Exercises after knee replacement at home

Follow your own protocol first

Every surgeon and hospital has its own plan for what you do in which week, and it can differ depending on the type of replacement and how surgery went. Treat this guide as background to help you understand that plan and stay consistent with it, not as a replacement for it. If anything here conflicts with what your team told you, do what your team told you.

The exercises below are the ones that show up again and again in home programs after a total knee replacement. They're grouped from earliest and easiest to later and harder.

Early exercises (often from the first days at home)

These are usually done lying on your back or sitting, a few times a day. Move slowly and breathe.

1. Ankle pumps. Point and pull your feet back and forth. Keeps blood moving in the legs. 10 to 20 reps, often every hour while awake in the early days.
2. Quad sets. Lying with the leg straight, tighten the front of the thigh to push the back of the knee down into the bed. Hold 5 seconds, relax. 10 reps.
3. Heel slides. Lying down, slide the heel towards your bottom to bend the knee as far as is comfortable, hold a couple of seconds, slide back. 10 reps. A strap or towel around the foot can help.
4. Straight leg raise. Bend the good knee, tighten the thigh on the operated leg and lift it straight to the height of the other knee. Lower slowly. 5 to 10 reps, if your team allows it.
5. Short arc quads. Lying with a rolled towel under the knee, straighten the knee to lift the heel, hold 3 seconds, lower. 10 reps.

Getting the knee straight

Full straightening is easy to lose and hard to get back, so many programs include time with the heel propped on a rolled towel and nothing under the knee, letting the leg relax straight for a few minutes. Avoid resting with a pillow under the knee for long periods unless your team says otherwise, because the knee can stiffen in a bent position.

Building strength (as walking improves)

1. Seated knee extension. Sit tall in a chair and straighten the knee slowly, hold 2 seconds, lower over 3. 2 sets of 10.
2. Sit to stand. From a firm chair, stand up using your legs as much as you can, then sit down slowly. Use your hands at first. 2 sets of 5 to 10. One of the most useful exercises there is, because it's what you do all day.
3. Standing knee bends. Holding a counter, bend the operated knee to bring the heel towards your bottom. 2 sets of 10.
4. Mini squats. Holding a counter, bend both knees a little and stand back up. Small range at first. 2 sets of 10.
5. Step ups. Later on, step up onto a low step leading with the operated leg, then step down with the other. 2 sets of 8 to 10.

Walking and stairs

Walking is part of the rehab, not separate from it. Short, frequent walks around the house, then outside, usually beat one long walk. Use the walking aid you were given until your physio says you can step down from it.

For stairs, the old saying helps: up with the good, down with the bad. Lead with the non-operated leg going up and the operated leg going down, with a hand on the rail, until strength and bend come back.

Pain, swelling and pacing

Some pain and swelling during the weeks after surgery is expected, and your team will have told you how to manage it. Many people find it easier to exercise when their pain relief is working. Ice and raising the leg after a session are common.

Watch the next-day response. If the knee is a lot more swollen or sore the morning after, ease back on the number of reps rather than stopping altogether, and mention it at your next appointment.

Call your surgical team or seek urgent care if

• The wound is red, hot, leaking or smells, or you have a fever or chills
• Your calf is swollen, tender, hot or red
• You suddenly feel short of breath or have chest pain (call emergency services)
• Pain suddenly gets much worse, or you can no longer bend or take weight like before

A sample day in the early weeks

Many home programs break the day into two or three short sessions rather than one long one. A morning session might be ankle pumps, quad sets, heel slides and short arc quads, about fifteen minutes, followed by ice and the leg raised. Around midday, a short walk around the house and a few minutes of the leg resting straight on a rolled towel. In the evening, the same set of exercises again, plus a few sit to stands if you've been cleared for them.

As the weeks go by, the lying exercises give way to more standing work and longer walks. What stays the same is the rhythm: a little, often, with rest in between.

Tracking your progress

Your physio will usually measure how far your knee bends and straightens at appointments. You can track things at home too, in plain terms: how far your heel slides back, how many sit to stands you can do without hands, how long a walk feels comfortable, and whether you need the rail on the stairs.

Writing those down once a week turns slow change into something you can see, which helps on the days it feels like nothing is improving. It also gives your physio real information instead of "it's OK, I think".

Questions worth asking your team

• Which exercises should I be doing this week, and how many times a day?
• How much bend and straightening should I be aiming for by my next appointment?
• When can I stop using my walking aid, and when can I drive?
• What level of pain or swelling should make me call you?

Does Apex One have a knee replacement program?

No. Apex One doesn't have a program for after knee replacement, so follow the plan your surgical team and physio gave you. Its knee programs (general knee strength, runner's knee and jumper's knee) aren't made for after surgery, so don't use them unless your physio tells you to. Much later, once your team clears you for normal strength training, Apex One's camera rep counter can count squats and lunges out loud.

Count every rep with your phone

Questions

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