Total Knee Post Op Exercises

Post-Operative Exercises after Total Knee Replacement

After a total knee replacement, patients should gradually return to normal, everyday activities using pain and fatigue as a guide for progression. You should consistently follow the exercises given to you at the hospital until your first physical therapy appointment, no later than two weeks after surgery.

The initial therapy focus should be on range of motion and will require daily exercises prescribed by your physician and physical therapist. You will need to work through discomfort to get your knee fully straight and bent. Consistent work on range of motion during the first eight weeks is critical to a successful outcome. Focusing on a normal walk will help with strengthening. Do not push the pace or distance, focus on a smooth and normal gait “heel-toe” pattern, with emphasis on straightening your knee as you step.

The following is a general guide for postoperative total knee rehabilitation. Most patients do require formal physical therapy for several months after a total knee replacement to have a successful outcome. As you and your therapist work to improve your range of motion, you should expect some discomfort. Your therapist will be able to adjust your exercise routine so that your specific needs are met.

Early Postoperative Weeks 1-2: These exercises should begin immediately after surgery and continue until you have started formal physical therapy. Your therapist may ask you to continue some or all of the initial exercises and will start you on some bending exercises. You should also continue any other exercises given to you by your therapist at the hospital.


The following exercises can be completed in bed:

  • Ankle Pumps (gad pedals): Slowly push your foot up and down. Perform 10 repetitions every 5-10 minutes. As your activity level increased, perform these exercises during periods of prolonged sitting.
  • Glute Sets: While lying on your back or seated, tighten your buttocks muscles and hold for a count of 5. Repeat 10 repetitions 3-4 times per day.
  • Quad Sets: While lying on your back or seated with your leg out straight and heel on the floor, tighten your thigh muscles and hold for a count of 5. Repeat 10 repetitions 3-4 times per day.
  • Extension Hangs: While lying on your back, put a towel roll or pillow under your heel so there is a space under your knee. Relax in this position, allowing gravity to straighten your knee. It is common for this to be a bit uncomfortable. Sustain for 1-3 minutes and repeat 2-3 repetitions 3 times per day.


  • Soon after your surgery, you will be out of bed and able to stand. When moving from lying to sitting and sit to stand, it is common to feel a bit dizzy the first several times. While doing the standing exercises, use a counter or something firm to steady your balance until a few weeks have passed and you have regained the strength to remain confident and steady during the standing exercises.

Weight shifts:

  • While standing at your kitchen counter or table for balance assistance, slowly shift your weight from one let to the other, for a total of 20 repetitions, repeating 3-4 times per day.


  • As you are comfortable, you should begin taking regular walks throughout the day. Focus on a normal gait pattern and do not push to fatigue in the first several weeks. Attempt short 2-5 minute walks regularly throughout the day.