“DR. TREVOR” STEFANSKI, M.D.
Minimally Invasive Specialist
Knee Replacement Recovery: Physical Therapy and Activity Guide

Knee Replacement Recovery:
Physical Therapy Activity Guide

Weeks 1–2: Early Home Recovery

Goals:

Reduce swelling, manage pain, and restore initial mobility.

1. Compression and Elevation

  • Use a compression bandage or Velcro wrap from your foot to mid-thigh.
  • Elevate your leg for 40 minutes every hour (toes above the nose).

2. Icing

  • Apply ice to your surgical leg for 40 minutes every hour to reduce swelling.

3. Physical Therapy

  • Perform these exercises every hour while awake:
    • Seated knee flexion/heel slides: 10 repetitions.
    • Knee extension (passive/assisted): 10 repetitions.
    • Ankle pumps: 10 repetitions.
    • Walk 5–10 steps/hour.
    • Heel hangs: 10 minutes, 3x/day.
  • Limit stair climbing as much as possible.
  • Focus on range of motion (ROM) exercises with a goal of 0–110° by Day 14.

4. Step Count Goals

  • Week 1: 750 steps/day maximum.
  • Week 2: 1,200 steps/day maximum.

5. Other Tips

  • Avoid strengthening exercises (e.g., squats or lunges) until cleared by your surgeon.
  • If swelling or ROM doesn’t improve, consider additional interventions like lymphatic massage or a compression device.

Weeks 3–6: Progressing Recovery

Goals:

Build strength, increase mobility, and reduce swelling.

1. Compression and Elevation

  • Continue using a compression bandage or device.
  • Elevate your leg for 40 minutes, at least 3x/day.

2. Icing

  • Ice your leg for 40 minutes, 3x/day or more if needed.

3. Physical Therapy

  • Gradually stop using assistive devices (e.g., crutches or walker) as tolerated.
  • Perform range of motion exercises 6 times/day for 5–8 minutes each session.
  • Continue isometric quadriceps sets (tightening your thigh muscle) but avoid strengthening exercises like squats until after 6 weeks.
  • Focus on achieving maximum ROM (ideally matching your intraoperative ROM) by the end of Week 4.

4. Step Count Goals

  • Week 3: 2,000 steps/day maximum.
  • Week 4: 2,750 steps/day maximum.
  • Week 5: 3,500 steps/day maximum.
  • Week 6: 4,500 steps/day maximum.
  • Gradually increase by 1,000 steps/day each week, using pain and swelling as your guide.

5. Returning to Work

  • Avoid returning to work before 6 weeks if possible.
  • Standing, stairs, or lifting too early may increase swelling and slow recovery.

Additional Tips for Recovery

  • Maintain an anti-inflammatory diet and continue any recommended supplements.
  • Monitor for signs of excessive swelling or limited ROM. Contact your surgeon if these occur.
  • Focus on following the prescribed plan to ensure the best possible recovery and long-term success.