Ankle pumps
Pump the feet up and down to keep the blood moving.
- 20 times
- Every hour while awake
Should feel: The calf working Should not feel: Calf pain or swelling — tell us
Home / Patient library / Exercise sheets / Sheet 66
After total knee replacement
Hip & knee · After a total knee replacement
Count the weeks from the day of your operation. The date is on your discharge card.
If your doctor wrote a different plan on your prescription, follow that instead of this page.
A4 PDF, 0.8 MB. Free to download — no sign-up, no email address needed.
Weeks 0–2
Get out of bed and walk from the day after the operation, with a walker. Short walks, often. Work on getting the knee fully straight, and on bending it to about a right angle (90 degrees) by 2 weeks. Rest with the leg straight, and never put a pillow under the knee. Keep the ankles moving to protect against clots, and take every dose of the blood-thinning tablets we prescribe.
Weight bearing Full, as comfortable, with a walker, unless we have told you otherwise.
Terminal knee extension
Heel on a rolled towel, knee hanging free. Press it straight.
- Hold 5 seconds
- 10 times
- 3 times a day
Should feel: The back of the knee stretching Should not feel: —
Straight leg raise
Lift the straight leg 20 cm.
- 10 times
- 3 times a day
Should feel: The thigh working Should not feel: The knee sagging
Heel slides
Lie down and slide the heel up towards the buttock, bending the knee as far as you can.
- 10 times
- 4 times a day
Should feel: A stretch as the knee bends Should not feel: Sharp pain at the wound
Sitting knee bend
Sit on a firm chair. Slide the foot back under the chair to bend the knee, hold, then bring it forward.
- 10 times
- 3 times a day
Should feel: A stretch as the knee bends Should not feel: Sharp pain
Not yet A pillow under the knee. Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
Weeks 2–6
Stitches out. Keep the knee fully straight, and bend it a little further each week. Walk a little further each day. Some swelling and warmth around the knee are common for some weeks and settle slowly. Carry on with the earlier exercises.
Weight bearing Full. Move from the walker to a stick when you feel steady.
Standing hip abduction
Hold a chair. Lift the leg out to the side, keeping the body upright.
- 10 times
- Daily each side
Should feel: The side of the hip working Should not feel: Leaning over
Standing hip extension
Hold a chair. Take the leg backwards, keeping it straight.
- 10 times
- Daily each side
Should feel: The buttock working Should not feel: Arching the back
Sitting heel and toe raises
Sit with both feet flat on the floor. Lift the heels, lower them, then lift the toes.
- 10 times
- 3 times a day
Should feel: The calf and the front of the shin working Should not feel: Sharp pain
Heel-to-toe walking
Walk with your walker, putting the heel down first and rolling through to push off from the toes. Keep the steps even.
- 10 steps
- 3 times a day
Should feel: Steadier walking Should not feel: Wobbling — use the wall
Not yet A pillow under the knee. Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe. Driving.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
Weeks 6–12
Walk without a limp, and manage stairs more easily. Carry on with the earlier exercises.
Weight bearing Full. Use the stick outdoors until you are steady without it.
Step-up
Hold a rail. Step up onto a low step with the operated leg, then step down with the other leg.
- 10 times
- Daily
Should feel: The thigh working Should not feel: The knee falling inwards
Mini squat
Hold a support. Bend the knees a little way, then straighten.
- 10 times
- Daily
Should feel: The thighs working Should not feel: Deep groin pain
Static cycling
Set the seat high, so the knee is almost straight at the bottom. Pedal gently with little resistance.
- 10 minutes
- Daily
Should feel: The knee moving freely Should not feel: Pain in the knee or hip
Calf raises
Rise onto both toes and lower under control.
- 15 times
- Daily
Should feel: The calf working Should not feel: Sharp pain
Not yet Heavy lifting. Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe.
Move to the next stage only after we have seen you, and the X-ray if one was planned.
Month 3 onwards
Back to your usual activities. Keep walking, and keep the thigh strong. Tell any dentist or doctor that you have a knee replacement.
Weight bearing Full.
Single-leg balance
Stand on one leg beside a worktop.
- 30 seconds
- 3 times a day
Should feel: Working to stay steady Should not feel: Losing balance — hold on
Step down
Stand on the operated leg on a low step and lower the other heel slowly towards the floor.
- 10 times
- Daily
Should feel: Controlled lowering Should not feel: The knee falling inwards
Walking
Walk daily. Build the distance slowly.
- 20–30 minutes
- Most days
Should feel: Easier walking over weeks Should not feel: Swelling next day — do less
Not yet Running, jumping or impact sport. Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe.
Stop and telephone us if
- Sudden breathlessness or chest pain — go to the nearest hospital
- The calf becomes swollen, tight or painful — go to the nearest hospital
- The wound keeps leaking, the redness around it spreads, or you have a fever — come the same day
- Knee pain that suddenly gets worse after it had been getting better — come the same day
- The knee suddenly gives way, looks a different shape, or you cannot stand on it — come the same day
- A fall
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