Top Physiotherapy Exercises to Improve Knee Strength Before Surgery

17 Sept

Preparing for knee surgery involves more than just scheduling the procedure, it also means strengthening your body to support a smoother recovery. Physiotherapy is one of the most effective ways to do this with NHS pre knee replacement exercises designed to build knee strength and stability before surgery.

Your knee joint is surrounded by muscles, which, when strengthened, improve flexibility, enhance circulation, and reduce stiffness, all of which can help speed up post-surgical rehabilitation. Strong muscles also provide better joint support, which lowers the risk of complications and makes everyday movements like walking, standing, or climbing stairs more manageable during recovery.

Pre-surgery physiotherapy not only prepares your knee for its imminent operation, but also builds confidence, leaving you feeling less anxious.

Here are the 6 best exercises to do before total knee replacement surgery designed to improve knee strength and optimise surgical outcomes. These exercises target the quadriceps, hamstrings, glutes, and calves, which all play a role in stabilising and protecting the knee. Perform each exercise 5–6 days per week and aim for 2–3 sets per exercise, resting when needed.

N.B. Always check with your physiotherapist before starting, as they can tailor these exercises to your condition and ensure you don’t put unnecessary strain on your knee. Request a pre knee replacement exercises pdf for ease.

1. Chair Pushup

Sit on the edge of a sturdy chair, feet flat on the floor.
With hands firmly on the armrests or side of the chair, straighten your arms to slightly lift your bottom off the seat.
Hold for 3–5 seconds, then lower back down to the seating position.
Repeat 10–15 times.

Chair Pushups help build upper body strength and support mobility.

2. Straight Leg Raises

Lie on your back, straightening one leg and bending the other.
Gradually lift the straight leg to knee height while tightening your thigh muscles.
Hold for a few seconds, then lower slowly.
Repeat 10–15 times.

The lying straight leg raise builds strength in the quads and hip flexors.

3. Short Arc Quads

Lie on your back and place a foam roller or towel under your knee.
Keeping your leg straight, lift your foot with toes pointing to the ceiling.
Hold position for 3–5 seconds before slowly lowering back down.
Repeat 10–15 times.

Short Arc Quads build quadriceps strength and improve knee flexibility.

4. Standing Hip Extension

Place hands on a stable surface for balance, keeping your knee straight.
Lift one leg straight back while keeping your upper body upright.
Squeeze glutes for a few seconds, then slowly lower your leg.
Repeat 8–12 times.

This gluteal set strengthens the glutes and hip muscles, easing pressure on the knee.

5. Calf Raises

Stand with feet hip-width apart, holding a stable surface for balance.
Slowly rise onto your toes, then lower back down.
Repeat 10–15 times.

Calf raises strengthen calves and improve ankle stability to support knee function.

6. Mini Squats

Stand with feet hip-width apart, holding a stable surface.
Bend your knees slightly (no more than 30–45°), then return to standing.
Repeat 10–12 times.

A half squat activates the quads and glutes while promoting balance.

Remember, the stronger the muscle, the faster the recovery.

Exercises to Continue After Surgery

After knee surgery, exercises such as side leg raises, standing hip abduction, inner thigh squeeze and several knee straightening stretches are introduced in phases. You’ll be required to start gently restoring movement to the knee, then slowly progress to rebuild the strength and stability.

Always follow your surgeon’s or physiotherapist’s timeline, as rushing recovery can eventually become a setback. Healing speed varies depending on the type of surgery performed (e.g., knee replacement, ACL repair, meniscus surgery).

Days 1–14: Mobility & Activation

Ankle Pumps: Point and flex your feet 10–20 times every hour.
Quad Sets: Tighten thigh muscles, hold 5–10 sec, 10–15 reps, 3–4 times/day.
Heel Slides: Bend and straighten knee gently, 10–15 reps.
Long Arc Quads: Extend leg and lower back down, 10–12 reps.

Weeks 2–6: Strength & Range of Motion

Sitting Knee Flexion: While seated, bring one foot towards the back of the chair, hold 10 sec. Complete 10 reps.
Bridges: Lift hips while lying down, hold 3–5 sec. Complete 10–12 reps.
Standing Heel Raises: Rise onto toes, 10–15 reps.
Mini Squats: 8–12 reps, only if pain-free.
Stationary Cycling: Great for range of motion and circulation.

Weeks 6–12: Advanced Strength & Function

Step-Ups: Onto a low step, 8–12 reps per leg.
Lunges: 8–10 reps each side.
Side-Lying Leg Raises: Strengthens hip abductors, 10–15 reps.
Single Leg Stance: Balance on one leg and hold position for 30–60 secs per leg.

The Importance of Strengthening Your Knee Joint Before Surgery

Many individuals have had the regrettable afterthought, ‘what I wish I knew before knee replacement surgery’, having suffered with delayed recovery and minor complications. Having a strong knee prior to surgery leaves you with a better chance of experiencing a smooth, fast recovery.

Working on the muscles that support your knee with knee bending exercises such as leg curls, clamshells and sitting kicks will help you improve joint stability and protect the healing tissues after surgery.

You’ll be able to move more confidently, lowering the risk of a fall or setbacks during your recovery period. Preparing your body for surgery is proven to be highly beneficial; in short, a stronger knee means better outcomes afterward.

Contact Victorian Bone & Joint Specialists for a printable exercises before knee replacement instruction pack and we’ll provide you with all the support you need.

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