Pre & Post Knee Replacement Exercises: A Comprehensive Guide

It is Stephen Dunn from CORE Therapy and Pilates. I am a Pilates physical therapist in West Lake Hills, TX, and I have been serving the people in the area with knee pain, knee arthritis and post op total knee replacement since 2005. I want to present a series of knee exercises designed to prepare individuals for knee replacement surgery and to aid in post-operative recovery. These exercises are not only beneficial for those undergoing surgery but also for those experiencing knee pain or stiffness.

What exercises should I do when I get my total knee replacement?

Essential Equipment:

  • A rolled-up towel
  • A foam roller

Exercises to Strengthen Your Knee:


Quad Set:

  • Place the towel roll under the knee.
  • Tighten the quadricep muscle on top and push the knee down into the towel.
  • This is an isometric exercise: hold for five seconds and relax.
  • Repeat the process.

Hamstring Set:

  • Position your leg so that you can pull it towards you using the hamstring.
  • This can be done on the edge of a table or against the ground.
  • Pull the heel towards you (it won't actually move) and hold for five seconds, then relax.

Short-Arc Quad:

  • Lay on your back with the foam roller under your knee.
  • Tighten the quadricep and lift the foot while keeping the knee down.
  • Hold the position for five seconds and then relax.

Straight Leg Raise:

  • Remove the foam roller and bend one leg up, keeping the other leg straight.
  • Perform a quad set, then lift the straight leg to the level of the bent knee.
  • Exhale as you lift and inhale as you lower.

Long Arc Quad:

  • Sit on the edge of a table or chair.
  • Straighten the knee and hold the position isometrically for five seconds, then lower.


  • Aim for about twenty repetitions for each exercise.

These exercises are foundational for anyone looking to maintain or improve their knee health, especially before and after surgery. Remember, always consult with a specialist before starting any new exercise regimen.

For personalized guidance or further inquiries, contact a client specialist at 512.215.4227.

What exercises to avoid after total knee replacement?

After a total knee replacement, it's essential to follow your surgeon's and physical therapist's advice on which exercises to avoid to ensure proper healing and prevent complications. While the specific recommendations can vary based on individual circumstances, here are some general exercises and movements that are often advised against during the early stages of recovery:

High-Impact Activities:

  • Running or jogging
  • Jumping or any plyometric exercise

Deep Squats or Lunges:

  • These can put excessive strain on the new knee joint.

Twisting Movements:

  • Rotating the knee, especially under weight or resistance, can be harmful.


  • This can be uncomfortable and might be discouraged, especially in the early stages after surgery.

Leg Extensions with Heavy Weights:

  • Using heavy weights can put undue stress on the knee joint.

High-impact Sports:

  • Sports like basketball, tennis, or soccer which involve rapid changes in direction and the potential for collision.

Excessive Stair Climbing:

  • While stairs are often part of the rehabilitation process, excessive stair climbing can be strenuous on the new joint.

Deep Flexion Activities:

  • Such as sitting cross-legged, squatting, or any activity that requires bending the knee more than 90 degrees.

Any Exercise that Causes Pain:

  • It's essential to listen to your body. Mild discomfort can be expected, but sharp pain is a sign to stop and consult your therapist or surgeon.

Lifting Heavy Weights:

  • Especially in a manner that puts significant stress on the knees.

It's crucial to remember that as you progress in your recovery, some of these restrictions may be lifted, and you might be able to gradually reintroduce certain activities with the guidance of your healthcare professionals. Always prioritize safety and ensure that you're following the prescribed rehabilitation program to achieve the best outcomes after your total knee replacement.

What helps knee replacements heal faster?

Recovering from a total knee replacement requires patience, but there are several strategies and best practices that can help expedite the healing process:

Follow Physical Therapy Recommendations:

  • Engage in prescribed exercises to strengthen the muscles around the knee and improve flexibility.
  • Attend all physical therapy sessions and follow the therapist's advice.

Manage Pain and Swelling:

  • Take prescribed pain medications as directed.
  • Use ice packs on the knee to reduce swelling.
  • Elevate the leg to help decrease swelling.

Maintain a Healthy Diet:

  • Eat a balanced diet rich in protein, vitamins, and minerals to support tissue healing.
  • Stay hydrated.

Avoid High-Impact Activities:

  • As mentioned previously, avoid activities that put excessive strain on the new knee joint.

Wear Compression Stockings:

  • These can help reduce the risk of blood clots and decrease swelling.

Practice Good Wound Care:

  • Keep the surgical site clean and dry.
  • Follow your surgeon's instructions regarding wound care and when you can shower or bathe.

Stay Active:

  • Engage in low-impact activities like walking, as recommended by your therapist or surgeon.
  • Avoid sitting or lying down for extended periods. Move around periodically to promote circulation.

Use Assistive Devices:

  • Initially, use walkers, crutches, or canes as advised to ensure you don't put too much weight on the new knee too soon.

Stay Positive and Patient:

  • A positive mindset can significantly impact recovery. Understand that healing is a process and celebrate small milestones.

Avoid Smoking and Excessive Alcohol:

  • Smoking can delay bone and wound healing.
  • Excessive alcohol can interfere with medications and the healing process.

Sleep and Rest:

  • Ensure you get adequate sleep, as the body heals faster when well-rested.
  • Take short naps during the day if needed.

Stay Hydrated:

  • Drink plenty of water to support cellular functions essential for healing.

Follow-up Appointments:

  • Attend all scheduled check-ups with your orthopedic surgeon to monitor your progress and address any concerns.

Educate Yourself:

  • Understand the do's and don'ts after surgery. Being informed can prevent actions that might hinder recovery.

Remember, every individual's healing process is unique. Always consult with your healthcare professionals to ensure you're taking the right steps for your specific situation.

Learn more about exercises after a total knee replacement here.

Check out our blog offering tips for knee arthritis HERE.

Take the Next Step Towards a Pain-Free Life! If you're scheduled for a total knee replacement or have been diagnosed with knee arthritis or osteoarthritis, don't navigate this journey alone. Call us at 512-215-4227. Our team is here to guide, support, and provide the expert care you deserve. Make the call today and invest in your mobility and quality of life.