Have you just had a knee replacement surgery, and you are wondering whether you will need physiotherapy to help you get back to your feet.
⚫In this article I will rely on my knowledge as a radiographer.
⚫I also consulted physiotherapy in the orthopaedic clinic.
⚫And of course, on scientific studies on the subject matter.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: December, 2025. Written by Juliet Semakula, a diagnostic radiographer.
After knee surgery, it is important to relax the knee muscles as much as possible until you are ready to put some weight on the leg and start exercises.
Yes, you will need physical therapy after knee replacement surgery. They are crucial for regaining strength, flexibility, and mobility. While some studies suggest that for certain patients a supervised home exercise program might be sufficient.
Exercise under the guidance of your physiotherapist will form a key part of your recovery.
Some people wonder what can happen when you do not have physiotherapy after knee surgery.
Without physical therapy, the healing process would be much slower, and you may never regain the expected strength or mobility around the injury.
However, I’ve encountered many people who skipped physical therapy after knee arthroscopy without apparent issues.
Recent research suggests physiotherapy exercises are associated with an improvement in physical function and reduced pain at 3-4 months after your total knee replacement. Exercises will help improve your movement and strength, as well as helping to reduce pain and swelling.
▶️What are the three knee surgeries for which physical therapy is most common.
1️⃣Total knee replacement
2️⃣Anterior cruciate ligament
3️⃣Knee arthroscopy
▶️Can you have physical therapy sessions at home for the knee
Yes, you can have physical therapy sessions at home for your knee after surgery.
But normally in the first few days after knee surgery, it’s often difficult to walk long distances. I remember when my friend could not drive and even being in a car was very uncomfortable as a passenger.
Sometimes in the first few weeks after surgery a physiotherapist may make house calls to check on how you are doing and prescribe you simple exercises you can try at home.
Some patients do start simple exercises of knee movement at home until they transition to a clinic for specified therapy.
▶️When should physio start after knee replacement surgery?
The goal of initial rehabilitation is to:
Restore knee range of movement, what your physio wants to see, if you can bend your knee to 90 degrees and be able to straighten the knee without pain.
I have had surgeons advise patients who have had knee arthroscopy, not to start physical therapy until two weeks later.
I think this can be very useful to have a physical therapy assessment during this period to determine what you can or cannot do.
According to some research studies: people who start early rehabilitation within 2 weeks of knee replacement surgery recover better than others (Masaracchio,2017)
In 2019, a randomised controlled trial investigated early exercise therapy protocols after total knee replacement surgery (Sattler 2019)
It showed that a simple self-directed, low-cost, three-exercise bike pedalling–based protocol was superior to a therapist-led standard multi-exercise regimen, for both functional and patient-reported outcomes
Based on the results of this trial, patients who had a total knee replacement completed a few simple home-based exercises focusing on:
⚪Bike pedalling, which is often prescribed in some health care settings, after knee replacement, with the circular motion being theorized to improve flexion range of movement.
A stationary floor pedalling device (Sattler,2019)
⚪ knee extension.
⚪Heel-toe walking practice
For the first two weeks following their knee surgery had optimal outcomes and a good range of movement.
Following this early recovery period, patients were able to gain 90-degree knee flexion. And for those who had difficulty progressing with their mobility benefited from some supervised physiotherapy treatment.
Source: Sattler 2019
▶️How many times a week should I do physical therapy after knee replacement?
Note! Although different exercise prescriptions include a core set of exercises, usually the number of exercises, number of repetitions, and resistance prescribed are normally tailored to each patient’s needs and abilities.
Physical therapy after total knee replacement is a journey that takes time and commitment.
Most patients spend at least 3 months in structured therapy, followed by continued home exercises.
Milestones such as bending the knee, walking without support, and returning to daily activities guide the process.
Some people who have undergone knee replacement surgery may find that only about ten sessions suffice, while others feel the need for several months of rehabilitation.
▶️How much walking is too much after knee replacement?
Generally, it is not recommended to do more walking than is comfortable for you.
➡️At the early stages after a knee replacement, you should start with shorter and manageable walks.
➡️Then gradually increase as you feel. Always listen to your body to avoid over exertion.
➡️Follow a plan: Your physical therapist may provide a specific timeline, such as walking 20 minutes a few times a week initially, and gradually increasing the duration.
➡️Don’t overdo it: Pushing yourself too hard can cause more pain, swelling, and hinder your recovery
➡️Balance activity and rest: Continue to perform your prescribed physical therapy exercises and follow the guidance on increasing walking duration and intensity.
Overtraining: Be cautious about increasing your walking time too quickly between sessions. If your knee becomes swollen, you may be doing too much too early.
Always consult your doctor or physical therapist for more advice because they are dealing with your case. They will be able to give you appropriate guidance based on your specific recovery and goals
▶️Can you do knee rehabilitation on your own?
If you feel reassured, have no concerns, and see how to regain knee flexibility and resume daily activities without the supervision of a physical therapist, then skipping physical therapy is an option!
Your knee will take time and effort for it to heal properly as scar tissue around the knee heals and muscle strength around the knee is restored.
Exercising the main knee muscles is very important both before and after having a knee surgery.
Despite patients with total knee replacement receiving an in-hospital physiotherapy program of some description, the optimum type of total knee replacement exercise intervention in the early postoperative phase remains unknown.
A recent systematic literature review and meta-analysis exposed an urgent need for further high-quality studies into supervised exercise therapy programs that aim to provide greater functional outcomes satisfaction following surgery, particularly in the early postoperative period
Differing health care protocols provide some instruction for exercises after total knee replacement to be used in combination with healthcare professionals’ clinical judgment to adjust or progressions
Here are some of the recommended knee exercises I normally see being recommended by physiotherapists that you can do at home
♦️Knee bends on chair
⚪Sit in a chair with your foot on the ground.
⚪Slide your foot firmly towards you and then release.
⚪Hold for three seconds each time in the fully bent position.
⚪ Don’t allow your hips to move, just the foot.
♦️Inner range quads exercise:
⚪Sit with your knee bent over a rolled-up towel and tighten up your knee muscles to lift your heel off the ground.
⚪Keep your knee firmly down on the roll.
⚪Hold for a few seconds, trying to get your heel as high as you can, then relax and repeat.
⚪If you have kneecap problems, you may need to avoid this exercise if it causes pain.
♦️Passive knee stretches:
⚪Sit or lie with your leg out in front of you. Put your heel up on a block or pillow so that the knee hangs in mid-air.
⚪Let your knee stretch for a short time under its own weight, building up to about five minutes (or less if it’s painful).
♦️ Static quad exercise:
⚪With your knee straight, tense up the front muscles of your thigh as if you’re trying to straighten your knee and lift your heel.
⚪Hold for a few seconds then relax.
♦️Straight-leg raise:
⚪Sit or lie with your leg out straight.
⚪Tighten your thigh muscles, straighten your knee and lift your whole leg 6 inches up off the bed or floor.
⚪Hold for three seconds and then lower slowly.
Caution! Don’t do this exercise if you’ve had a total hip replacement on the same side.
Most research studies of the currently available literature fail to demonstrate any significant benefit for supervised physiotherapy over unsupervised home exercise regimens following primary knee surgery as a routine practice.
Ultimately, adherence to your physical therapist’s instructions is crucial for maximizing the function and longevity of your new knee joint.
We have come to the end of this article; any questions and experience let’s meet in the comments section. Wishing you a quick recovery!🙋
You may also be interested in these articles.
⚫A total knee replacement recovery time-line?
⚫How to sleep with a broken knee? 4 tips for comfort.
⚫When to worry about swelling after knee surgery?
⚫What is the recovery time after knee arthroscopy?
Below are some of the resources I have used.
📚Sources:
Masaracchio M, Hanney WJ, Liu X, Kolber M, Kirker K. Timing of rehabilitation on length of stay and cost in patients with hip or knee joint arthroplasty: A systematic review with meta-analysis. PLoS One. 2017 Jun 2;12(6):e0178295. doi: 10.1371/journal.pone.0178295. PMID: 28575058; PMCID: PMC5456061.
Wainwright AV, Kennedy DM, Stratford PW. The Group Experience: Remodelling Outpatient Physiotherapy after Knee Replacement Surgery. Physiother Can. 2015 Fall;67(4):350-6. doi: 10.3138/ptc.2014-44. PMID: 27504034; PMCID: PMC4962650.
Chaudhry YP, Hayes H, Wells Z, Papadelis E, Khanuja HS, Deirmengian C. Not All Patients Need Supervised Physical Therapy After Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. Cureus. 2023 Feb 20;15(2):e35232. doi: 10.7759/cureus.35232. PMID: 36968854; PMCID: PMC10032555.
Groot L, Latijnhouwers DAJM, Reijman M, Verdegaal SHM, Vliet Vlieland TPM, Gademan MGJ; Longitudinal Leiden Orthopaedics Outcomes of Osteoarthritis Study (LOAS) Group. Recovery and the use of postoperative physical therapy after total hip or knee replacement. BMC Musculoskelet Disord. 2022 Jul 13;23(1):666. doi: 10.1186/s12891-022-05429-z. PMID: 35831841; PMCID: PMC9277921.
Sattler L, Hing W, Vertullo C. Changes to rehabilitation after total knee replacement. Aust J Gen Pract. 2020 Sep;49(9):587-591. doi: 10.31128/AJGP-03-20-5297. PMID: 32864678.