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How to recover after knee surgery: tips from our physical therapists
Recovery after knee surgery starts with controlling swelling and getting the knee to straighten fully. You then build motion and, over the following weeks, strength and balance, always following your surgeon's protocol. Our physical therapists' top early tips: ice in short 10-minute sessions, sleep with a pillow under your ankle (not under your knee) to help the knee straighten, and start physical therapy as soon as your surgeon clears you.
Knee surgery recovery is one of the biggest topics on our YouTube channel. The four clips below have been viewed more than 7 million times. Whether you had a knee replacement or an ACL or meniscus repair, the early weeks follow the same principles. Protect the healing tissue, control swelling, get the knee straight, then rebuild motion, strength and balance.
Three things to do in the first weeks
In the video on the left, one of our physical therapists gives three "must-dos" after a knee replacement:
- "Ice is your friend." Ice for about 10 minutes on, then 10 minutes off. Going longer adds little, because the ice pack warms up. Aim for at least three times a day.
- Pillow under the ankle, not the knee. A pillow under the knee feels comfortable, but it trains the knee to stay bent. Propping the ankle helps it straighten, which makes walking and therapy easier.
- Get to physical therapy as soon as your surgeon clears you. "The faster we can get you moving," our therapist says, "the faster you get back to doing what you love."
Respect healing time
In the video on the right, our therapist explains that "we have to allow appropriate healing time for the tissues to heal." In that patient's case, bending was limited to about 60 degrees for the first two to three weeks. It was then slowly progressed toward full motion, with strengthening added at about four to six weeks depending on how the patient was doing.
Those numbers belong to that patient's surgery. Limits differ a lot between a knee replacement, an ACL reconstruction and a meniscus repair, so always follow the protocol your surgeon gives you. Your physical therapist builds the plan around it.
After ACL and meniscus repair: extension first
The clip on the left shows a knee that "just had two structures repaired in one surgery, the ACL and the meniscus." The early focus is "calming the swelling and gently pushing for full knee extension, because that early range of motion is what prevents stiffness later." Getting the knee fully straight early is a common goal after many knee operations. It is needed for a normal walking pattern.
After knee replacement: beat stiffness
In the clip on the right, our therapist notes that "getting the knee moving is only part of the recovery. Sometimes the body forms scar tissue very quickly, making the knee stiff and sensitive." That is why therapy after a knee replacement works on three things together: restoring motion, building strength and retraining balance, "so the patient can get back to normal function."
What a typical rehab plan includes
- Swelling control: ice, elevation and gentle movement
- Range of motion: working toward full straightening and steadily more bending
- Strength: quadriceps, hamstrings, hips and calves, progressed as healing allows
- Balance and walking: moving from a walker or crutches to walking on your own
- Return to activity: for athletes, sport-specific training and return-to-play testing
For some patients, the AlterG anti-gravity treadmill lets walking and running training start at a fraction of body weight.
When to call your surgeon
Call your surgeon promptly if you notice rising redness, warmth or drainage at the incision, fever, or calf pain and swelling. Also call for sudden worsening pain or a knee that will not bend or straighten as expected. Seek emergency care for chest pain or shortness of breath.
Related care at Precision Care
Where to get care in New York City
Precision Care physical therapists work with your surgeon's protocol at all three offices, with tools such as the AlterG anti-gravity treadmill when your plan calls for it. You can request an appointment online or call the office closest to you. An online request is not a confirmed booking until the office contacts you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
What should I do right after knee surgery?
Follow your surgeon's instructions, control swelling with ice and elevation, work on getting the knee straight, and start physical therapy as soon as your surgeon clears you. Our therapists suggest icing in 10-minute sessions at least three times a day.
Should I put a pillow under my knee after surgery?
Our physical therapists recommend putting the pillow under your ankle, not your knee. A pillow under the knee keeps it bent, while propping the ankle helps the knee straighten, which you need for normal walking.
How long should I ice my knee after surgery?
Our therapists recommend about 10 minutes on and 10 minutes off. Going longer adds little because the pack warms up. Aim for at least three times a day, and protect your skin with a cloth layer.
When does strengthening start after knee surgery?
It depends on the surgery and your surgeon's protocol. In one of our videos, strengthening began at about four to six weeks after the tissues had time to heal, but your surgeon and therapist set the timing for you.
Why is my knee so stiff after a knee replacement?
Swelling and scar tissue, which can form quickly, often make the knee stiff and sensitive. Regular range-of-motion work, strengthening and balance training in physical therapy help restore movement.
Educational only, not medical advice. These videos and this article explain common treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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