The Crucial Role of Physiotherapists in Hip or Knee Replacement Surgery

Physiotherapists are uniquely positioned to get you moving again, safely, after hip and knee replacements. We’re also the best professionals to prepare you for surgery ("pre-habilitation") or to help you try to prevent surgery in the first place.

Not sure what you get when you start physiotherapy? While every person’s treatment is unique, this blog post summarizes all the benefits you can expect when you start a course of physiotherapy treatment at River East Physiotherapy.

1. Comprehensive Assessment

After surgery, your physiotherapist's role is to do a thorough assessment of your condition. This helps you understand the challenges and limitations you're facing because of your surgery.

For post-op hip replacements, the physiotherapist will look at how far you can bend your hip (your "range of motion"), how strong your hip muscles are, and how well you are walking (your "gait pattern"). This is to help us understand how well you're moving, and what might be restricting your movement.

For knee replacements, your physiotherapist will focus on how much your knee can bend and straighten (knee range of motion), how strong the muscles are around your knee, and how stable your knee is.

The main purpose of this assessment is to design a personalized treatment plan tailored to your unique needs.

2. Personalized Treatment Plan

Based on the assessment, your physiotherapist will create a personalized treatment plan, in collaboration with you. This plan will be tailored to you and you only, ensuring the exercises and other treatment techniques are both safe and effective.

The treatment plan will usually include a combination of exercises, manual therapy, and pain management techniques, to get you to your goal.

At River East Physiotherapy, we offer one-to-one sessions and group classes for hip and knee replacements.  Your treatment plan will specify whether one or both approaches are right for you.

3. Pain Management

Pain is common before and after hip and knee replacements. While your doctor or surgeon may have prescribed you medication for the pain, the physiotherapist’s role is to complement that with drug-free pain relief techniques.

Drug-free pain relief could mean your physiotherapist prescribes certain types of movements to reduce your pain.  They can also teach you what to do and not to do in your every day life, to reduce the pain.  In clinic, they may ease your pain with ice, heat therapy, electrotherapy (such as transcutaneous electrical nerve stimulation, or TENS), low level laser, and/or therapeutic ultrasound.

By managing your pain effectively, you'll be able to focus on your exercises and rehabilitation without unnecessary discomfort and suffering.  That means you'll likely get better, faster.

4. Range of Motion and Flexibility Exercises

Physiotherapists design exercises to improve how you move, and how far your joint can bend or straighten after surgery. For post-op hip replacements, targeted exercises aim to increase hip flexibility and promote proper hip alignment. For knee replacements, exercises usually focus on knee bending and straightening.

5. Strengthening Exercises

Strengthening exercises are crucial for rebuilding muscle strength around the replaced joint. Muscles surrounding the hip and knee support the hip and knee.  With more support, you tend to feel less pain.

Strengthening exercises are also important for getting back to your full function or achieving your goals.  For instance, if your goal is to walk your dog for an hour a day, the muscles around your hip need to have enough strength and endurance to make that walking (and dog toy throwing) possible.

As part of your treatment plan, our physiotherapists design exercises that gradually challenge the muscles without straining the newly replaced joint. For post-op hip replacements, strengthening exercises may target the glutes, quadriceps, and hip abductors, while knee replacements may focus on the quadriceps, hamstrings, and calf muscles.

6. Improving Gait

At River East Physiotherapy, our physiotherapists teach patients how to walk correctly after hip and knee replacements. "Gait" (walking and running) training is essential to promote a balanced, stable, and confident walking pattern.

At first, you may practice walking with crutches, a walker or a cane. You'll then gradually transition to walking unaided, as your strength and stability improves.

The large majority of post-op joint replacement patients focus on walking. However, higher performing patients may choose to work on running, with more guidance from their physiotherapist and doctor.

7. Better Proprioception, Balance and Coordination

Proprioception means knowing where your body part is without looking at it.  For example, closing your eyes and holding your arm up to your side. You know it's there, correct?  And if you open your eyes, it's exactly where you think it is, right?  That's good proprioception.

Proprioception affects how well you can balance. Proprioception is frequently affected by joint surgery, since your proprioceptive sensors are located in your joints.

In your treatment plan, your physiotherapist will likely include exercises that improve your proprioception and coordination.

Having good proprioception helps you do your day-to-day activities and reduces your risk of falling.

8. Monitoring Your Progress

Throughout your rehabilitation journey, your physiotherapist's role is to continuously monitor your progress. That means your treatment will always be progressing as time goes on until you hit your goal.

Your physiotherapist will regularly assess your mobility, strength, and overall improvement. This could happen briefly in group classes, or it could be more extensive in your one-on-one treatment sessions with your physiotherapist.

9. A Custom Exercise Program

We know the large majority of your time is spent outside the physiotherapy clinic.  Your physiotherapist will therefore prescribe you a custom exercise program, which can be done in the clinic and at home.  So you can make progress towards your goals in between your appointments.

Custom home exercise programs empower patients to take an active role in their recovery - and rely less and less on their physiotherapist over time.

Is physiotherapy for hip and knee replacement right for you?  Call us to book an appointment, or set up a FREE 15-minute phone consultation with one of our physiotherapists.

Key Take-Aways

Physiotherapists play an indispensable role in patients' preparation for post-op hip and knee replacements, and in their rehabilitation. Physiotherapists' expertise in assessment, treatment planning, pain management, and custom exercises significantly improve patients' rehabilitation journey.

Physiotherapists empower people to regain their mobility, confidence, and independence. By monitoring and adjusting patients’ treatment plans, physiotherapists ensure patients receive the most appropriate care throughout their recovery.

Ultimately, the compassionate and expert care provided by physiotherapists plays a vital role in helping post-op hip and knee replacement patients reclaim their lives and achieve their physical fitness goals.


1. What activities should I avoid after knee or hip surgery?

Every person is different, and surgical approaches are also different. In fact, surgical approaches to hip and knee replacement are improving rapidly, and post-op restrictions seem to be lessening.  These days, what you shouldn't do after surgery really depends on your surgeon, the prosthetic they use, and their approach.

With that uncertainty, don’t hesitate to ask your surgeon or physiotherapist what activities are appropriate for you. It’s our job to answer your questions.

That said, after knee surgery, most people should avoid high-impact activities that put lots of stress on the knee joint, such as running, jumping, or heavy lifting. Also, avoid activities that involve sudden changes in direction, like tennis or basketball, during the early stages of recovery.

After hip replacement surgery, avoid forcing your hip into the end range of bending or twisting. And heavy loading of your hip (such as running or pedalling hard on a bicycle) should wait until later in the recovery - your physiotherapist or surgeon can tell you when.

2. What sports should I avoid after knee replacement?

After knee replacement, generally avoid higher impact and higher risk sports, such as football, soccer, downhill skiing, mountain biking and basketball. These activities can put undue strain on the artificial joint, increasing the risk of implant failure or injury. Opt for lower impact activities like swimming, cycling, and walking, which promote joint health and reduce stress on the new knee.

3. How many times a week should I see my physiotherapist after knee replacement?

It depends on your goals! Your physiotherapist can help you from as early as day one. For instance, when you come home from the hospital, most people can benefit from a physiotherapist helping them learn how to use their gait aid (walker, crutches, and/or cane), teaching them how to use stairs safely, and answering their questions on what’s okay to do and what’s not okay to do.

More generally, in the initial stages of recovery we recommend physical therapy two to three times a week. As the recovery progresses and your strength and mobility improve, you may choose to come to physiotherapy once a week or less. However, people with more challenging goals, such as getting back to high-performance sport or a physically demanding job, may need physiotherapy up to five times a week.

As for how long to continue to physiotherapy, it depends on whether you’ve achieved your goals! Everyone’s goals for physiotherapy are different. For instance, if your goal is to walk normally again, two months of physiotherapy might be enough. But if your goal is to get back to running, or get back to a roofing job, it may take you a year or so - until you no longer need the expert advice and motivation of your physiotherapist.

4. What do you do in Group Hip & Knee Classes?

Click here to learn about our group classes, including what we do in classes, when classes are offered, and how you can prepare.