Physical Therapy For kNee Replacement

Updated: Jun 16

If you are wondering what knee replacement physical therapy is all about this article will walk you through the process we use at HIDEF Physical Therapy.


Knee replacement surgery is no small surgery. The surgery involves replacing the ends of the long bone of the shin and long bone of the thigh as well as putting a plastic back on the knee cap. Some of these surgeries are robotically assisted, while some are still performed in the traditional open surgery manor.



Knee replacement recovery time varies depending on status prior to the surgery but in general can be up to a 1 year long process. I know this sounds like a long time but don't worry, the majority of the gains occur in the first 16 weeks. You will even be walking on your new knee the same day as surgery.


Timeline for knee replacement surgery recovery:

0-6 weeks: Our first goal is to gain back range of motion, reduce swelling, and improve the ability to contract the quadriceps muscle. In the first 6 weeks we will perform a combination of exercise starting on the table and progressing to standing. These include hamstring curls, quad sets, gait training, balance training, and return to squats or sit to stands. These exercises will focus on regaining the ability to activate muscles and improve ability to safely walk, balance, and climb stairs. During this time we will also provide manual therapy such as massage and passive range of motion to help improve mobility of the knee. Depending on your pain level prior to surgery your knee may already be feeling better than it did by 4-6 weeks.


Things to look out for in the first 6 weeks

  • Infection: Usually hot, swollen, and angry skin near the incision site. This is sometimes hard to differentiate from the normal redness and swelling that occurs after surgery

  • Deep vein thrombosis (DVT): this is usually a hot and painful area typically at the calf and back of the knee.



6-12 weeks: The goal over the first 12 weeks is simple. We want to get to a "quite knee". This means full pain free range of motion, minimal swelling, and pain free walking. In this time we want to reduce atrophy that occurs after surgery, and maximize strength. We do this by performing progressive strength exercises including shuttle press, squats, and step ups and step downs from progressively higher steps. We can also use techniques such as blood flow restriction training in certain cases to help us achieve our goals.


12 weeks and on: This is the time when we start to focus on your specific goals. Whether it be golf, tennis, hiking, or simply keeping up with your peers, family members, and grandchildren we can tailor our exercises to meet the goals. After 12 weeks is where we really start to accelerate. We start to incorporate more dynamic balance exercise, resisted stepping, unilateral squatting, and many other strength exercise progressions.


As the months go by your knee will become stronger and stronger. You will continue to regain the ability to do activities that you weren't able to prior to surgery, These improvements can continue to occur up to 18 months after surgery. After about 9 months the improvements are small and incremental but are still important in order to maximize the performance of your new knee.


At HIDEF Physical therapy Bellevue we specialize in knee replacement physical therapy and post operative care.


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