Physiotherapy after knee replacement: a week-by-week guide

Every surgeon has their own protocol, and your own recovery will depend on your health and fitness before the operation. Always follow your surgeon’s instructions — this guide shows the usual pattern so you know what to expect.

Before surgery: get stronger

If your operation is planned, a few weeks of exercise beforehand (“prehab”) builds strength in the thigh and hip muscles, improves movement, and lets you learn the exercises you will need afterwards. People who go into surgery stronger usually find recovery easier.

In hospital: the first few days

• Physiotherapy usually starts within a day or so of surgery.
• Ankle pumps — moving your feet up and down — keep the blood flowing.
• Quadriceps tightening — pressing the back of the knee down into the bed — wakes up the thigh muscle.
• Gentle bending of the knee, and walking with a walker as your team advises.

Weeks 1–2 at home

• Focus on getting the knee fully straight and bending it a little more each day.
• Control swelling with rest, elevation and cold packs as your surgeon advises.
• Short, frequent walks around the house with your walker.
• Many people aim to bend the knee to around 90 degrees in the first couple of weeks — your surgeon will tell you your targets.

Weeks 2–6

• Strengthening exercises become more important: straight leg raises, sit-to-stand from a firm chair, small knee bends.
• Gradually moving from a walker to a walking stick, when your physiotherapist and surgeon agree.
• Learning stairs: up with the good leg first, down with the operated leg first, using the railing.

Weeks 6–12

• Walking further without support, and more natural walking without a limp.
• Balance exercises, getting up from lower seats, and returning to more daily tasks.
• Driving, travel and returning to work, when your surgeon says it is safe.

After three months

Most people are walking well and doing everyday activities by now, but strength and stamina keep improving for many months. Full recovery can take up to a year, so keep up your exercises.

Tips for a better recovery

• Be regular. Short, frequent exercise sessions every day matter more than occasional long ones.
• Plan pain relief as prescribed so you can exercise comfortably.
• Don’t put a pillow under the knee when resting — it can stop the knee from straightening fully.
• Use ice and elevation after exercise if the knee swells, as advised.
• Keep your follow-up appointments with your surgeon.

At Nisarg we guide patients through every stage of rehab after knee replacement, fractures and other operations. See how we help after surgery.

This article is general information to help you understand your options. It is not a substitute for advice from your surgeon or a personal assessment by a physiotherapist.