One of my patients came to me saying “Doctor, I am a hard core runner and have been running marathons since the age of 25 years. Since 1 year I have been getting knee pain on and off and my Orthopaedic doctor is suggesting that I should do a knee replacement surgery for my degenerated knee. Hence, I have done my knee surgery and now there is a lot of restriction in knee movements.”
This mesmerizing journey from restriction in basic walking and bending knee till running 42 kms marathon is an outcome of consistent and tailored physiotherapy.
There are some basic things which you should know and should be aware about while doing knee rehabilitation.
Knee surgeries, such as total knee replacement (TKR) and ligament repairs, are common in India, especially among older adults and athletes. While they can relieve pain and improve mobility, they also come with certain limitations. If you or a loved one is considering knee surgery, it’s important to understand how it may impact daily life and activities. Click here to read more
How Knee Surgeries Affect Your Knee Movement?
1. Limited Range of Motion
After knee surgery, you might struggle with fully bending or straightening your knee. This can make it difficult to perform simple activities like:
- Sitting cross-legged (Padmasana or Sukhasana in yoga)
- Squatting, which is essential for using Indian-style toilets
- Climbing stairs comfortably
2. Reduced Strength and Endurance
Even after recovery, the operated knee may not be as strong as before. Muscle weakness and joint stiffness can limit activities like:
- Long walks or running
- Standing for extended periods
- Playing sports that require sudden movements
3. Risk of Pain and Swelling
Post-surgery, some people experience pain, swelling, or discomfort, especially after:
- Prolonged sitting or standing
- Lifting heavy objects
- Weather changes (many people report increased joint stiffness in cold weather)
Daily Life Challenges After Knee Surgery
1. Difficulty in Sitting on the Floor
Indian culture involves a lot of floor sitting, whether for prayers, meals, or social gatherings. Many knee surgery patients find it hard to sit and stand from the floor without support.
2. Modified Exercise Routine
You may need to switch from high-impact exercises like jogging or aerobics to low-impact activities such as swimming, cycling, or physiotherapy-guided exercises.
3. Travel and Outdoor Limitations
Traveling, especially in crowded buses or trains, can be challenging post-surgery. Uneven roads and long-standing hours can add to the discomfort.
How to Regain Maximum Mobility
1. Physiotherapy and Rehabilitation
Regular physiotherapy can help regain flexibility, reduce pain, and strengthen muscles. It’s crucial to follow prescribed exercises to maintain mobility.
2. Lifestyle Modifications
- Using Western-style toilets instead of Indian-style ones
- Wearing knee braces or support if needed
- Avoiding sudden, jerky movements
3. Proper Diet and Supplements
Consuming a diet rich in calcium, vitamin D, and protein helps in faster recovery and keeps the knee joint strong.
Why Physiotherapy is Essential After Knee Surgery
Physiotherapy is not just about exercise; it’s a structured approach to restoring mobility and preventing complications. Here’s why it’s essential:
1. Restores Joint Mobility
After surgery, the knee joint can become stiff. Immediate physiotherapy helps in
- Increasing flexibility with gentle stretching exercises
- Improving knee bending and straightening through controlled movements
- Enhancing coordination with guided walking techniques
2. Reduces Pain and Swelling
Pain and swelling are the first thing which we should encounter post-surgery. Rehabilitation in first 3 weeks should include treatment aiming for minimizing pain and reducing swelling. Physiotherapists use:
- Ice therapy to minimize inflammation
- Electrical stimulation to quadriceps muscle helps activate the muscle and helps reduce pain due to muscle inactivity due to pain
- IFT and TENS, ultrasound therapy for pain relief
- Compression techniques to boost blood circulation and reduce swelling
3. Strengthens Muscles for Stability
Weak muscles can slow recovery and increase the risk of falls. Physiotherapy includes:
- Quadriceps and hamstring strengthening exercises
- Weight-bearing and resistance exercises
- Weight bearing exercises can be progressed each week from lying down exercises to sitting and then standing exercises
- In standing exercises form basic hip and knee exercises progression is made till functional exercises involving all lower limb muscles.
- Walking training for leg muscles helps to improving walking and moving around after surgery.
- Hydrotherapy for low-impact muscle activation
Check out loading of knee joint by clicking here
4. Improves Balance and Prevents Re-Injury
Even after recovery of basic knee and leg movements and regaining strength continuous physiotherapy is required for 2-3 months. Goals for this phase is improving balance and prevent re-injury. Techniques include:
- Stability training with balance boards
- Core strengthening exercises
- Gradual transition to independent walking
- HUBER 360 machine helps improve functional balance with visual feedback and targeted movements
5. Helps to return back to sports
Very important and neglected phase in almost all knee surgeries rehabilitation. This phase comes after 4-5 months of proper and targeted rehab where in person is able to do all activities without support and independently with good endurance in leg muscles.
A good physiotherapist will guide you about the correct time and ways to improve your stamina and help you return back to sport as early as possible. This includes:
- lower limb endurance training for improving leg stamina
- agility training for sports which involve agility as a main component
- running drills
- Functional training and drills according to activity or sports
The last phase is very different for each and every individual and differs according to sports. It also depends on the baseline activity and strength which the person has before the surgery.
Stages of Physiotherapy for Complete Fitness
Recovery after knee surgery happens in phases. Each stage requires specific exercises and care.
1. Initial Recovery Phase (First 4 Weeks)
- Start with gentle knee movements to prevent stiffness
- Use a walker or crutches for support
- Perform ankle pumps and breathing exercises to improve circulation
- Follow a pain management routine with ice therapy
2. Strengthening Phase (4-12 Weeks)
- Begin weight-bearing exercises to regain strength
- Increase range of motion through guided physiotherapy
- Practice balance training to improve coordination
- Start climbing stairs with support
3. Advanced Rehabilitation (3-6 Months)
- Focus on functional exercises like walking longer distances
- Engage in low-impact sports like swimming or cycling
- Perform resistance exercises to regain full knee strength
- Transition to normal activities with minimal support
4. Return to Normal Life (6+ Months)
- Continue strength training and flexibility exercises
- Adapt lifestyle habits to protect knee health
- Consult a physiotherapist for long-term mobility strategies
Lifestyle Tips for Faster Recovery
1. Follow a Nutritious Diet
Proper nutrition supports healing. Include:
- Calcium-rich foods like milk, paneer, and sesame seeds
- Protein sources such as dal, eggs, and lean meats
- Anti-inflammatory foods like turmeric and ginger
2. Maintain a Healthy Weight
Excess weight puts pressure on the knee joint, slowing recovery. To manage weight:
- Eat balanced meals with fibre and lean protein
- Engage in regular physiotherapy exercises
- Avoid prolonged inactivity
3. Stay Active Without Overexertion
- Move regularly to prevent stiffness
- Avoid sudden, jerky movements
- Use knee braces or supports if recommended
4. Adapt to Comfortable Movements
In India, many daily activities involve bending the knees. Modify movements to avoid strain:
- Use a Western-style toilet instead of an Indian-style one
- Sit on a chair instead of squatting on the floor
- Take breaks during long walks or standing hours
- For athletes avoiding heavy training before 6-8 months
- Avoiding returning back to sport before 9 months
- Avoiding activities which creates strain on the knee
Common Myths About Physiotherapy After Knee Surgery
Myth 1: Rest is Better Than Exercise
Truth: Complete rest can lead to stiffness and muscle weakness. Physiotherapy ensures controlled movement for better recovery.
Myth 2: Pain Means Something is Wrong
Truth: Mild discomfort is normal during physiotherapy exercises. However, sharp pain should be reported to the therapist.
Myth 3: Knee Surgery Patients Should Avoid Stairs Forever
Truth: With proper rehabilitation, most patients can climb stairs normally within a few months.
Myth 4: Physiotherapy is Only for the Initial Recovery Phase
Truth: Long-term physiotherapy helps maintain knee strength and flexibility, reducing the risk of future problems.
Did you know what is worse than ACL Injury? Click here to know
Conclusion
Knee surgeries can improve your quality of life, but they also bring certain restrictions. Understanding these limitations and adapting with proper physiotherapy and lifestyle changes can help you maintain an active and independent life. Check for more details.
Physiotherapy is the key to a full recovery after knee surgery. With proper exercises, lifestyle changes, and professional guidance, you can regain complete mobility and return to your normal activities.
Always consult a physiotherapist for a personalized rehabilitation plan after knee surgery!
