You have a date for knee replacement surgery, or you have just come home from the hospital with a new knee. Either way, the same question is on your mind: what happens now, and how long until I can walk, climb stairs, and get my life back?
The surgery replaces the damaged joint. Rehabilitation is what makes the new joint work. The first three months after a total knee replacement are when most of the recovery happens, and physiotherapy is the main driver of that recovery. The exercises are simple, but they need to be done every day, and the timing matters. Doing the right thing at the wrong time can slow you down.
This guide explains knee replacement rehabilitation in Surrey in plain language: what happens before surgery, what the first days at home look like, the week-by-week recovery timeline, the bending and straightening goals your physiotherapist will measure, the exercises that help, the things to avoid, and when to call your surgeon. It is written for people who have had, or are booked for, a total knee replacement. That is the operation where the whole knee joint surface is replaced.
One honest note. This guide is about total knee replacement, not partial (unicompartmental) knee replacement, where only one side of the joint is replaced. The recovery timelines and exercises are different. If you are having a partial replacement, your surgeon and physiotherapist will give you a different plan. This guide is for the total replacement that most people in Surrey receive.
What Is a Total Knee Replacement?
The operation usually takes one to two hours. Most people stay in hospital for one to three days, although some go home the same day. You will be up and walking with a walker on the day of surgery or the day after. That surprises many people, but early movement is one of the most important parts of recovery. The longer you stay in bed, the stiffer the knee gets.
A new knee does not feel like your old knee. It will feel heavy, tight, and strange for the first weeks. The skin around the incision will be numb in places, and the knee will be swollen. All of that is normal. The knee is not meant to feel normal yet. It is meant to get better week by week, and that is what rehabilitation is for.
Before Surgery: Prehab Makes Recovery Easier
Prehab means physiotherapy before your operation. It is one of the best things you can do for your recovery, and it is often overlooked. The stronger your leg is going in, the faster it comes back after surgery.
A prehab program usually starts four to six weeks before surgery. Your physiotherapist will test your knee bending and straightening, your leg strength, and your walking. Then you will work on three things. First, strengthening the quadriceps, the big muscles at the front of the thigh, because these are the muscles that straighten the knee and they weaken quickly after surgery. Second, keeping the knee as flexible as possible, because a knee that bends well before surgery bends better afterwards. Third, practising with walking aids, so you are not learning to use a walker or crutches for the first time while you are in pain.
From Hospital to Home: The First Days
The hospital physiotherapist will get you walking before you go home. You will use a walker at first, and you will practise getting in and out of bed, sitting and standing from a chair, and walking to the bathroom. You will also start the first exercises: ankle pumps to prevent blood clots, gentle knee bending, and tightening the thigh muscle while the leg is straight.
Before you leave, the hospital team will check that you can walk a short distance, climb a few stairs with a rail, and get in and out of a car. You will go home with a prescription for pain medicine, instructions for looking after the incision, and a follow-up appointment with your surgeon, usually around two weeks after surgery.
The first days at home are the hardest. The knee will be swollen and sore, and you will be tired. That is normal. The pain medicine is there to be used, and it works best if you take it on schedule for the first week, rather than waiting until the pain is severe. Take it about 30 minutes before your exercises, so you can move the knee with less pain.
Ice the knee for 15 to 20 minutes at a time, several times a day, with a cloth between the ice and the skin. Keep the leg raised on pillows when you are resting, with the knee straight and the ankle higher than the knee. Do not put a pillow under the knee. That feels comfortable, but it lets the knee heal in a bent position, and a knee that cannot straighten fully is a problem that is hard to fix later.
The First 2 Weeks: Movement Comes First
The first two weeks are about three things: controlling pain and swelling, getting the knee moving, and walking safely. You will have physiotherapy, either at home or at a clinic, and you will have exercises to do several times a day.
The most important exercise in the first two weeks is straightening the knee. Lie on your back with the leg straight, tighten the thigh muscle, and press the back of the knee down into the bed. Hold for five seconds, then relax. Do this ten times, three times a day. It looks easy and it is hard, because the muscle is weak and the knee is swollen. But full straightening is the single most important goal of early rehabilitation, and it is easier to keep than to regain.
The second exercise is bending the knee. Sit in a chair and slide your foot back under the chair, as far as you comfortably can, then hold for a few seconds and slide it forward again. Do this ten times, three times a day. It will be uncomfortable. Some discomfort is expected. Sharp pain is not, and if the pain is sharp or the swelling jumps up after exercising, you have done too much.
Walk every hour you are awake, even if it is only to the bathroom and back. Use the walker until your physiotherapist tells you it is safe to switch to a cane. Do not rush the walking aids. A fall in the first weeks can damage the new joint, and the walker is there to keep you safe while the leg is weak. Most people switch to a cane at around two to three weeks, and walk without an aid at around four to six weeks, but the timing depends on your strength and balance, not the calendar.
Weeks 2 to 6: Building Strength and Bending
By two weeks, the incision is usually healing well and the surgeon will check it at your follow-up appointment. The swelling is starting to come down, and you are walking more. This is the phase where the real work starts.
Your physiotherapist will add strengthening exercises. Straight leg raises, where you lift the leg a few inches off the bed while keeping the knee straight, build the quadriceps. Seated knee extensions, where you slowly straighten the knee against a light resistance, build the same muscle in a different way. Standing exercises, holding onto a counter, build the hip muscles that keep you steady when you walk.
Bending is the main focus in this phase. Your physiotherapist will measure the bend with a goniometer, a simple tool that measures the angle of the joint. The goal is to reach about 90 degrees of bend by two weeks, and about 110 to 120 degrees by six weeks. That is enough to sit comfortably, climb stairs, and get in and out of a car. Most people reach it with daily exercises. If the bend is stuck, your physiotherapist will work on it with hands-on treatment and may talk to your surgeon about options.
Driving is another question that comes up often. You cannot drive until you can bend the knee enough to sit in the car, press the pedals, and react quickly in an emergency. For a right knee replacement, that is usually around six weeks. For a left knee, and an automatic car, it may be sooner. Your surgeon will clear you, and your insurance needs that clearance. Do not drive before you are cleared.
Weeks 6 to 12: Getting Your Life Back
By six weeks, most people are walking without an aid, the swelling is much less, and the knee bends well. This is when rehabilitation shifts from getting the joint moving to getting you back to your life.
By eight to twelve weeks, most people are doing most of their normal activities: walking the dog, shopping, light housework, and gardening. Golf, swimming, and cycling are usually possible by three months. Running, jumping, and contact sports are not recommended with a knee replacement, because they wear the plastic part out faster. Your surgeon will give you a list of activities that are safe and ones to avoid, and it is worth following.
Bending and Straightening Goals: The Numbers That Matter
Your physiotherapist will talk about two numbers: flexion and extension. Flexion is how far the knee bends. Extension is how straight it goes. Both matter, and they matter for different reasons.
Extension, getting the knee fully straight, is the more important of the two. A knee that cannot straighten fully makes you limp, and a limp loads the hip and the back and wears you out. Full extension is 0 degrees, meaning the leg is completely straight. The goal is to reach 0 degrees in the first two weeks and keep it. If the knee is stuck even a few degrees short, your physiotherapist will work on it aggressively, because the longer it stays bent, the harder it is to straighten.
Flexion, the bend, is measured in degrees too. You need about 90 degrees to sit in a chair and walk normally, about 110 degrees to climb stairs comfortably, and about 120 degrees to get in and out of a car and tie your shoes. Most knee replacements are designed to bend to about 120 to 130 degrees. Reaching 110 to 120 degrees by six weeks is a good result, and it is enough for almost everything in daily life.
Safe Exercises After Knee Replacement
These are the core exercises of knee replacement rehabilitation in Surrey. They are safe for most people after a total knee replacement, but they are not a prescription. If your surgeon gave you different instructions, follow those. If an exercise causes sharp pain, or the swelling jumps up and stays up, stop and tell your physiotherapist.
Ankle Pumps and Circles
Move your ankle up and down, then in circles, ten times every hour you are awake for the first two weeks. This prevents blood clots and keeps the circulation going. It is the simplest exercise and one of the most important.
Quadriceps Sets
Lie on your back with the leg straight. Tighten the muscle at the front of your thigh and press the back of your knee down into the bed. Hold for five seconds, then relax. Do ten repetitions, three times a day. This is the exercise that keeps the knee straight and wakes the thigh muscle up after surgery.
Heel Slides
Lie on your back and slowly slide your heel towards your bottom, bending the knee as far as you comfortably can. Hold for five seconds, then slide it back out. Do ten repetitions, three times a day. This is the main exercise for improving the bend.
Straight Leg Raises
Lie on your back, tighten the thigh muscle, and lift the leg about 30 centimetres off the bed, keeping the knee straight. Hold for three seconds, then lower slowly. Do ten repetitions, once or twice a day, once your physiotherapist says you are ready, usually after the first week. This builds the quadriceps strength you need to walk without a limp.
Seated Knee Extensions
Sit in a chair with your feet flat on the floor. Slowly straighten your operated knee until the leg is out in front of you, hold for three seconds, then lower slowly. Do ten repetitions, once a day, from about week two. This builds the same muscle in a sitting position and helps with stairs.
Standing Hip Exercises
Hold onto a counter for balance. Lift your operated leg out to the side, then back, keeping the knee straight. Do ten repetitions each way, once a day, from about week three. Strong hip muscles keep your walking steady and take load off the new knee.
What to Avoid After Knee Replacement
Most of the things to avoid are about protecting the new joint while it heals and not falling.
- Do not put a pillow under your knee when resting. It feels comfortable, but it lets the knee heal in a bent position.
- Do not twist on the operated leg, especially when it is carrying your weight. Turn your whole body instead.
- Do not kneel on the operated knee until your surgeon says it is safe, usually after three months, and even then use a cushion.
- Do not sit in a low chair, a low toilet, or a deep sofa for the first six weeks. A raised toilet seat and a firm chair with arms make sitting and standing much easier.
- Do not drive until your surgeon clears you.
- Do not run, jump, or play contact sports. These wear the replacement out faster.
- Do not skip your exercises because the knee feels better. The exercises are what keep the knee bending and the muscles strong, and stopping early is the most common reason people lose range of motion.
When to Call Your Surgeon or Physiotherapist
Most of the discomfort after knee replacement is normal. But some things are not, and they need a call the same day. Call your surgeon or your physiotherapist if any of these happen:
- The incision opens, leaks fluid, or becomes increasingly red, hot, or swollen
- You develop a fever above 38 degrees, or chills
- The calf becomes very painful, swollen, or tender, which can be a sign of a blood clot
- You have chest pain or sudden shortness of breath, which needs emergency care, call 911
- The knee becomes suddenly much more painful after a fall or a twist
- You cannot bend or straighten the knee at all, and it was moving before
- The knee feels unstable, or gives way when you put weight on it
- The numbness around the incision spreads, or you develop new weakness in the foot
Frequently Asked Questions
How long does knee replacement rehabilitation take?
Most of the recovery happens in the first three months. You will be walking with a walker in the first days, with a cane by two to three weeks, and without an aid by four to six weeks. Bending and strength improve steadily for six to twelve months. The knee keeps getting better for up to a year, although the biggest gains are in the first three months.
How much should my knee bend after replacement?
The goal is about 90 degrees of bend by two weeks and 110 to 120 degrees by six weeks. That is enough to sit, climb stairs, and get in and out of a car. Most knee replacements can bend to about 120 to 130 degrees. Full straightening, 0 degrees, is even more important than the bend, and the goal is to reach it in the first two weeks and keep it. Your physiotherapist will measure both numbers at each visit.
Is knee replacement rehabilitation painful?
Yes, especially in the first two weeks. The knee is swollen and sore, and the exercises are uncomfortable. That is normal, and it improves week by week. Take your pain medicine on schedule for the first week, and take it about 30 minutes before exercising. Some discomfort during exercises is expected. Sharp pain is not, and if the pain is sharp or the swelling jumps up and stays up, you have done too much and should tell your physiotherapist.
Can I climb stairs after knee replacement?
Yes. Most people practise stairs in the hospital before going home. The rule is "up with the good leg, down with the bad leg": lead with your unoperated leg going up, and lead with your operated leg going down, always holding the rail. By six weeks, most people climb stairs comfortably. A stair lift is not needed. If your home has stairs, your physiotherapist will check that you can manage them before you are discharged.
Will I need physiotherapy for the rest of my life?
No. Formal physiotherapy usually lasts six to twelve weeks after surgery, with visits becoming less frequent as you improve. After that, you keep doing the exercises on your own, and you keep walking, cycling, or swimming as part of your normal routine. A knee replacement needs lifelong sensible use, not lifelong physiotherapy. Avoid running and jumping, keep the muscles around the knee strong, and see your surgeon for the follow-up checks they schedule.
Get Help with Your Knee Replacement Recovery in Surrey
A knee replacement is a big operation, and the recovery is a real project. But it is also one of the most successful operations in medicine. Most people who have it say the same thing a year later: they wish they had done it sooner. The difference between a good result and a great result is usually the rehabilitation, and the rehabilitation is mostly the daily exercises.
If you are booked for knee replacement surgery, or you have just had one and want a clear plan, book an assessment at Renew Physiotherapy for knee replacement rehabilitation in Surrey. We will measure your bending and straightening, test your strength and walking, and build a program around your surgery date and your goals. We will tell you honestly what to expect, week by week, and we will keep you on track through the first three months when it matters most.
5722 176a Street, Surrey, BC V3S 4H2
Phone: (236) 450-0171
Email: Info@renewclinics.ca
Website: www.renewclinics.ca
Book your knee replacement rehabilitation assessment today and start your recovery with a clear plan.