How Physiotherapy Helps in Total Knee Replacement Rehab

Every person’s knee is unique just as every person is different. The rate at which your knee recovers may differ from someone else’s.  If you find you’re not doing really well (pain and swelling not great, range of motion not improving) and would like to do more, listed below are some exercises for knee joint pain.


Early stage (0 – 2 weeks)


  • Swelling control
  • Range of motion (ROM) – 0-100°, focusing especially on getting the knee out straight, ie terminal extension
  • Safe mobilizing – depending on quads control and confidence


  • Take it easy – gentle exercise and short walks. As a general guide, walk to the toilet and meals and a couple of 5 minute walks around the house per day
  • Ice regularly – up to 6x/day for 20 minutes
  • Use a compression bandage to help with swelling
  • If pain or swelling increase with exercises or activity then BACK OFF

Exercises  for knee joint pain:

    • Circulation drills – foot pumping, static quads etc.
    • Calf and hamstring stretches
    • Static quads with small rolled towel working on terminal extension. This is the most important exercise to get your knee straight and activate your thigh muscles.
    • Straight leg raising and or inner range quads over roll


Mid Stage (2 – 6 weeks)


  • Dressing change
  • Swelling reduction
  • A straight knee (terminal extension)
  • ROM 0-120° (by the end of 6 weeks)
  • Walking well


  • Continue regular icing- still up to 6x/day for 20 minutes
  • If pain or swelling increase with exercises or activity then BACK OFF
  • Regular knee physiotherapy to monitor progress


  • Calf / hamstring stretches
  • Static quads with small roll
  • Straight leg raise or Inner range quads over roll
  • Standing 3 way leg swing
  • Calf raise
  • Bending (flexion) drills- in chair or with band or over the edge of a table. Use the ones that work!
  • Practice walking with a good pattern. Try to eliminate limp.

This is an important period in your recovery. The priority is to settle the knee down and work on the range of motion ie. to straighten and bend. If you are too active or push your strength work in this stage, then pain and swelling may slow this process.

4 5

Mid to Late Stage (6-12 weeks and beyond)


  • Strengthening
  • Return to function. Mobilising normally on stairs etc.
  • Continue to work on range of motion (if required)
  • ROM 0-130° or greater (by the end of 12 weeks)


  • Progression of activity
  • You will be back to most activities at 3-4 months but you will still notice that your knee may get warm or swell or feels a little stiff afterwards


  • Strengthening and functional retraining- Bridging, Squats, step ups, sit-stand
  • Gait re-education and balance training
  • Bike or hydrotherapy (hydrotherapy may be commenced earlier if your wound is dry and healed)
  • Walking program – a progressive walking program can usually be commenced after 6 weeks7
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