Physical Therapy After Knee Replacement: What to Expect

By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published October 2026

You've decided to have a knee replacement, or you just had one, and now the big question is what recovery actually looks like. How soon will you be walking? How long until you can drive, climb stairs, or get back to the things you love?

Physical therapy is one of the most important parts of knee replacement recovery. This article explains when therapy usually starts, what the first weeks look like, typical recovery timelines, common exercises, and which warning signs to report to your surgeon right away.

Important: Every surgeon and every patient is different. Your surgeon's instructions and protocol always come first. The timelines below are typical ranges, not rules.

The short answer

Physical therapy usually starts very soon after knee replacement surgery; the American Academy of Orthopaedic Surgeons notes that most patients can begin exercising their knee within hours of surgery (AAOS OrthoInfo). Early therapy focuses on bending and straightening the knee, controlling pain and swelling, and walking safely. Most people can resume most normal daily activities within 3 to 6 weeks, and many continue to gain strength and confidence for months. The APTA's 2026 knee replacement guideline supports supervised physical therapy, exercise to restore knee motion and strength, and preoperative exercise, and recommends against routine use of continuous passive motion (CPM) machines after uncomplicated surgery (Bove et al., Physical Therapy 2026).

When does PT start after a knee replacement?

Often on the day of surgery or the next day, depending on your surgical team. In the hospital or surgery center, a physical therapist typically helps you:

• Get out of bed and stand safely
• Walk with a walker or crutches
• Start gentle exercises to bend and straighten the knee
• Learn how to get in and out of bed, a chair, and a car
• Practice stairs, if you have them at home

After you go home, therapy usually continues in an outpatient clinic, at home, or both. The 2026 APTA guideline notes that outpatient physical therapy is preferred when possible (Guideline Central summary).

Before surgery helps too. The same guideline recommends preoperative exercise programs to improve outcomes before and after surgery (Bove et al., 2026). If your surgery is still ahead, ask your surgeon whether starting therapy now makes sense.

What happens in the first few weeks?

The early weeks focus on a few key goals:

• Knee motion. Getting the knee fully straight and gradually bending it further. The guideline recommends against routine bracing or splinting after uncomplicated surgery and supports active and assisted range-of-motion exercises (Guideline Central summary).
• Pain and swelling control. The guideline supports cold therapy and elevation early on (Guideline Central summary). Follow your surgeon's instructions on pain medication.
• Quadriceps strength. The thigh muscle often weakens after surgery. The guideline recommends electrical stimulation of the quadriceps early after surgery to help rebuild strength, walking, and function (Guideline Central summary).
• Walking. Progressing from a walker to a cane to walking on your own, as your surgeon and therapist advise.
• Daily tasks. Getting dressed, bathing, stairs, and getting in and out of the car safely.

Some soreness, swelling, and stiffness are normal in the early weeks. Your physical therapist will help you tell the difference between expected discomfort and signs that need your surgeon's attention.

How long does recovery take?

Recovery varies with your health, your knee before surgery, and how consistently you do your exercises. Typical ranges include (AAOS OrthoInfo):

• Most normal daily activities: about 3 to 6 weeks after surgery
• Driving: often around 4 to 6 weeks, once your surgeon clears you and you're off medications that affect driving
• Strength, endurance, and confidence: many people keep improving for several months

Return to work, exercise, and recreational activities depends on your job, your goals, and your surgeon's guidance.

What exercises are typical?

Your exact program depends on your surgeon's protocol and how you're progressing. Common exercises include:

• Ankle pumps to help circulation
• Quad sets, tightening the thigh muscle to straighten the knee
• Heel slides to gently bend the knee
• Straight leg raises to build thigh strength
• Seated knee bends and straightening
• Sit-to-stand practice from a chair
• Step-ups and stair practice as you progress
• Balance exercises and a gradual walking program
• Stationary cycling, often later in recovery

Don't start new exercises without your surgeon's or therapist's okay, and stop and call if an exercise causes sharp or rapidly increasing pain.

How can physical therapy help?

An outpatient evaluation after knee replacement may include:

• A review of your surgeon's protocol and any precautions
• Knee motion and swelling measurements
• Quadriceps and hip strength
• Walking, balance, stairs, and getting up from a chair
• Your goals for home, work, and activities
• A check of the incision area and screening for warning signs

A typical plan may include:

• Exercises to restore knee bending and straightening
• Progressive strengthening for the thigh, hip, and calf
• Hands-on treatment to support knee motion, when appropriate
• Walking and balance training, including weaning off a walker or cane
• Pain and swelling management strategies
• A home program and updates to your surgeon on your progress

Physical therapy doesn't guarantee a specific result or timeline, but consistent, guided rehab plays a big role in how well and how quickly you recover.

At Nova Physical Therapy in North Hollywood, knee rehabilitation, including rehab after surgery, is one of our core services, and every plan starts with an evaluation so treatment fits your surgeon's protocol and what we find.

Which signs should I report to my surgeon?

Call 911 right away if you have sudden shortness of breath or sudden chest pain, which can be signs of a blood clot that has traveled to the lungs (AAOS OrthoInfo).

Call your surgeon promptly if you notice signs of a possible blood clot (AAOS OrthoInfo):

• Increasing pain in your calf
• Tenderness or redness above or below your knee
• New or increasing swelling in your calf, ankle, or foot

Also call your surgeon promptly for possible signs of infection (AAOS OrthoInfo):

• A persistent fever higher than 100°F, or chills
• Increasing redness, tenderness, or swelling around the incision
• Drainage from the incision
• Increasing knee pain with both activity and rest

Also contact your surgeon if you have a fall, a sudden loss of knee motion, or new numbness or weakness in the leg. We watch for these signs during every visit and contact your surgeon or refer you for medical care when findings call for it.

Do I need a referral for physical therapy in California?

Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.

Frequently asked questions

How soon after knee replacement can I walk?
Many people stand and walk with a walker or crutches on the day of surgery or the next day, with help from a physical therapist. Your surgical team will guide when you start.

How long will I need physical therapy after knee replacement?
It varies. Many people do several weeks to a few months of outpatient therapy, depending on their progress, goals, and surgeon's plan.

Is it normal for my knee to be swollen weeks after surgery?
Some swelling for weeks or even months is common. Cold therapy and elevation can help. New or increasing swelling in the calf, ankle, or foot should be reported to your surgeon.

Do I need a CPM machine?
The 2026 APTA guideline recommends against routinely using continuous passive motion machines after uncomplicated knee replacement. Follow your surgeon's instructions.

When can I drive after knee replacement?
Many people return to driving around 4 to 6 weeks after surgery, but only once your surgeon clears you and you're off medications that affect driving.

Should I do physical therapy before knee replacement?
Preoperative exercise is recommended in the 2026 APTA guideline to improve outcomes. Ask your surgeon whether it's right for you.

Do I need a referral for physical therapy after surgery?
After surgery, your surgeon usually sends a referral and protocol. California also allows direct access within the limits described above, but your surgeon's guidance comes first.

About Nova Physical Therapy

Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from knee pain, back and neck pain, sports injuries, work injuries, auto accident injuries, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.

Schedule an evaluation

If you have a knee replacement coming up or are recovering from one, an evaluation can help you build a plan that fits your surgeon's protocol and your goals.

Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online

Disclaimer

This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Your surgeon's instructions always come first, and recovery timelines vary. Only an in-person evaluation can determine what is right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.

References

1. Bove AM, Carroll LA, Cone S, et al. Clinical practice guideline for physical therapist management of total knee arthroplasty: revision 2026. Phys Ther. 2026;106(7):pzag058. Link
2. Guideline Central. New 2026 APTA PT Management of Total Knee Arthroplasty Guideline. July 2026. Link
3. American Academy of Orthopaedic Surgeons, OrthoInfo. Total Knee Replacement. Link