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Knee Replacement Exercises – Complete Guide Before and After Surgery
Exercise plays a critical role both before and after knee replacement surgery. At Nagpal Robotics in Bathinda, Punjab, Dr. Parampreet Singh Nagpal's expert physiotherapy team works with every patient to ensure an optimal rehabilitation programme — beginning weeks before surgery (prehabilitation) and continuing through full recovery (rehabilitation). This guide provides a comprehensive overview of the best knee replacement exercises for each phase of recovery.
Important: Always perform exercises as directed by Dr. Nagpal's physiotherapy team. Stop any exercise that causes sharp pain, and never push through severe discomfort.
Phase 1: Pre-Operative Exercises (Prehabilitation) – 4–8 Weeks Before Surgery
Research consistently shows that patients who complete prehabilitation exercises before knee replacement surgery have faster and more complete recoveries. Stronger muscles before surgery mean better control and stability after surgery.
1. Quadriceps Sets (Quad Contractions)
How to do it: Lie flat on your back. Place a small rolled towel under your knee. Tighten your thigh muscle (quad) by pressing the back of the knee down towards the floor. Hold for 5–10 seconds. Relax.
Reps: 10–20 repetitions, several times per day
Purpose: Activates and strengthens the quadriceps without stressing the knee joint.
2. Straight Leg Raises (SLR)
How to do it: Lie flat. Bend the non-surgical leg. Tighten the quad of the surgical leg and lift it to the height of the opposite bent knee. Hold 2–3 seconds. Lower slowly.
Reps: 3 sets of 15
Purpose: Strengthens quadriceps and hip flexors without joint compression.
3. Heel Slides
How to do it: Lie flat. Slowly slide your heel towards your buttocks, bending the knee. Hold at the point of comfortable stretch. Slide back out.
Reps: 3 sets of 10
Purpose: Maintains knee flexion range of motion before surgery.
4. Ankle Pumps
How to do it: Lying or sitting, flex and point the foot up and down, like pressing a car pedal.
Reps: 20–30 repetitions per hour
Purpose: Promotes blood circulation and prevents clot formation — especially important after surgery.
5. Short Arc Quads (SAQ)
How to do it: Lie flat. Place a rolled towel under the knee to raise it to about 30 degrees. Slowly straighten the knee fully. Hold 5 seconds. Lower slowly.
Reps: 3 sets of 10–15
Purpose: Strengthens the final degrees of quadriceps extension — critical for stair climbing and walking.
Phase 2: Early Post-Operative Exercises – Days 1–7 After Surgery
Physiotherapy at Nagpal Robotics begins within 24 hours of surgery. Early mobilisation reduces clot risk, prevents stiffness, and activates muscles needed for safe walking.
6. Ankle Pumps (Continued)
Continue every hour while awake to prevent deep vein thrombosis (DVT). Crucial in the early post-operative period.
7. Quadriceps Sets (Post-Op)
Same as pre-operative. Begin on Day 1. These reactivate the quad muscle which tends to "switch off" after surgery.
8. Bed-Supported Heel Slides
Slide the heel toward the buttocks on a smooth surface (use a plastic bag on the sheet). Goal: achieve 90 degrees of knee bending within 5–7 days of surgery.
9. Sitting Knee Flexion and Extension
Sit at the edge of the bed or in a chair. Let gravity help the knee bend. Then use the other leg to gently support it straight. Progresses knee range of motion safely.
Phase 3: Intermediate Exercises – Weeks 2–6 After Surgery
As the surgical wound heals and pain diminishes, exercises become more active and functional.
10. Standing Knee Flexion
Stand holding a support. Bend the operated knee backwards, bringing the heel toward the buttocks. Hold 5 seconds. Lower slowly. Improves flexion range and quad/hamstring strength.
11. Supported Squats (Mini Squats)
Stand holding a support. Bend both knees to about 30–40 degrees. Hold 5 seconds. Return to standing. Strengthens quads and improves functional ability.
12. Step-Ups
Step onto a low step with the operated leg leading up and the non-operated leg leading down. Gradually increase step height as strength improves.
13. Walking Programme
Begin with short walks indoors using a walker or crutches. Gradually increase distance, transitioning to a cane, then no support. Target 20–30 minutes of walking per day by Week 6.
Phase 4: Advanced Exercises – Weeks 6–12 and Beyond
With clearance from Dr. Nagpal, more challenging exercises improve strength, balance, and endurance.
14. Stationary Cycling
Excellent low-impact exercise that improves knee flexion, builds quad and hamstring strength, and maintains cardiovascular fitness. Begin with low resistance and short duration.
15. Swimming
Water-based exercise reduces joint load while providing excellent resistance for muscle building. Begin swimming (not diving) when surgical wound is fully healed — typically 6–8 weeks post-surgery.
16. Balance and Proprioception Exercises
Single-leg balance on stable then unstable surfaces (foam pad). Improves joint position sense and prevents falls — important for elderly patients.
Get Expert Physiotherapy Guidance at Nagpal Robotics
Our experienced physiotherapy team develops a personalised exercise programme for every knee replacement patient.
Call: +91 98551-63355 Book AppointmentFrequently Asked Questions
What exercises should I do before knee replacement surgery?
Focus on strengthening the quadriceps and hamstrings: quadriceps sets, straight leg raises, heel slides, ankle pumps, and short arc quads. These prehabilitation exercises improve post-operative outcomes.
When can I start exercising after knee replacement?
Physiotherapy and gentle exercises begin within 24 hours of knee replacement at Nagpal Robotics. Early mobilisation is critical for recovery.
How long should I do exercises after knee replacement?
Active physiotherapy continues for 3–6 months. A home exercise programme should be maintained for life to keep the knee strong and functional.