoring Range of Motion: After surgery, it’s common for the knee joint to feel stiff. Gentle exercises help improve flexibility and restore a full range of motion. Getting full extension in your knee (straightening it) is crucial in the first 4 weeks post surgery. A straight knee is essential for proper gait. Flexion (bending it) will take longer and progress over the next 6-12 weeks. 
  1. Building Strength: Strengthening the muscles around the knee is vital for stability and support. Targeted exercises can enhance muscle strength, promoting better joint function. 
  1. Reducing Swelling and Improving Circulation: Proper exercises can aid in reducing postoperative swelling and promote better blood circulation, contributing to a faster and more comfortable recovery. 

Early Post-Surgery Exercises: 

  1. Ankle Pumps: While lying down, gently move your ankles up and down to improve circulation and prevent blood clots. 
  • Aim for 3 sets of 20 reps, every 2-3 hours throughout the day. 
  1. Quad Sets: Tighten the muscles at the front of your thigh (quadriceps) and hold for a few seconds. This helps strengthen the quadriceps muscles without putting strain on the knee joint. 
  • Aim for 3 sets of 10 reps, 3 second holds, every 2-3 hours throughout the day. 
  1. Straight Leg Raises: Lie on your back with one leg bent and the other straight. Lift the straight leg off the ground, keeping the knee straight, and hold for a few seconds before lowering it back down. 
  • Aim for 3 sets of 10 reps, 3 second holds, every 2-3 hours throughout the day. 

Range of Motion Exercises: 

  1. Heel Slides: While lying on your back, gently slide your heel toward your buttocks, bending your knee as far as comfortable. Hold, then return to the starting position. You can use a towel or band to help bend if further. 
  • Aim for 3 sets of 10 reps, 30 second holds, at least 3 times a day. 
  1. Passive Knee Extension: Sit on a chair with your feet flat on the ground. Place a rolled towel under your ankle and let your knee gently straighten under the towel’s weight. 
  • Aim for 3 sets of 10 reps, 30 second holds, at least 3 times a day. 
  1. Knee Flexion Stretch: Sit on the edge of a bed or chair with your surgical leg extended. Slowly slide your foot back until you feel a gentle stretch in the knee. Hold, then relax. 
  • Aim for 3 sets of 10 reps, 30 second holds, at least 3 times a day. 
  1. Stationary Bike Riding: Begin with a few minutes of gentle pedaling, Gradually increase the duration and resistance as tolerated. Cycling helps improve joint mobility and increases circulation. 

Strengthening Exercises: 

  1. Terminal Knee Extension: Stand with your back against a wall and a rolled towel behind your surgical knee. Straighten your knee against the towel’s resistance, then slowly release. You can also do this by tying a theraband around knee joint to an object in front of you and straighten your knee against the resistance of the theraband. 
  • Aim for 3 sets of 15 reps, at least 3xday 
  1. Squats / Sit-Stands: While sitting, focus on leaning forward and pushing off your heels to stand up straight. Make sure to get your quads and glutes engaged and fully straightening your knee and hip. Slowly sit back down controlled. If you feel unsteady, hold onto a walker or a table initially to get your balance. 
  • Aim for 3 sets of 10 reps, at leat 3xday. 
  1. Step-Ups: Stand in front of a step or low platform. Step up with your surgical leg, then step down. Use a railing or support for balance if needed. If it feels too difficult, start by going up with your good leg and going down on your surgical leg. 

Safety Tips for Post-Surgery Exercises: 

  1. Start Slowly: Begin with gentle exercises and gradually progress as your strength and comfort levels improve. 
  1. Listen to Your Body: If an exercise causes pain or discomfort beyond the normal expected level, stop and consult your physical therapist or healthcare provider.  
  1. Take your medication: Take your pain medication as prescribed by your surgeon to help ease the discomfort during the exercises. There will be discomfort when trying to regain range of motion post surgery. 
  1. Icing: Make sure to ice your knee to keep your inflammatory levels down. 15 minutes after a set of exercises is ideal to allow you to consistently do your exercises daily. 
  1. Consistency is Key: Regular, consistent exercise is essential for a successful recovery. Follow your prescribed exercise routine diligently. 

What our physiotherapists can do for you: 

  1. Manual Therapy / Stretching: Our physiotherapists are all trained in evidence based manual therapy techniques that can help aid you through your recovery quicker. Manual therapy is designed to help with increasing range of motion and decreasing pain and stiffness. 
  1. Prescribing Exercises: As mentioned above, exercises are the key to a proper knee replacement recovery. Our physiotherapists all specialize in prescribing and modifying exercises to make your journey easier.  


Total knee replacement surgery is a transformative journey, and post-surgery exercises are a cornerstone of the recovery process. By incorporating these exercises into your rehabilitation plan, you can enhance your chances of regaining optimal knee function and enjoying a more active, pain-free lifestyle. Our physiotherapists at Revere Physiotherapy have a combined 10+ years working at hospitals around the lower mainland and specialize in total knee replacement rehabilitation. Remember, always consult with your healthcare team before starting any exercise regimen to ensure it aligns with your individual recovery needs. 

Reach out to us at with questions regarding your recovery! 

We also offer free 10 minute consultations to help you determine fit. Call us at 604-566-5108 and we will set you up with one of our expert physiotherapists.  

Book an appointment right away if you feel ready to do so! 

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