Total Knee Replacement Exercises
Total Knee Replacement Exercises
Marian Barnick

Marian Barnick

Registered Kinesiologist and Human Movement Specialist



In this video, we are talking all about:

how to take your first steps in stretching after total knee replacement, 

the rules you need to follow to stay safe, 

the reasons you may be hesitating on getting that knee moving, 

and of course, the movement compensations you need to avoid that will keep you from reaching your maximal recovery.

total knee arthroplasty

The reason you’re going to have trouble moving your knee is because of the issue that happen in the tissue after your surgery. 


The pain, the edema, possible muscle spasms, there will be bleeding in there, inflammation in the tissues. These are common problems in your knee and surrounding tissues after your T.K.A.


And these factors are what’s interfering with your function and why you need to work through rehabilitation as soon as you can after surgery.


It’s easy to say start moving right after surgery, but you’ve been doped up with a bunch of medications, you’re on pain medications, there’s medications that are put right into the joint itself, and of course the anesthesia that’s being used as well. 


So it can definitely be tough to move after surgery. But there’s also reasons that you might be hesitant to get moving and to start your stretches.


You can be afraid of increasing that pain level fear that you’re going to damage what’s been done with surgery and the reason you had to go through all of this in the first place. 



You might worry about pulling on your incisions or the stitches or the staples that have been put in. And this is something really important to look at too with the flexion exercise.



So we do want to be careful and watch what’s going on and how much you’re moving. 



And as an aside, that could be something where your surgeon may put limits on how much flexion he wants you to do or allows you to do during the first week or two after surgery. You also may be fearful that you are doing too much.



You may have a fair amount of pain and you may think it’s because you are moving too much and you may be scared that you’re not doing the right things with rehabilitation. 


That’s why it’s important for us to go through how you should be doing your flexion mobility after surgery, and we’ll get to that in just a moment.


Even though this surgery is now considered common , undergoing a total knee replacement surgery is a major surgery. 


And the most important outcome for patients after surgery is to have a decrease in pain, to regain their function, and get back to being active. 



And that’s why your post-surgical rehab program is the most important thing you can do.



It’s true that the more you put into it, the better your outcome. 


Now, of course, your results are going to depend on a lot of variables.



Every patient is different and there are many different types of total knee replacements. 


There are variations in the implants, there’s variations in how the surgeon performs the surgery and how the implants are placed into your joint, and it is vital to listen to your surgeon for your best recovery. 


Now, one thing all surgeons will agree on that restoring range of motion is the most important part of any early rehab program. 


That’s why starting on day one after surgery, yes, you heard me day one after surgery, post-surgical rehab works to improve knee range of motion, and that is what is vital in getting you back to being active.


Now these rehab exercises are not just for knee mobility. So when you’re performing what we’re going through today, which is knee flexion exercises, it’s not just getting that knee moving better in that range of motion.

knee bending exercises after surgery

Improving joint mobility is key for a number of benefits, and that includes decreasing swelling,

reducing joint inflammation, 

improving blood flow, 

helping the lymphatic system, 

reducing risk of contractures, 

helping to improve scar tissue formation by limiting those adhesions, 

reducing blood clot risk, 

and of course decreasing your pain.



Yes, moving your knee will actually help you decrease pain.


full range of motion

So for long-term benefits, regaining full range of motion is essential to restore that natural capacity of movement, and that’s what’s assisting us in regaining muscle strength because we want those muscles to work over the full range of motion.


You will have decreased strength if you cannot move through the full range of that knee joint. This is me in the hospital working on my ankle pumps, and of course, I’m following the same rules that I’m going to ask you to follow as well.



You need to make sure that you are cleared from your surgeon to do your activities.



This is important both for your exercises as well as any restrictions that your surgeon may put on you right after surgery. 



If you are icing your knee, I don’t want you to stretch after icing. 



Icing decreases blood flow, it tightens up the tissues, so I want you to ice after you’ve done your stretching, after you’ve done your mobility exercises, and that’s going to help with your pain and inflammation as well.



I want pain also to guide your activity level, especially with rehab exercises. 


It will hurt. 


I am not gonna sugarcoat this at all. You are gonna have pain, but again, don’t go that more pain equals better recovery. It doesn’t work that way.


Your body’s gonna let you know what you should be doing, and I want you to listen to it.




So let’s take a look at knee flexion after total knee replacement.




What we’re looking at here is a slight bend in the knee. You are not starting at zero degrees. 


I also want to show you we’re taking off that sock because we want to make things as easy as possible and sliding the heel without the sock is going to be easier.


But note that range of motion. 


Coming up as much as possible, holding and bringing back down – not to zero degrees – you’re not gonna get there yet right after surgery.  And you’re not gonna get to that 130 degrees for flexion. 



But the goal here is to start where you can and flex as much as you can.



Now, normally with stretching, we’d be holding that position 15 to 30 seconds for stretching, but we’re not doing that because it’s more like a pumping action.  


We want to get all those extra benefits, not just improving the range of motion, but pumping out all that inflammation, making sure we don’t get those blood clots, getting the lymphatic system moving.



All of that here with that range of motion in the knee for flexion. 


So let’s sum this up. 

We want to start as soon as possible. 


Day 1 is absolutely fine, as long as your surgeon tells you it is A-okay. 

post surgery rehab

When you’re moving, you’re going to be moving before you ice and you’re going to be icing after to help control pain as well as inflammation.

mobility exercises

If you’ve got any questions, if you have any concerns about going through your rehab program, leave a note below, or send an email- and ask me any questions about this.

Also, make sure to grab your FREE copy of The Mobility Guide that’s going to help you determine which lower body movements have decreased mobility and guide you through improving range of motion for recovery as well as performance.  

Here’s the link:

knee pain when walking

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