Activities You Cannot Do After Knee Replacement Surgery – Knee Joint Care Tips

Discover post-knee replacement activities to avoid for optimal joint care. Age In Place School/Buena Physical Therapy offers expert tips for a safe recovery.

I am an orthopedic physical therapist with over forty years of clinical experience.
I have seen thousands of total knee replacement recipients as a hospital therapist seeing patients immediately after surgery, as a home health therapist seeing patients during their first three weeks after surgery, and as the owner of Buena Physical Therapy seeing them during their outpatient clinic portion of their rehabilitation.

Understanding What You Cannot Do After Knee Replacement Surgery

After undergoing knee replacement surgery, it’s crucial to understand the boundaries of your new joint to ensure a successful recovery and long-term functionality. Acknowledging what activities you cannot do after the surgery is key to preventing complications and maintaining joint integrity. During the replacement recovery process, you should steer clear of certain high-impact activities that place excessive stress on your new prosthesis. Typically, these are activities to avoid, as they may jeopardize the healing of your recent surgery.

The activities you may not be able to perform post-surgery include running, jumping, or any strenuous sports that involve contact or rapid changes in direction. Participating in high-impact sports is often discouraged due to the potential for damaging the new joint or causing undue wear. That’s not to say you must lead a sedentary lifestyle after surgery; on the contrary, low-impact exercises are encouraged to strengthen the muscles around the knee and improve flexibility.

The main category of exercises that my patients encounter as problematic is cardiopulmonary exercise. They have usually declined in cardiopulmonary conditioning because pre-surgery increases in pain has decreased their ability to continue their exercise routines.

I advise my patients to resume their cardiopulmonary exercises as soon as possible, starting with limited outside walking immediately after surgery and continuing to progress with this walking until they are ready for strenuous cardiopulmonary exercises.
Read my two articles on walking immediately after surgery:
Walking: The Perfect Exercise After Total Knee Replacement
Walking After A Total Knee Replacement: (When and How Much?)

After this initial phase of walking exercises and the new knee replacement is more tolerant of more aggressive cardiopulmonary exercises than the lungs and heart, I advise my patients to do cardiopulmonary exercises on a treadmill or elliptical machine.

The treadmill is ideal because one can get to the exact desired heart rate using elevation and speed settings that best protect the total knee replacement, as well as having a cushioned tread pad that decreases heel strike impact.

Always consult your physical therapist for personalized guidance.

Joint replacement is a significant procedure that demands respect for the body’s healing timeline, and being aware of what activities might put your recovery at risk is foundational to a successful outcome. Following surgery, it’s critical to align with your physical therapy team’s directives and understand why certain actions should be postponed or avoided indefinitely. From lifting heavy weights to engaging in high-stress physical tasks at work, it’s crucial to set boundaries that protect your total knee replacement and overall well-being.

While considering activities to avoid after surgery, the focus should be on protecting your prosthesis and promoting healing. Remember, a tailored plan created by a physical therapist is always the best route to ensure your activities after knee replacement are safe, beneficial, and conducive to a healthy, active lifestyle as you age in place.

Featured Image Pain after TKR croped
Femor & Tibial Knee Replacement Components

Activities to Avoid Directly After Knee Replacement

When you’ve undergone a knee replacement, it’s crucial to give your body time to heal and adjust to your new joint. During the recovery process, there are certain activities you should avoid to ensure a smooth and successful rehabilitation.

  • Avoid high-impact activities such as running, jogging, and jumping, as these can damage the new joint.
  • Do not twist your knee aggressively, as this can put unnecessary stress on the knee joint.
  • Do not kneel on hard surfaces as this can cause pain and pressure on the knee.
  • Avoid lifting heavy weights that could overload the knee joint.
  • Do not participate in contact sports which may risk a blow to the knee and potentially damage the prosthesis.
  • Refrain from excessive bending of the knee beyond your surgeon’s advised range of motion, especially soon after surgery.
  • Avoid climbing ladders or doing activities that involve a risk of falling and injuring the knee.
  • Do not sit in the same position for long periods as this can increase stiffness; make sure to change positions frequently.
  • Avoid crossing your legs at the knees, as this can hinder blood flow and put undue stress on the knee joint.
  • Do not ignore signs of infection such as increased redness, swelling, or persistent pain, and consult your doctor immediately.
  • Avoid soaking in a bathtub, hot tub, or pool until your incision has fully healed and you have your surgeon’s approval.
  • Do not drive a vehicle until your doctor confirms that your reflexes and knee strength have adequately recovered.
  • Refrain from smoking or using tobacco products as these can impede healing and recovery of the surgical area.
  • Do not take over-the-counter supplements or medications without consulting your surgeon, as they might interact with your prescribed medication.
  • Avoid standing for long periods without taking breaks, which can lead to swelling and discomfort.
  • Avoid stairs frequently in the early stages of recovery, limiting their use until you regain strength and balance.
  • Do not rush your recovery; respect the healing process and follow your physical therapy regimen diligently.
  • Avoid exposure to direct trauma to the knee by using protective gear during activities as directed by your surgeon.
  • Don’t forget to attend follow-up appointments with your surgeon to monitor your progress.

At Age In Place School / Buena Physical Therapy, Inc., we understand the importance of protecting your investment in your health, and that’s why we advise patients to take special care not to engage in high-risk activities that could compromise their new joint.

First and foremost, after surgery, it’s vital to not participate in any high-impact sports or exercises that put excessive strain on your knee. This includes running, jumping, or any activity that involves abrupt stops and starts. Such high-risk activities not only increase the wear on your replacement components, but can also lead to injury and set back your recovery. Instead, focus on low-impact exercises that we, as your therapists, can customize for you.

In the initial weeks directly after surgery, it’s equally important not to do activities that involve deep knee bends or squatting, as these movements place intense pressure on your new joint. Similarly, you need to avoid tasks that require prolonged periods of standing or walking without rest. Not adhering to these restrictions can lead to complications and increase your recovery time.

For my patients, I guide them through a personalized recovery plan tailored to protect the new joint replacement. I emphasize the importance of not pushing the knee too quickly and ensuring that they don’t shortcut their recovery for short-term gains.
Remember, your body will thank you for taking the necessary precautions and allowing it the proper time to heal and adapt.

Rest assured, the list of what you can do will grow as you progress through your healing journey, so focus on recovery and patience now, for better mobility and function in the future.

Following these initial precautionary directives, and progressing through a comprehensive rehabilitation program, I have had many patients return to their favorite activities, such as golf, horseback riding, and even skiing.

Knee Replacement Recovery: Resuming Normal Activities

Following a knee replacement, it’s crucial for patients to understand that the recovery period is a gradual journey back to normal activities. The key objective of the recovery process is not only to heal the surgical site but also to enhance joint function through a carefully designed program of rehabilitation.

Here at Age In Place School/Buena Physical Therapy, Inc., we prioritize your safe return to mobility and guide you on the path to resume activities at a pace that your body can handle.

As a patient, you’re likely eager to get back to your usual lifestyle. However, certain activities must be reintroduced with caution after surgery. Your patience will be paramount as you should not rush the process.

Initially, heavy lifting, jogging, or other high-impact exercises may be off-limits because they can put undue stress on your new knee. The focus during the first phase of replacement recovery should be on regaining strength and range of motion through targeted exercises and therapy.

Throughout the rehabilitation period, I’ll monitor my patient’s progression and adjust their treatment plan accordingly. This individualized approach ensures that as they gradually resume activities, they do so with the right support and guidance.

It’s important to follow the advised precautions and therapy routines to avoid complications and maximize the benefits of the knee replacement. With time and dedication, the goal is to reintroduce normal activities back into your daily routine, allowing you to enjoy an active lifestyle once again.

Keep in mind that everyone’s recovery timeline is different; some patients may find that they can resume activities sooner than others. It’s vital that you listen to your body and communicate openly with your physical therapist. They are there as your partners in recovery, committed to helping you achieve the best possible outcome after your knee replacement surgery.

Walking Stick Rear view cropped and watermarked 1

Exercise After Knee Replacement: Identifying Safe Activities

Embarking on your recovery journey after a knee replacement requires understanding which exercises and activities are suited to ensure a safe and effective healing process. The emphasis is often on low-impact exercises that foster knee health without overburdening the newly replaced joint.

I prioritize educating my patients on the nuances of knee replacement recovery, ensuring the activities chosen promote a swift return to mobility without compromising on long-term results.

Engaging in low-impact exercise after surgery is a cornerstone of a successful rehabilitation program. Activities such as swimming, cycling, and using an elliptical machine can provide the necessary stimulus for recovery, aligning with the principles of sports medicine that advocate for graded, progressive load on healing tissues.

These safe activities leverage the buoyancy of water or the support of equipment to minimize strain while enhancing cardiovascular health and muscular endurance.

Yet, it’s crucial to recognize the distinction between general activity and targeted exercises post-surgery. Recovery protocols often emphasize specific therapeutic exercises designed by health professionals to cater to the individual’s condition and the integrity of the knee joint. Safe activities are those that respect the physiological limits and align with the gradual tissue adaptation process.

While high-impact sports and activities that involve twisting, jumping, or heavy lifting are not recommended directly after surgery, integrating recommended exercises within the confines of recovery protocols ensures long-term functionality and durability of the prosthesis.

It is through patient education and the proper selection of low-impact, therapeutic activities, that I champion optimal recovery trajectories for my patients. Remember, maintaining consistency in your exercise regimen, under the careful guidance of a orthopedic physical therapist, will yield the best outcomes for your joint replacement health post-surgery.

Heel Raises watermarked Cropped
Heel Raises with toes on a 2×4

Rehab and Care Tips Following Knee Replacement Surgery

Embarking on the journey to recovery after a knee replacement requires commitment to a tailored rehab regimen designed with your unique health profile in mind.

I’m dedicated to guiding my patients through comprehensive rehabilitation strategies that optimize their healing and enhance their overall well-being. Their recovery is my priority, and part of that involves educating them on essential care tips to safeguard their new knee joint.

After surgery, it’s crucial to approach exercise with caution and be mindful of the activities you incorporate into your routine. During the initial phases of recovery, your physical therapy will include gentle range-of-motion exercises and progressive walking programs that encourage proper joint function without overstraining the knee.

Getting the extension range of motion to straight within 6 weeks is critical.
Achieving optimal flexion range of motion has a longer window of opportunity.

My patient-centric approach underscores the importance of personalized attention; hence, every exercise plan I advocate is inherently reflective of their specific needs and recovery goals. In the aftermath of replacement surgery, it’s essential to recognize that the new knee is undergoing a remarkable transformation, and thus, patience and meticulous care are indispensable.

I encourage patients to focus primarily on low-impact activities that foster joint flexibility, stability, and strength, which are key components for a successful healing process.

To maximize outcomes following a knee replacement, I collaborate with them to establish a conducive healing environment, both in clinical settings and at their home.
The integration of suitable equipment and support systems plays a pivotal role in their after-surgery journey.

Resuming normal activities should be a gradual and well-calibrated endeavor, ensuring that the integrity of their joint replacement is maintained. Remember, the objective of rehabilitation is not merely to return to pre-surgery function but to emerge even stronger and more resilient.

The Timeline of Recovery After Knee Surgery

After knee replacement surgery, the recovery timeline is a crucial aspect for every patient to understand. The journey back to a normal, functional life is marked by several milestones that need to be acknowledged within the rehabilitation process.

Typically, the timeline of recovery after surgery is expected to progress over weeks to months, with each phase ushering in new abilities and responsibilities for the patient. Initially, rehabilitation efforts are focused on wound healing, pain management, and the commencement of gentle physical therapies to prevent stiffness and maintain circulation within the knee joint.

As the weeks pass and recovery advances, the patient’s participation intensifies. The physical therapy sessions become more robust, aiming to restore strength, improve flexibility, and increase the range of motion of the replaced knee.

During this period, it’s crucial to note that there are several activities that a patient after joint replacement must avoid to prevent complications and ensure the integrity of the replacement. The patient’s adherence to the prescribed recovery protocols and their commitment to the rehabilitation exercises are pivotal for a successful recovery.

  • Extension range of motion to be less than 10 degrees short of full extension. Almost all of my patients achieve somewhere between 5 degrees short of full extension to full extension by three weeks post-op.
  • Flexion range of motion to be greater than 95 degrees of flexion. Most of my patients achieve between 100 degrees and 120 degrees of flexion by three weeks post-op.
  • Fall risk improves from High Fall Risk to Low Fall Rist by three weeks post-op.
  • Muscle strength in the operated leg improves to 4 out of 5 strength by three weeks post-op.
  • Walking endurance increases to ¼ mile without a walker or cane by three weeks post-op.
  • Medication usage decreases to minimal by three weeks post-op.
  • Pain levels are at 3/10 or less by three weeks post-op

Most online articles I read state: “Usually, around the three to six-month mark, we begin to see significant strides towards resuming normal activities.”
That is not what I am seeing in my patient population.

The patients I’m seeing are walking without any assistive devices, doing normal activities of daily living independently, driving and shopping independently by the end of three weeks post-op.
They can drive themselves to the outpatient physical therapy appointments and are no longer homebound.

While the process of recovery after knee replacement surgery may appear daunting, awareness of the timeline and a commitment to follow through with rehabilitation efforts will pave the way to a successful outcome.

I always go over my expected outcome goals on the first visit with my patient, and they tend to achieve these goals.
This initial goal-setting discussion helps the patient understand if they are on track for this three-week timeline.
Read my article: Total Knee Replacement Outcomes After Home Physical Therapy

I encourage all my patients to embrace this process with patience and “Stay In The Lane”.
More is not better.
Doing more than the protocol I set for my patients frequently results in an exacerbation of symptoms and sets them back about a week as they recover from the flare-up.

High-Risk Activities That Can Compromise Knee Replacement Recovery

After undergoing knee replacement surgery, it’s crucial to understand which activities you cannot do to ensure successful replacement recovery.

High-impact activities pose significant risks and may compromise your new joint’s integrity. To protect the investment you’ve made in regaining your mobility through surgery, it’s advised to avoid high-risk activities, especially in the initial phases of healing.

Initially, any activity that involves jumping, running, or rapid direction changes should be firmly off the table as they subject your knee to stress that can damage the prosthetic components or surrounding tissues.

For those eager to resume their active lifestyles after knee replacement, it’s important to understand the delicate balance between activity and rest. While gentle exercise is crucial, participating in activities such as contact sports, heavy lifting, or anything that can cause a jarring impact should be avoided post-surgery.

These high-risk activities can not only delay your recovery but also increase the likelihood of dislocation or other complications. Instead, focus on low-impact activities that support gradual healing and strength building, such as swimming or cycling.

The period directly after knee replacement is a critical time for your joint’s health. Each activity you engage in should be measured against its potential to harm your new joint or assist in your recuperation. Steering clear of activities that cause excessive strain ensures that you don’t unwittingly undo the benefits of your surgery.

Whether you’re at home or participating in a supervised physical therapy session, remember that the goal is to recover smoothly, so patience is key. Even as you progress in your recovery, it’s vital to consult with your physical therapist about which activities remain high-risk and which ones can be cautiously reintegrated into your routine.

Trust that with time and proper care, a gradual return to more strenuous activities is possible, but be certain to avoid high-risk activities that can compromise your progress and put unnecessary pressure on your recovering knee joint.

Read my other articles about Total Knee Replacement

Perhaps you are approaching or already retired and wondering how you could earn extra money in retirement.
One option would be to do as I am doing.
Read my article How To Generate Retirement Income: Cash In On Your Knowledge.

Dr. Robert Donaldson

Dr. Donaldson is dually licensed; physical therapy in 1975 and doctor of chiropractic in 1995. He held credentials of Orthopedic Clinical Specialist in physical therapy for 20 years, QME in California, and taught at USC. He owns and operates an orthopedic physical therapy practice. See "About Me" page.

Recent Posts