You've had your knee replacement. The surgery went well. Now comes the part your surgeon probably told you about but didn't fully prepare you for:recovery is a job, and exercises are the most important part of it.
Most knee replacement patients spend just a few days in hospital before going home. That means the vast majority of your recovery happens at home — and the exercises you do (or don't do) in those first weeks will determine how well your new knee works for the next 20 years.
This guide covers the exercises physiotherapists recommend at each stage of recovery. It's not a replacement for professional guidance — every knee is different — but it gives you a clear picture of what to expect and what to work toward.
Important:Always follow your surgeon's specific instructions. If an exercise causes sharp pain (not just discomfort), stop and consult your physiotherapist or surgeon. Some swelling and stiffness after exercise is normal in the early weeks.
Week 1-2: The Foundation (Days 1-14)
Your goals in the first two weeks are simple:reduce swelling, maintain range of motion, and get moving safely. These exercises should be done 3-4 times per day in short sessions (10-15 minutes each). Frequency matters more than intensity right now.
Ankle Pumps
Lying on your back or sitting in a chair, slowly push your feet down (like pressing a gas pedal) and then pull them up toward your shins. This simple movement prevents blood clots and reduces swelling in the lower leg.
- Repetitions:20-30
- Frequency:Every hour while awake
Quad Sets (Thigh Tightening)
Lying on your back with your leg straight, tighten the muscle on top of your thigh by pressing the back of your knee down into the bed. You should see your kneecap move slightly upward. Hold for 5 seconds, then relax.
- Hold:5 seconds
- Repetitions:10-15
- Sets:3-4 times per day
This is arguablythe most important exercisein early recovery. Your quad muscle shuts down after surgery — quad sets wake it back up.
Heel Slides
Lying on your back, slowly slide your heel toward your buttocks, bending your knee as far as comfortable. Hold for 5 seconds, then slowly straighten. You can use a towel looped around your foot to gently assist the movement if needed.
- Repetitions:10-15
- Sets:3-4 times per day
- Goal:Work toward 90 degrees of bend by the end of week 2
Straight Leg Raises
Lying on your back, tighten your quad (as in quad sets), then lift your entire leg about 15 centimetres off the bed, keeping the knee straight. Hold for 5 seconds, lower slowly. If you can't keep the knee straight, stick with quad sets until you can.
- Repetitions:10
- Sets:3
Supported Standing and Weight Shifting
Using your walker or two crutches, stand with equal weight on both legs. Slowly shift your weight onto your surgical leg, then back. This retrains your brain to trust the new knee.
- Hold:5-10 seconds on the surgical leg
- Repetitions:10 shifts
Week 3-6: Building Strength
By week 3, your surgical wound should be healing well and swelling should be decreasing. Your goals shift tobuilding strength, improving range of motion, and returning to daily activitieslike walking longer distances, climbing stairs, and getting in and out of a car.
Standing Knee Bends
Stand behind a sturdy chair, holding the back for support. Slowly bend your surgical knee, bringing your heel toward your buttocks. Hold for 5 seconds at maximum bend, then straighten. Don't force it — let gravity and gentle effort do the work.
- Repetitions:10-15
- Sets:3
- Goal:90-100 degrees of bend
Step-Ups
Using a low step (start with 10 cm, progress to a standard stair height), step up with your surgical leg, straighten fully at the top, then step back down leading with your non-surgical leg. Hold the railing.
- Repetitions:10 per leg
- Sets:2-3
This exercise directly prepares you for stairs — one of the biggest functional goals after knee replacement.
Seated Knee Extension
Sit in a chair with your feet flat on the floor. Slowly straighten your surgical knee until the leg is fully extended. Hold for 5 seconds at the top, squeezing the quad muscle. Lower slowly.
- Repetitions:10-15
- Sets:3
- Progression:Add a light ankle weight (1-2 lbs) at week 4-5
Wall Sits
Stand with your back against a wall, feet shoulder-width apart and about 30 cm from the wall. Slowly slide down into a partial squat — don't go deeper than 45 degrees. Hold, then slide back up.
- Hold:10-15 seconds
- Repetitions:5-8
- Progression:Hold longer, slide slightly deeper
Week 7-12: Return to Function
By this stage, most patients are walking without a cane, climbing stairs with confidence, and doing light household tasks. Your goals now arefull range of motion, functional strength, and building endurance.
Stationary Bike
If you have access to a stationary bike, this is one of the best exercises for knee replacement recovery. Start with the seat high (less bend required) and minimal resistance. Pedal forward and backward. Gradually lower the seat as your range of motion improves.
- Duration:10-15 minutes, building to 20-30
- Frequency:Daily
Walking Program
Progress your walking distance gradually. A good rule of thumb:
- Weeks 7-8:15-20 minutes, flat surfaces
- Weeks 9-10:20-30 minutes, gentle inclines
- Weeks 11-12:30+ minutes, varied terrain
Balance Training
As your knee strengthens, balance training becomes important for preventing future falls and building confidence. Single leg stands, tandem walking, and step-ups on uneven surfaces all help. See our guide to balance exercises for seniors for a full program.
Full Squats (Partial)
Stand with feet shoulder-width apart, holding a countertop for support. Slowly squat down as far as comfortable — most patients will reach 90-100 degrees of bend. Rise back up. This exercise mirrors getting up from a low chair or toilet.
- Repetitions:10
- Sets:3
Recovery Milestones: What to Expect
Every recovery is different, but these are typical benchmarks:
- Week 1-2:Walking with a walker, 60-70 degrees bend, light household tasks
- Week 3-4:Transition to a cane, 80-90 degrees bend, short walks outside
- Week 6:Driving (automatic transmission, non-surgical leg was left knee)
- Week 8:Walking without a cane, 100+ degrees bend
- Week 12:Stairs without a railing, light gardening, returning to most daily activities
- Month 6:Full recovery for most patients, 110-120 degrees bend
- Month 12:Maximum improvement — your knee should feel natural
How Often Should You Exercise?
This is one of the most common questions we hear. The answer depends on where you are in recovery:
- Weeks 1-2:3-4 short sessions per day (10-15 minutes each). Frequency is key.
- Weeks 3-6:2 sessions per day (20-30 minutes each).
- Weeks 7-12:1 session per day (30-45 minutes) plus daily walking.
The golden rule:some discomfort during exercise is normal. Sharp pain, significantly increased swelling, or pain that lasts more than 2 hours after exercise means you've done too much. Scale back and consult your physio.
When to Work With a Physiotherapist
While these exercises are safe and well-established, working with a physiotherapist significantly improves outcomes after knee replacement. Research shows that patients who receive structured physiotherapy regain range of motion faster and report better satisfaction with their surgery.
You should strongly consider physiotherapy if:
- Your range of motion isn't improving on schedule
- You're still using a walker after week 3-4
- You have significant swelling that isn't decreasing
- You're feeling anxious or uncertain about pushing your knee
- You want to return to an active lifestyle (golf, hiking, tennis)
At Haven at Home, our physiotherapists come to your home for knee replacement rehab throughout Toronto, Scarborough, North York, Etobicoke, and Oakville. Recovery happens at home — and that's exactly where your physio should be too.
Ready to start your recovery right?Call416-795-0373to book an in-home knee replacement physiotherapy assessment.