OrthoVirginia Blog

Physical Therapy after a Knee Replacement

by Sarah Margerison, PT, DPT

You are tired of dealing with the stiffness, swelling, and pain associated with knee arthritis and have finally decided to schedule your partial or total knee replacement surgery. Your friends and family have told you all about how much better you’ll feel and how much more mobile you will be after surgery, but you also know that recovery from a knee replacement takes a lot of work. While it is true that recovery from a partial or total knee replacement takes time, with the proper preparations you will be back to doing the things you enjoy in no time.

Directly Following Surgery

After your surgery, you may stay overnight in the hospital for one or two nights. How long you stay depends on your doctor’s protocol and on your overall health. Before going home, you will likely be evaluated by a physical therapist in the hospital. The physical therapist will assess how you move, including how well you are able to get into and out of bed, go up and down stairs, and get out of a chair. What the therapist decides to evaluate depends on whether you have stairs in your home, where your bedroom and bathroom are in your home, and other similar factors.

The physical therapist in the hospital will also give you a set of exercises to start immediately. These exercises will focus on gaining mobility (ability to move) in your knee and getting strength back in your leg. The therapist in the hospital will also recommend any supplies you will need for when you return home, which may include a walker, shower chair, or other items.

When to Start Therapy

Some people start physical therapy in the clinic right away, while others will start working with a physical therapist who comes to their home. Where you start physical therapy depends on how well you can move around and if you are able to leave your home safely. Normally, therapy begins between two days and one week following your surgery. If you begin therapy in your home, expect to transition to an outpatient clinic within two to three weeks following your surgery.

Exercises to Perform and What to Expect

Immediately following surgery, you will likely experience significant swelling in the leg that had the surgery. The swelling may be in the knee and in the lower leg. You may notice bruising in your knee and lower leg as well. The best way to manage swelling is by icing your knee in an elevated position.

Outside of swelling, you may also notice that your leg feels temporarily weaker. Many times, the quadriceps, the thigh muscle that straightens your knee, will be difficult to “turn on”. This weakness is normal. As soon after surgery as you are able, practice trying to turn on this muscle and holding tension in the muscle for a few seconds. This will help your leg to become stronger and improve your ability to walk. Other exercises your therapist may assign are:
  • Long arc quad: sit in a chair and straighten your knee
  • Heel slides: lay on your back or sit in a chair and drag your foot backwards to bend your knee as much as possible
  • Heel raises: standing on both legs, lift your heels off the ground and lower them back down 
  • Hamstring stretches
  • Calf stretches
Follow the directions of your physical therapist and do the exercises he or she tells you to do.

Time to Recovery

With help from your physical therapist and guidance from your doctor you will regain the flexibility and strength in your knee and will be able to return to most or all the activities you enjoy. Recovery times vary based on the person, but most people return to their full activity in 10 to 16 weeks after a total knee replacement. If you had a partial knee replacement, recovery time is usually a bit shorter. By six months to one year your knee should feel nearly normal.