5 Exercises to Practice Before a Knee Replacement

It may seem counterintuitive to do exercises before a knee replacement. After all, if you could move and bend and squat without pain, you wouldn’t need surgery in the first place! But performing light exercise for 6–8 weeks of “prehab” can actually help you expedite your recovery. Sturdy legs, strong hips, and stable balance will give your new knee a jump start to success. In truth, the stronger you are before surgery, the better off your new knee will be!

Prehab Exercises to Do Before a Knee Replacement

Below is a quick routine of five simple exercises you can perform in the weeks and months leading up to your scheduled total knee replacement. Be sure to consult your physician before attempting these exercises or beginning any new workout regimen.

1. Quad Set

• Lie on your back with one knee bent and a rolled-up towel under your straight leg.
• Gently squeeze the quadricep muscles of that straight leg, pushing the back of your knee down into the towel.
• Hold for 3 seconds then relax. Don’t hold your breath!
• Repeat 10 times.

2. Straight Leg Raise

• Lie on your back with one knee bent and the other leg straight. 
• Slowly lift your straight leg until it is in line with the thigh of your bent leg.
• Slowly lower back to the start position.
• Repeat 10 times.

3. Heel Raises

• Stand upright with your feet shoulder-width apart, facing a countertop or sturdy chair for support if needed.
• Slowly lift both heels off the ground at the same time, shifting your weight to your toes.
• Hold for 1–2 seconds, then slowly lower your heels to the floor.
• Repeat 10 times.

4. Mini Squats

• Stand upright, with your feet slightly wider than shoulder-width apart.
• Perform a mini squat by bending your knees and hinging at your hips, as if you’re about to sit in a chair.
• Before reaching a full squat, straighten your legs and return to standing.
• Repeat 10 times.

5. Standing Hip Abduction

• Stand upright alongside a counter or sturdy chair to maintain your balance. You may loop a resistance band around your ankle or perform without it.
• Keeping your body upright and your leg straight, slowly kick your leg out to the side.
• Lower your leg back to the starting position.
• Repeat 10 times.

Making It a Routine—before a knee replacement!

Did you finish all five exercises? Great! But you’re not done yet. Go back and repeat these exercises twice more, for a total of three rounds. Your new knee will thank you later.

Now, you don’t have to perform these exercises every single day, but aim for 3–4 days a week. When they start to get easy, challenge yourself by adding some resistance in the form of a therapy band or light dumbbells. Just pay attention to your body and back off from any exercise that causes pain. You can always modify an exercise to make it more tolerable for your knee. 

Will It Really Help?

You may be thinking, “Well of course you want me to exercise before surgery. You’re a physical therapist!” While that may be true—after all, my enthusiasm for prehab is grounded in the real results I’ve seen in my patients—you don’t have to take my word for it. I have research to back it up!

For just a few examples, research suggests that prehab exercises before a knee replacement can improve post-operative performance and muscle strength as well as knee extensor strength and patient-reported outcomes. Patients who engage in prehab exercises typically see shorter hospital stays after surgery and are less likely to be discharged to an inpatient facility instead of going straight home.

If a shorter hospital stay, quicker return home, stronger knee, and faster recovery all sound good to you, then those few weeks of prehab will be well worth the time and effort!

What Else Can I Do to Prepare Before a Knee Replacement?

I’m glad you asked. Although prehab exercises make up an important piece of pre-operative preparation, there are many other things you should do to get your body and home ready for recovery. I explain all this and more in my book, Total Knee Replacement Made Simple.

Designed for the everyday TKA patient with a busy schedule, this book gets right to the point regarding what you need to know in the weeks and months leading up to your surgery. I’ve included a surgery checklist, example questions to ask your surgeon, and several pages of prehab exercises you can add to your routine. Read the whole book—it’s less than 100 pages!—and you’ll also learn what to expect from your recovery timeline, how to manage pain and swelling at home, and how to optimize your time in physical therapy up to a year after the operation. 

For more helpful resources, such as physical therapy for knee pain or the best ice machines for knee surgery, check out the rest of the blog!