Regaining Motion After Your Total Knee Replacement

6.06 blog

After you have a total knee replacement, one of your main goals is to regain the range of motion at your knee so that you can return to your everyday activities. Your range of motion refers to how far and in which directions you’re able to move your knee, and it impacts everything from walking and going up and down stairs to getting in and out of a car. After your surgery, your healthcare team will provide you with information about regaining your range of motion and body positioning, as well as a home exercise program to follow based on your needs. Below are a few examples of the type of instruction you might receive. Remember that every case is unique, and it’s critical that you follow the guidelines provided by your surgeon and physical therapist for a successful outcome after your surgery. Perform your exercises every day as recommended by your surgeon or therapist.

Management of swelling
Swelling can be prevented by elevating the operated leg when resting in bed. When elevating the leg, the ankle should be above the level of the heart and the knee must be straight.

Position at rest
The position of your body while you’re resting is one of the most important things to be aware of during your recovery phase. When you’re lying down in bed, place a towel roll under your operated heel so that your knee is straight, as tolerated. Do not put a towel roll or pillow under your operated knee.


Seated knee exercise
This exercise improves the mobility of your knee joint. Sit up tall on the edge of a bed or firm surface with your thighs supported and your foot resting on the floor. You can put a paper towel or pillow case under your foot on the operated side, to help it slide more easily:


Slide your foot on the paper towel or pillow case as far back as you can, as tolerated. You should feel a slight stretch in the front of your operated knee:


Pause, then slowly return to the starting position.

Stair stretch exercise
This exercise improves the mobility of your knee joint as well. Holding onto a rail, place your foot on a step with your operated knee bent. Move your hips forward to gently increase the bend in your knee. You should feel a slight stretch in the front of your operated knee:


Hold the stretch, then move your hips back to release. If you don’t have stairs your therapist can suggest modifications for you to achieve similar results with a different exercise.

These are some general guidelines, but every person is different. Always make sure that you follow your surgeon’s instructions.

Rupali Joshi is a physical therapist with the Rehabilitation Department at Hospital for Special Surgery.


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  1. How far should I go to push the back of the knee into mattress – pushing extension limits? Back of the knee hurts from stretching but every morning I have to press this to get full extension. Should I strive to match the slope of the other Tibia. given the same load?

    1. Hi John, thank you for reaching out. Rupali Joshi, Physical Therapist, says: “Everyone is different, so it would be best for you to contact your physical therapist if you have questions about your home exercise program. Following a total knee replacement, patients are often advised to practice pushing the back of the knee into the mattress while lying down as per tolerance multiple times a day, with the goal being to eventually straighten your knee. This can cause discomfort in the back of the knee, which is why it’s important to practice only as tolerated but multiple times a day. Reach out to your physical therapist or surgeon for specifics regarding how often to practice this exercise, how far to push, and for how long.”

  2. Great article, thank you. I have a tear on the inside of my left knee could you recommend suggestions for getting rid of the swelling and inflammation as well as healing exercises?

    1. Hi Sylvia, thank you for reaching out. It would be best to consult with a physician or therapist in person so that they can determine the best course of treatment. If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

  3. Nice concise article covering key points in regards to TKR rehabilitation. When it comes to proper elevation, I find many do not or have not been properly instructed about getting their knee above the heart.

    Its a good idea that the PT demonstrate the proper positioning and set the patient up one time so that they get a visual on proper elevation.

    1. Hi Richard, thank you for sharing your input! We’re glad that you enjoyed reading the article!