4 Balance Exercises after a Total Knee Replacement

The first steps you take on your new knee after a total knee replacement won’t be your strongest. In fact, you may notice considerable weakness in your leg and a new sense of instability. These 4 balance exercises after a total knee replacement will help you minimize post-surgical wobbliness once you’re back on your feet. Read to the end for a bonus warm-up exercise and information on the benefits of balance exercises after knee surgery.

1. Single-Leg Stance

You stand on one leg every time you take a step or go up and down stairs. That’s why the single-leg stance is one of the most important balance exercises to master as you rehabilitate your knee. 

• Stand with your feet hip-width distance apart, holding onto a counter or sturdy chair for support if needed.
• Keeping your body upright, lift one foot off the ground slightly. 
• Hold for 10 seconds and try not to lean on your planted foot.
• Rest and repeat 5 times on each leg.

2. Narrow-stance Reaches

Maintaining stability is a lot harder when your feet are close together and your upper body is moving. Narrow-stance reaches will give you practice for the everyday movements most likely to challenge your balance. 

• Stand tall with your feet as close together as possible with stability. 
• Reach forward with one hand, holding onto a counter or sturdy chair with the other hand if needed. Return the arm to the start position.
• Alternate arms, reaching with one arm at a time. Then, try reaching with both hands forward at the same time. Eventually try reaching out to the side or in different directions.
• Reach 10 times with each arm, then repeat for 3 sets.

3. Three-Way Hip Kicks

Rehabilitating your knee includes strengthening the hip muscles, which provide stability for walking, turning, and climbing stairs. 

• Stand with your feet shoulder-width apart, holding onto a counter or sturdy chair for stability.
• Slowly kick one leg in three directions: forward, out to the side, and back behind you.
• Return the leg to the start position after each kick.
• Complete 10 rounds of all 3 kicks on each leg, then repeat for 2 more sets.

4. Heel Raises

This final exercise targets the calf muscles, which control ankle position and contribute to overall stability. Stronger calves = better balance!

• Stand with your feet shoulder-width apart, holding onto a counter or sturdy chair for support.
• Shift your weight to your toes and lift your heels off the ground.
• Be careful not to lean onto the support; work towards performing this exercise without holding onto anything.
• Slowly return to the start position and repeat 10 times for 3 sets.

Bonus: Warm-up Exercise

If performing any of these exercises feels daunting, try the simple balance warm-up exercise below. 

• Stand tall between two sturdy supports, such as a countertop and chair. Hold onto both for stability when starting out.
• Raise one foot and shift your body weight over to the opposite leg.
• Carefully release your hands and try to stand without any support, holding for 5–10 seconds if possible.
• Return your hands to the support and shift your weight to the other side, repeating 10 times on each side.

Once this becomes easy, place a balance pad on the floor and practice shifting your weight while standing on the balance pad. Then, stop using the supports!

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Benefits of Balance Exercises After a Total Knee Replacement

Balance is one of many metrics we physical therapists use in the clinic to gauge a patient’s progress after knee replacement. Why? It takes strong muscles to maintain upright balance. Dynamic balance, or the ability to maintain balance while moving, requires coordination and proprioception—the awareness of your body’s movement through space. Moreover, your sense of balance reflects not only your physical health and strength, but also how likely you are to succeed at home. Good balance is essential for daily living, and without it, you’re at a higher risk of injury from falling. 

Improving your balance before surgery can help set you up for a stronger, faster recovery. But even if you’ve already had surgery and are heading to physical therapy, it’s not too late to make better balance a priority at home. In the first week or two after surgery, you’ll use a walker to get around. But as your gait improves and your legs strengthen, you’ll switch to a straight cane. By performing balance exercises after a total knee replacement, you can expedite your transition to a cane and eventually walk on your own. 

As you can see, improving your balance brings a host of benefits, from strengthening your legs and improving your coordination to shortening your recovery and the time you have to use a cane! Plus, if you’re over age 65, balance exercises are one of the best safeguards against fall prevention. Get in the habit of balance training now, and you’ll reap the benefits for years to come!