Physical Therapy After a Total Knee Replacement

Physical Therapy After a Total Knee Replacement

Knees are one of the most commonly replaced joints that surgeons work with. It’s no surprise with how much weight and activity we expose our delicate knees to on a daily basis. Over time, cartilage can wear out, tendons and ligaments can become thin and snap, and the bones may start to grind against each other with every slight movement. 

If your doctor has recommended total knee replacement as a remedy for your knee pain, physical therapy before and after the surgery is one of the best ways to support your knee health long-term. Knee surgery can seem scary, and you may be wondering if you will ever feel the same afterward. However, with expert assistance and a physical therapy plan that is tailored to you, you can regain your knee strength and get back to a normal level of functioning. 

 

How Physical Therapy Can Help After Knee Replacement Surgery

Although it may seem a bit counterintuitive, exercising your knee as soon after surgery as you can (within one day) will help it heal quicker and better than rest and relaxation will. After your surgery, a physical therapist may visit your room and have you perform a few light exercises to help your knee heal. We recommend waiting for a professional to show you the proper techniques so your wound doesn’t reopen or you don’t reinjure your knee. 

After you are released from hospital care, you may have to seek out physical therapy on your own. Visiting a professional therapist instead of trying to stretch and bend your leg on your own is the best way to help your knee recover well. In the first two weeks after surgery, your goal is to focus on wound care, managing pain, reducing the swelling, and progressing to walking with an assistive device such as walker, crutches, or a cane. 

Once you feel comfortable with this level of motion, your physical therapist will teach you different techniques for safely restoring your range of motion, strength, balance, and function. You may focus on sitting, standing, walking, and even climbing stairs in order to perform your normal daily activities while your knee continues to heal. Strengthening exercises can help the muscles around your knee support the joint enough to give you the ability to walk without an assistive device. 

When you can confidently walk on your own, you may think physical therapy is complete. However, continued therapy is necessary for fully getting used to your new normal. 

Balance training with a physical therapist will help your knee properly respond in less than ideal situations, such as walking on uneven ground, navigating slippery walkways, or stopping suddenly while walking. Twisting motions can also be helpful for teaching your body to rotate and turn without pain. Balancing with your knee and maintaining control are other actions your physical therapist can help you achieve.

Lastly, your physical therapist can help you restore function to your knee for job-specific activities you may have to perform. Climbing a ladder, sports-related movements, and other physically demanding job skills may require further physical therapy to help keep your new knee safe from injury. 

 

Stretching After Knee Surgery

Right after surgery, a physical therapist will walk you through a few light stretches and movements to initiate healing and regain strength. You may lay flat on your back and flex your quadriceps to remind your muscles how to control your leg movements. Then, you may try lifting your leg off the bed while keeping it as straight as possible. Pumping your ankle is another way to restore movement to your knee and prevent scar tissue from hindering further movements. Repeating these motions several times until your muscles become fatigued is the best way to retrain your knee for movement again. 

Knee bends are the next step in knee recovery. Bending the knee while lying flat on the bed and while sitting in a chair will help your knee move correctly when moving on to the next step—walking. Walking slowly for short distances with a supportive device is the end goal for the first phase of recovery. Your physical therapist will provide tips on how much pressure you can apply to help strengthen but not reinjure the knee while performing these activities. 

Once you have mastered the above stretches, your physical therapist can help you advance to stair climbing, resistance training, and standing leg bends. If your knee swells after performing any activities, you can manage the swelling with ice and elevation.

 

How Physical Therapy can Help Before Knee Replacement Surgery

While most people understand that physical therapy is necessary for after a total knee replacement surgery, many people don’t know that therapy before the surgery can be additionally beneficial. A physical therapist can help get your knee to a strong and healthy place before the surgery, resulting in a shorter recovery time afterward. 

A physical therapist can also show you how to use assistive walking devices beforehand so you are already used to handling one when you must rely on one after the surgery. They may even offer tips on how to make your home as risk-free as possible so you aren’t as prone to slips, trips, and falls after returning from the hospital. For example, removing tripping hazards, securing rugs, and placing heavily used items within reach are all ways to organize your home for easier functionality after you return from surgery. 

Other healthy lifestyle choices you can make before surgery are quitting smoking and eating a healthy and well-balanced diet. These two actions can help your body recover faster and support your overall health.

The best-case scenario is that physical therapy before knee surgery is so successful that you don’t need surgery to address your knee pain. Regardless, physical therapy before you get to the point of needing surgery is recommended for all types of knee pain. You don’t have to accept knee pain as a normal part of aging. See the experts at Synergy PT today for the best knee care for before and after surgery.

As we age, maintaining health and independence becomes a top priority. Strength training, a type of resistance exercise often overshadowed by cardio or flexibility exercises, is a cornerstone of healthy aging. Whether you’re in your 30s or 80s, incorporating strength training into your routine can help you live a longer, more vibrant life. Here’s why everyone needs to embrace strength training and how to overcome common barriers to getting started.

1. Avoiding Frailty

Frailty, marked by reduced strength, endurance, and physical function, is a growing concern with age. According to the National Institute on Aging, frailty increases the risk of falls, disability, and hospitalization. For women, who face a higher risk of osteoporosis, frailty can also lead to fractures with prolonged recovery. Strength training combats frailty by building muscle mass and bone density. 

A 2021 study in the Journal of Clinical Medicine found that resistance training significantly improved muscle strength and reduced frailty markers in older adults. For women, this is especially critical, as stronger muscles and bones reduce the risk of osteoporotic fractures. Exercises like weightlifting, bodyweight workouts, or resistance bands enhance physical resilience, making daily tasks like carrying groceries or climbing stairs safer and easier.

(Want to know more about osteoporosis and PT’s role in it’s prevention and treatment? Check out our previous article for more information: Osteoporosis, Osteopenia, and Physical Therapy

2. Staying Able to Do the Things You Love

Strength training ensures you can keep enjoying activities like gardening, hiking, or playing with grandkids. According to an article in Harvard Health Publishing, muscle strength can begin to decline by about 1-2% per year after age 35 due to sarcopenia, also known as age-related muscle loss. This muscle loss accelerates as our bodies age. This loss can limit your ability to perform daily tasks or pursue hobbies, particularly for women who may experience accelerated muscle loss during menopause due to declining estrogen levels. 

Regular strength training preserves functional capacity, and benefits multiple domains of health. A  2019 study published in Frontiers in Physiology showed that resistance exercise not only improved musculoskeletal health, but also helped patients manage chronic conditions like cardiovascular disease and diabetes (Mcleod et al., 2019). Older adults who participated consistently in resistance strength exercise maintained better mobility, overall health, and independence than those who did not. Additionally, the same study found that those using light weight or only body weight while strength training was just as effective as heavy weights (McLeod et al., 2019). The most important factor of strength training for healthy aging is finding a routine that is suited to your body and your ability. A consultation with a physical therapist can help you find the right routine and guide you through proper exercise form to ensure your exercise is preventing injury, not causing it.  Strength training empowers you to stay active, healthy, and independent.

3. More Muscle Mass Equals Improved Blood Sugar Control

Building muscle isn’t just about strength—it’s about metabolic health. Muscle tissue helps regulate blood sugar by improving insulin sensitivity, which is vital for preventing or managing type 2 diabetes, a condition more prevalent with age (Mcleod et al., 2019). Increased muscle mass enhances glucose uptake, reducing blood sugar spikes. This is particularly important for women, who may face increased risks for diabetes complications. Researchers have found that  resistance training improved glycemic control in older adults with type 2 diabetes (Mcleod et al., 2019). In their review of resistance exercise and blood sugar management, resistance exercise performed for 8 weeks resulted in clinical improvements in A1C management and improvements in insulin resistance. These findings are relevant not just to individuals living with diabetes, but also those with insulin resistance, metabolic disorders, or a family history of diabetes. More muscle mass means greater glucose storage capacity, supporting overall metabolic health. Even moderate strength training, like lifting weights twice a week, can make a significant difference.

Common Barriers to Starting Strength Training

Despite its benefits, many hesitate to start strength training. Here are common barriers and solutions:

  • Lack of Knowledge: Many feel intimidated by unfamiliar exercises. 
    • Solution: Start with simple bodyweight moves like squats or push-ups. Online resources from the American Council on Exercise (ACE) offer free beginner guides, or consult a certified personal trainer for a tailored program.
  • Fear of Injury: Older adults, especially women with lower bone density, may worry about getting hurt. 
    • Solution: Begin with low weights or resistance bands under professional guidance. A 2018 study in Journal of Strength and Conditioning Research confirms supervised strength training is safe and effective for all ages when done correctly.
  • Time Constraints: Busy schedules can make exercise feel daunting. 
    • Solution: Short, 20-minute strength workouts 2-3 times per week still deliver impactful benefits, per American College of Sports Medicine guidelines.
  • Gym Intimidation: Gyms can feel overwhelming for beginners. 
    • Solution: Try home workouts with minimal equipment or join small group classes for older adults, which foster a supportive environment. Women-only classes can also provide a comfortable starting point.

Getting Started with Strength Training

To reap the benefits, aim for 3 sessions per week. Focus on compound movements—exercises that work multiple muscle groups at once, like squats, deadlifts, lunges, assisted pull-ups, and pushing-pressing motions. These maximize efficiency and functional strength. Start with light weights, resistance bands, or bodyweight exercises, gradually increasing intensity.

Safety Tip: Deadlifts, a powerful and functional movement, we commonly integrate this into out-patient rehabilitation strategy, but it does require proper technique to avoid injury. Begin with no weight, using a broomstick or similar tool to master form under a skilled coach’s guidance before adding weight. This is especially important to protect against lower back strain or injury.

Always consult a healthcare provider before starting a new exercise program, especially if you have chronic conditions like osteoporosis, chronic low back pain or shoulder problems. If you do struggle with any of these, one of our physical therapists can design a program tailored to your needs, and we’re here to support you every step of the way. If you are free from chronic conditions or pain a skilled coach or trainer can also be a great fit to get you started safely.

Strength training isn’t just for bodybuilders—it’s for everyone who values aging gracefully, staying active, and feeling their best. By building strength now, you’re investing in a healthier, more independent future.

References:

Harvard Health. (2023, February 14). Age and muscle loss. https://www.health.harvard.edu/exercise-and-fitness/age-and-muscle-loss

Mcleod, J. C., Stokes, T., & Phillips, S. M. (2019). Resistance Exercise training as a primary Countermeasure to Age-Related Chronic Disease. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00645

Talar, K., Hernández-Belmonte, A., Vetrovsky, T., Steffl, M., Kałamacka, E., & Courel-Ibáñez, J. (2021). Benefits of Resistance training in Early and late Stages of Frailty and sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Journal of Clinical Medicine, 10(8), 1630. https://doi.org/10.3390/jcm10081630

Request An Appointment

Please fill out this form and
we will contact you about scheduling.