How to Safely Return to Exercise After Knee Surgery

Knee surgery can be a major turning point. Whether it was a meniscus repair, ACL surgery or total knee replacement, the road back to exercise requires caution, patience and the right guidance. Fortunately, you can get back to moving if you do it the smart way.

Every year, roughly 790,000 knee replacement surgeries are performed in the United States alone. While success rates are high, full recovery depends heavily on how well you follow your rehab plan. Here’s a step-by-step guide to help you return to exercise safely after knee surgery.

1.   Follow Post-Surgical Instructions

When you have knee surgery, you’ll be under anesthesia, meaning you’ll fall asleep within a few minutes and won’t feel anything. You may feel groggy or unusually tired when you wake up, so don’t rush back into your normal routine. Less is more in the first few days after your surgery. Pushing too soon can delay healing or reverse progress.

Respect your surgeon and physiotherapist’s guidance completely. This includes taking prescribed medications, using crutches or braces if needed and attending follow-up appointments.

2.   Start With Gentle Range-Of-Motion Exercises

Once your doctor clears you for movement, begin with range-of-motion work, such as heel slides, straight leg raises and quad sets. These movements prevent stiffness while encouraging blood flow and joint mobility. Avoid any exercise that causes sharp pain or swelling, and speak to your healthcare provider if either occurs.

3.   Prioritize Physical Therapy

Physical therapy (PT) isn’t optional after knee surgery. A licensed physical therapist will guide you through strengthening exercises, monitor your progress and adjust your plan based on your healing. PT typically includes balance drills, light resistance work, mobility and gait training. Make an effort to attend every session. Consistency is key during your recovery.

4.   Rebuild Strength Gradually

After you’ve regained basic movement and stability, it’s time to build strength. Focus on low-impact exercises like:

• Stationary cycling.
• Swimming or aqua jogging.
• Seated leg presses.
• Body weight squats with good form.

Avoid high-impact or twisting movements at this stage.

5.   Listen to Your Body

Pain is a signal to stop what you’re doing. It’s not a challenge to push through. Some soreness and fatigue are normal, but pull back if you experience swelling, instability or sharp pain after exercising. Recovery isn’t linear, and rest days are part of training.

6.   Introduce Functional and Sport-Specific Training

Once your therapist and surgeon give you the green light, you can gradually introduce higher-level movements. These might include:

• Step-ups
• Light jogging
• Controlled plyometrics
• Agility work

If you’re an athlete, this phase mimics the movements you’ll return to. But don’t skip steps. You want to build strength, balance and range of motion first.

7.   Fuel Your Recovery With Nutrition

What you eat matters. Aim for a diet rich in lean protein, healthy fats and anti-inflammatory foods like leafy greens, berries and fatty fish. Increase your protein intake to promote healing and rebuild tissue following your procedure.

8.   Modify, Don’t Avoid

You don’t have to stop doing what you love. You may just need to do it differently. Modify workouts, use resistance bands or switch to low-impact equipment like an elliptical or rowing machine.

9.   Maintain a Long-Term Strength and Mobility Routine

Just because you’re cleared doesn’t mean the hard work stops. Make strength training and mobility exercises a lifelong habit. Strong quads, in particular, support and strengthen the knee joint, helping to prevent reinjury.

10.       Monitor Your Progress

Keep track of how far you’ve come. That might mean logging your exercises, taking photos of your mobility progress or noting how each week feels better than the last. Tracking helps you stay motivated and spot early signs of overtraining or setbacks.

Own Your Recovery

Returning to exercise after knee surgery requires discipline and patience. However, with the right steps, you’ll get back to where you were — and you might come back even stronger.