Exercise Program For

Total Knee Replacement

North Shore/Coast
Garibaldi, Vancouver
and Richmond
Exercise Program for Total Knee Replacement
General Instructions
These exercises help you to improve your range of motion, muscle strength and
mobility after your operation.
Important: Do ONLY the exercises that the therapist has advised you to do.
● Do the exercises at least 2 times a day or until your therapist tells you to
change and write the number done in the exercise log. (At the back of this
booklet)
● If your pain increases for more than two hours after exercise, cut back a bit
and talk to your therapist
● Use a walking aid until your therapist advises you to stop.
● When resting keep your knee as straight as possible.

● Use ice on your knee for 15 to 20 minutes □ before and □ after you do your
exercises. You can use a bag of frozen vegetables instead of ice.

Core Stability Exercises

These exercises help to re-teach the muscles
that help stabilize your lower back.
Transversus Abdominis
1. In Lying
Lie on your back with your knees bent
and feet flat. Tighten your lower belly
muscles by pulling your belly button
down to your spine. Breathe normally.
Hold .................. seconds.
Repeat .................. times.

2. In Sitting
Sit in a straight back chair. Put your
feet flat on the floor. Tighten your lower
belly muscles by pulling your belly back
towards the chair.
Hold .................. seconds
Repeat .................. times.

2
Range of Motion (ROM) Exercises
3. Heel Slides (Knee Flexion)
On a slippery surface (garbage bag) bend
your knee and pull your heel towards
your buttocks. You may find it easier if
you bend your good leg.
You may use your hands or a towel
behind your thigh to help you.
Hold .................. seconds
Repeat .................. times.

4. Passive Extension
Put a small roll under your heel. Gently
straighten your knee. You may gently
push down just above the knee with your
hands and /or by tightening your thigh
muscles.
Hold .................. seconds.
Repeat .................. times.

5. Chair Knee Flexion

Keep your feet on the floor. Slide the
foot of your operated leg back, bending
your knee.
Hold .................. seconds.
Repeat .................. times.

6. Passive Knee Flexion In Sitting

Keep your feet on the floor. Bend your
knee. Keep the foot of your operated
leg fixed on the floor. Slide your bottom
forwards in the chair.
Hold .................. seconds.
Repeat .................. times.

3
 7. Assisted knee flexion in sitting
Sit on a chair with your feet hanging.
Cross the ankle of your non-operated leg
over the ankle of the operated leg. Gently
push your operated leg back with your
good leg until you feel a stretch.
Hold .................. seconds.
Repeat .................. times.

8. Step Lunge
Put your operated leg up onto a step,
holding onto the rail, slowly bend your
knee and move forwards until you feel a
stretch in the front of your knee.
Hold .................. seconds.
Repeat .................. times.

9. Hamstring Stretch
Sit on the edge of a sturdy chair.
Straighten your operated leg out in front.
Pull your toes/foot back towards your
face. Slowly bend forwards from your
hips. Keep your back straight until you
feel a stretch in the back of your thigh.
Hold .................. seconds.
Repeat .................. times.

10. Calf Stretch

Keep your back leg straight. Keep your
heel on the floor turned slightly outward.
Lean into the wall until you your calf
stretch.
Hold .................. seconds
Repeat .................. times.
4
 11. Quads Stretch
Lie on your stomach with a pillow under
your lower belly. Bend up your operated
leg towards your buttocks. Help to bend
your knee by using your other leg, or a
towel.
Hold .................. seconds.
Repeat .................. times

Strengthening and Functional

Exercises
12. Isometric Quadriceps
With your kneecap facing the ceiling.
Pull your toes towards you and push the
back of your knee into the bed. Tighten
the muscles on the front of your thigh.
Hold for 5 seconds.
Repeat .................. times.

13. Quads Over A Roll

Place a large can or a rolled towel
under the back of your operated knee.
Straighten your knee by tightening the
muscles on the front of your thigh. Keep
your leg in contact with the roll.
Hold .................. seconds.
Repeat .................. times.
Progress to .....................................................

14. Hamstrings
(Standing Knee Flexion)
Stand on your non-operated leg. Hold
onto a counter for support.
Bend your operated leg up towards your
buttock (keep your thighs in line).
Hold .................. seconds.
Repeat .................. times.
Progress to .....................................................

5
 15. Mini Squats
Hold onto a chair/counter top. Keep your
feet flat on floor. Slightly bend your knees
(30–45 degrees). Then slowly straighten.
Repeat .................. times.

16. Sitting to Standing from a High Chair

Sit on the edge of a high chair. Lean
forwards and slowly stand up without using
your hands. Sit back on the chair by bending
forwards and slowly sit down.
Repeat .................. times.

17. Wall Slides

Stand with your back against the wall.
Place your feet shoulder width apart and 6
inches away from the wall. Place your hands
on your thighs. Slide down the wall by
slowly bending your knees (30–45 degrees
maximum). Slide back up the wall.
Repeat .................. times.

18. Leg Lunge

Begin by standing. Put your hands on your
hips. Step forward
with your operated leg. Slowly bend your
knee (maximum of 60 degrees.)
Return to your starting position.
Repeat .................. times.

6
19. Step Ups
Stand facing a low step. Holding onto the
rail, place the foot of your operated leg onto
the step. Slowly step up. Slowly return to
your starting position.
Repeat .................. times.

20. Step downs

Stand on a low step. Holding onto the rail,
step down slowly with your non-operated
leg. Slowly return to your starting position.

21. Standing Balance

In front of a counter, and with a chair
behind you for safety, stand on your
operated leg. Lift your good leg off the floor.
Try to hold
your hips level and keep your back straight.
Hold .................. seconds.
Repeat .................. times.

22. Stationary Bicycle

Adjust the seat so that you can complete
a full circle of the pedals. As you improve,
lower the seat and begin to add resistance.

23. Walking
Using a walking aid if necessary, slowly
increase the distance you walk daily. Try
to walk as normally as you can.
Wear good supportive footwear, and to
begin with, walk on a level surface.

7
 Other Exercises Recommended by your Therapist

8
 EXERCISE LOG
Exercises Week Of Week Of Week Of
S M T W T F S S M T W T F S S M T W T F S
1 TA in Lying
2 TA in sitting
3 Heel Slides (Knee Flexion)
4 Passive Extenstion
5 Chair Knee Flexion
6 Passive Knee Flexion Sitting
7 Assisted Knee Flexion Sitting
8 Step Lunge
9 Hamstring Stretch
10 Calf Stretch
11 Quad Stretch
12 Isometric Quadriceps
13 Quads Over a Roll
14 Hamstrings
15 Mini Squats
16 Sit to Stand
17 Wall Slides
18 Leg Lunge
19 Step Ups
20 Step Downs
21 Standing Balance
22 Stationary Bicycle (mins.)
23 Walking (mins.)
Please record the total number of repetitions per day (exercises 1-23)

9
10
EXERCISE LOG
Exercises Week Of Week Of Week Of
S M T W T F S S M T W T F S S M T W T F S
1 TA in Lying
2 TA in sitting
3 Heel Slides (Knee Flexion)
4 Passive Extenstion
5 Chair Knee Flexion
6 Passive Knee Flexion Sitting
7 Assisted Knee Flexion Sitting
8 Step Lunge
9 Hamstring Stretch
10 Calf Stretch
11 Quad Stretch
12 Isometric Quadriceps
13 Quads Over a Roll
14 Hamstrings
15 Mini Squats
16 Sit to Stand
17 Wall Slides
18 Leg Lunge
19 Step Ups
20 Step Downs
21 Standing Balance
22 Stationary Bicycle (mins.)
23 Walking (mins.)
Please record the total number of repetitions per day (exercises 1-23)
 EXERCISE LOG
Exercises Week Of Week Of Week Of
S M T W T F S S M T W T F S S M T W T F S
1 TA in Lying
2 TA in sitting
3 Heel Slides (Knee Flexion)
4 Passive Extenstion
5 Chair Knee Flexion
6 Passive Knee Flexion Sitting
7 Assisted Knee Flexion Sitting
8 Step Lunge
9 Hamstring Stretch
10 Calf Stretch
11 Quad Stretch
12 Isometric Quadriceps
13 Quads Over a Roll
14 Hamstrings
15 Mini Squats
16 Sit to Stand
17 Wall Slides
18 Leg Lunge
19 Step Ups
20 Step Downs
21 Standing Balance
22 Stationary Bicycle (mins.)
23 Walking (mins.)
Please record the total number of repetitions per day (exercises 1-23)

11
 Graphic images adapted from:
Visual Health Information
Therapy Skill Builders
Physio Tools

For more copies, email phem@vch.ca

and quote Catalogue No. FB.873.EX.372
© Vancouver Coastal Health, June 2005

The information in this document is intended solely for the person

to whom it was given by the health care team.

www.vch.ca
FB.873.EX.372