The Role of Physiotherapy Before and After Knee Replacement Surgery
Physiotherapy plays a fundamental role before and after knee replacement surgery, helping to optimise recovery and support long-term function.
Pre-operative rehabilitation aims to maximise baseline strength, joint mobility and functional capacity, while also helping patients understand what to expect from the rehabilitation process. This allows them to enter surgery in the best possible physical condition and with a clearer understanding of the recovery ahead.
With this patient in particular, we worked hard on getting the fundamentals right before surgery, working closely with his consultant to prepare him as effectively as possible for his post-operative rehabilitation.
Following surgery, physiotherapy supports the management of pain and swelling, knee mobility, wound recovery and a safe, progressive return to everyday function.
While increasing knee flexion and returning to previous activity levels are often important goals following a knee replacement, these need to be balanced against the individual's symptoms, function and longer-term needs. Progressing activity or range of movement too quickly can aggravate symptoms and potentially hinder recovery.
In many cases, establishing the fundamentals — effective pain and swelling management, full knee extension, safe walking, adequate strength and confidence with everyday activities — provides the strongest foundation for long-term success.
Restoring movement
Hands-on treatment can be useful in managing soft-tissue restrictions, reducing pain and improving joint and tissue mobility where appropriate. Positioning, movement and exercise can also help support circulation and manage post-operative swelling.
Restoring full knee extension is a particularly important early objective. An extension deficit can affect standing, walking, quadriceps function and overall gait mechanics, and may become increasingly difficult to address if it persists.
Rebuilding strength and function
Progressive exercise rehabilitation is essential for restoring quadriceps activation, lower-limb strength, proprioception, balance and overall functional capacity.
Gait re-education is equally important. Pain, weakness, swelling and restricted mobility can all lead to compensatory movement patterns following surgery.
Physiotherapy allows us to identify these changes and address them through targeted strengthening, mobility work, functional retraining and appropriately graded loading.
As rehabilitation progresses, exercises can gradually become more demanding and increasingly specific to the activities the individual wants to return to.
Looking beyond range of movement
Ultimately, successful knee replacement rehabilitation isn't simply about achieving the greatest possible knee flexion or returning to previous activity levels as quickly as possible.
It's about achieving safe, sustainable and meaningful function for the individual.
An individualised physiotherapy programme allows us to establish appropriate goals, monitor progress and recognise when rehabilitation should progress — or when a more measured approach may be appropriate.
By getting the fundamentals right first, patients can develop the strength, movement quality, confidence and symptom control needed to support successful long-term outcomes following knee replacement surgery.
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