Part of Total knee replacement rehab
Knee replacement exercises after 2 weeks: the grind window
Warning signs, and when to get help
What are the knee replacement exercises after 2 weeks?
The loading ones. Movement work carries on in the background, but the exercises that define this window ask the operated leg to take your weight again and to do it well.
They are stage 2 of total knee replacement rehab, where each one has its page, its video and its starting dose: seated knee extension and the straight leg raise with the leg turned out for the thigh, sit to stand using armrests for the movement you repeat most in a day, the side to side weight shift and the forward and backward weight shift to get the leg used to being stood on, calf raises and the mini squat at a counter, and walking with a cane for when your team moves you from crutches to one stick.
This page gives no repetitions, no sets and no frequency of its own. Two different doses for one exercise is how people end up guessing, so the exercise pages and the program are the numbers and your physio adjusts them. If your team gave you a weight-bearing limit, that limit decides how much of your weight goes through the leg in every standing exercise here, and nothing on this page changes it.
Two cautions from the program cover all of these. Keep a counter or a sturdy chair within reach for anything done standing, and breathe steadily through each repetition rather than holding your breath. Check with your doctor before you start if you have a heart or lung condition, or blood pressure that is not under control.
The NHS early precautions run alongside the exercises rather than apart from them: do not kneel on the new knee until your doctor says you can, do not sit with your legs crossed for the first 6 weeks, avoid twisting your knee, bending down and reaching up as much as you can, do not stand for long periods, since standing still is what swells the ankles, and leave household tasks that involve lifting or moving anything heavy for the first 3 months. The twisting, bending and reaching one is about how you get through your day, not about the exercises your team has given you. The NHS also asks you to keep the leg raised as much as you can, and that is the instruction people quietly drop once they are up and about more, which is the point in recovery when the ankle starts puffing up by the evening. No exercise in this window asks you to kneel.
What changes at about 2 weeks, and what does the work become?
Nothing is switched over at two weeks. It still feels like a new phase, and the reasons for that arrive at about the same time.
The wound closes. The NHS puts the removal of stitches or clips at about 10 days, and once the skin is dealt with, the daily worry about the dressing stops taking up room. Units do differ here, and some close the skin with stitches underneath it that dissolve and never need taking out, so the date and the method are your own team's to tell you rather than ours.
Closed is not the same as healed, which is the part that catches people out. Keep the knee out of water you would sit in until the wound has sealed and dried, so no baths, pools, hot tubs or sea for now, because soaking a wound that has not fully sealed is a way into a new joint (OrthoInfo). Ask your team about showering and about whether anything still needs to go over the scar, since their answer depends on how your wound actually looks.
So the knee is still swollen, still sore, and less of a surgical site than it was. It is not past the point where an infection can start, though. Infection around a new joint can begin in the days or the weeks after the operation (OrthoInfo), so the wound, temperature and hot knee signs below keep their full weight for the whole of this window. None of the three has to be there for an infection to be starting. OrthoInfo names increased pain or stiffness in a joint that had been working well among the signs of an infection around a new joint, says the signs can be as little as mild redness and swelling, and says fever is no longer considered a sign of one.
That is also why an infection somewhere else in your body counts in these weeks. Any infection in the body can spread to a joint replacement, and bacteria getting into the bloodstream during dental work, a urine infection or a skin infection is a known route in (OrthoInfo). Two practical things follow. Tell your team about a chest, urine, tooth or skin infection in these early weeks rather than treating it as unrelated. And if you have dental treatment booked, tell the dentist you have a knee replacement and ask your surgeon whether you need antibiotics before it, since OrthoInfo leaves that decision to your surgeon and it depends on you rather than on a general rule.
The limiting factor changes too. In the first fortnight the thing stopping you was the knee not moving. From here the thing stopping you is the leg not yet trusting your weight, which is a different problem with a different answer. The exercises for weeks 0 to 2 explains why the earlier work was movement, including what happens to the thigh muscle after this operation.
So the work becomes load. Standing up without hauling on the furniture. Standing on the operated leg long enough to step past it. Getting the calf working, because the calf is what makes walking look like walking.
None of that means heavier. It means weight through the leg instead of movement of the joint, which is a change of direction and not a change of effort.
Movement work does not stop, though, and this is where people drop it. Bending and straightening practice carries on through this window alongside the new exercises, and the straightening work is still the one that quietly disappears first.
Why does progress flatten in weeks 3 and 4?
Because what you were measuring has slowed down while what you are attempting has gone up. It is the most common conversation in this window, and almost nobody is warned about it.
In the first fortnight the knee changes visibly from day to day, so progress feels continuous. From about week three the changes are smaller and spread over weeks, so the same amount of work produces much less obvious return. At the same time you are walking further, out of the house more and doing more of your own day, which is more total load on a leg that is still recovering, so you feel worse rather than better for it. That combination is what week three feels like, and it is offered here as practice experience rather than as a research finding.
What follows from that is practical. Judge the week, not the day: compare what you can do now with a fortnight ago, not with yesterday. Expect the fatigue, because the tiredness in this window surprises people more than the pain does. And keep doing the exercises on the flat days, since the flat days are the whole window.
What a dip should not include is movement going backward. Being as stiff as last week and being stiffer than last week are different observations, and the second one needs a phone call rather than patience. The warning signs below carry that line with the timescale on it.
The reason for being prompt rather than patient is that the timing is not neutral. Where a stiff knee has to be freed up under anesthetic, more range is gained when that is done at around 6 to 12 weeks than when it is left later (Hosanee and colleagues, 2026), and weeks three to six is when that gets noticed or missed. A knee that keeps stiffening is also checked for other causes first, infection among them, which is a second reason a plateau belongs with your team rather than with more stretching on your own at home.
How do you know you are ready to move up?
Not by a date, and not by a figure. Total knee replacement rehab sets out the signs it uses to move between stages, which turn on the current exercises feeling manageable and on your team being happy with how you are walking. Those are judgements about you, made with the people who see you walk.
What this page can usefully add is what not to use as a signal. Not the week number, because two people at week four can be in very different places for reasons neither of them chose. Not how far you can walk on a good day, because a flat floor at home flatters everybody. Somebody else's progress least of all, since that is the comparison that does the most damage in this window.
Your own team is the authority on readiness and on anything they have limited. If you are doing your rehabilitation on your own at home, NICE expects you to know your goals and to have someone to contact for advice while you do it (NICE NG157), so use that contact rather than guessing.
Getting out of the house, and getting off the aid
The first walk that is longer than the house is a milestone and it is usually overcooked. The usual version of it is a trip that would have been unremarkable before the operation and that turns up as a swollen, sore knee the same evening.
Build the outdoor walking the way you built everything else, in short trips repeated rather than one long one, and pick the ground deliberately. A dry, flat, familiar route with somewhere to sit is a different proposition from a supermarket, a curb and a wet sidewalk. South Tees physiotherapists are explicit that walking well with support beats walking badly without it.
When the aid comes down, and in what order, is its own question with its own page. How long you use a walker, frame or stick covers the readiness checks and what the NHS actually says about it. What this page will say is that no week number entitles you to put it down, whatever a protocol chart suggests, and that the cost of keeping it too long is much smaller than the cost of a fall.
What happens at the 6 week check-up, and what should you raise?
The NHS describes a follow-up appointment about 6 weeks after the operation to check you are recovering well. It is usually short, so the people who get the most from it are the ones who arrive with a list.
Raise the things the appointment can actually change. How your bending and straightening compare with what your surgeon is aiming for, and what they want you to do about it. If the knee has stopped gaining ground over the last fortnight, say so out loud instead of waiting to be asked, because this appointment sits at the front of the window in which a stiff knee is dealt with best. Whether you still need the walking aid, and which one. Whether your pain relief is still the right one, and whether you have enough of it, since South Tees makes the point that effective pain relief early on is what lets you move and exercise more comfortably, and warns that the supply you left hospital with may only be a week's worth, so you ask for more in good time rather than run out.
Then the wound and the scar, which the person seeing you will want to look at anyway: anything still weeping, a patch that has not closed over, a stitch working its way out, skin that is numb or sore to touch, or a scar you are not sure how to look after. A wound that is getting redder, hotter, more painful or is leaking is the exception, and it is not something to save for the appointment. That is a same day phone call, and it is in the warning signs below.
Then what happens to the compression stockings, which the NHS says most people wear for at least 6 weeks. Whether you can start kneeling, since the NHS leaves that one to your doctor's go-ahead and this is the appointment to ask for it. And your own questions about work, driving and anything else you are planning around.
Bring the specific thing you cannot do rather than a general report. Not getting into the back of a car, not managing the stairs at work, not sleeping: those give the clinician something to examine and act on. Not making progress is also a reason to speak up, and more physiotherapy is something to ask for rather than wait to be offered. The exercises for weeks 6 to 12 sets out the criteria NICE gives for that.
If you want the whole arc instead of this window, the recovery timeline week by week gives each published figure with the source that produced it.
When to phone your physio or surgical team
This window has a particular trap, which is that you are now well enough to explain things away. A hot knee gets put down to doing too much on Saturday. New breathlessness gets put down to being unfit. Both deserve a phone call.
Contact them the same day for a wound that is more red, hot or painful, is leaking or has edges parting, for a temperature or feeling hot, cold and shivery, for a calf that becomes newly swollen, warm or tender, for a knee whose pain keeps climbing while you rest, and for tiredness or breathlessness that has been building over days. Sudden breathlessness, chest pain or coughing up blood is an emergency call rather than a same day one.
Contact your physio or team within a few days if your knee has stopped bending or straightening any further week to week, is getting stiffer, or feels as though it gives way. Keep using the walking aid until that has been looked at.
One line below sits well past this window, and it is here because people read a page like this long after the dates on it have gone by. Pain in the knee that had settled and has come back, or pain that is getting worse month by month, is a review rather than an emergency. The routine line says who to ask, and it says what would make it a same-day call instead.
One thing about clots is specific to this window. If the tablets or injections you were given to lower your clot risk have come to an end, the risk has not ended with them, which is part of why the stockings usually run on longer than the medicine does. The clot signs below apply for the whole of this window and past it.
Each warning sign below carries the urgency it needs. In this window especially, the right response to being unsure is to ask, because nothing on the list gets easier to treat by waiting a fortnight.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: since your operation, you suddenly become short of breath, you get chest pain or pain in your upper back that may be worse when you breathe in, you cough up blood, your heart is beating very fast, or you faint. Call emergency services straight away, even if your leg looks normal. These can be signs of a blood clot in the lungs (pulmonary embolism).
- Emergency: after a fall or a knock, you cannot put weight on the leg, your knee or thigh is very painful, or the leg looks out of shape or shorter than the other. Go to an emergency department straight away, and do not drive yourself. If you cannot get up, call emergency services. A broken bone around a knee replacement is rare, but it needs treatment in hospital. If a smaller fall or knock leaves the knee newly painful, swollen or bruised, even if you can still walk on it and the leg looks normal, stop the exercises, go back to your crutches or sticks and keep your full weight off that leg, and get it checked by your surgical team the same day. A break in the bone around a new knee is not always obvious at first, and walking normally on one can move the broken ends apart.
Get help today
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: swelling in the operated leg that is increasing from week to week instead of settling, including swelling spreading into your calf, ankle or foot, pain in your leg or calf away from the wound, increasing pain in your calf, or tenderness or redness above or below your knee. Get medical advice the same day. Some swelling is expected for months after this operation, but OrthoInfo lists new or increasing swelling in the calf, ankle and foot, increasing calf pain, and tenderness or redness above or below the knee among its warning signs of a blood clot in the leg, and asks for them to be reported to your doctor rather than watched. Your clot risk does not end on the day your tablets or injections do. If you are also short of breath or have chest pain, call emergency services.
- Same day: you are taking tablets or having injections to lower your risk of a blood clot and you notice blood in your urine, black or bloody stools, bleeding gums, a nosebleed that goes on and on, bruising far beyond what the knock would explain, or you are being sick or coughing up blood. Get medical advice the same day, and do not stop the medicine on your own. Bleeding more easily is the known trade-off of these medicines (NHS), and the dose or the type may need looking at. Go to an emergency department if the bleeding will not stop, you feel faint, or you bang your head while you are taking it, even if you feel fine, because the NHS advises getting urgent advice after a head injury on medicine that thins your blood and only a hospital can scan for a bleed inside the head.
- Same day: your wound becomes more red, hot, swollen or painful, starts to leak or ooze, is still leaking in the second week or has never stopped, has pus coming out of it or its edges start to come apart, or you have a high temperature or feel hot, cold or shivery. Contact your surgical team or get medical advice the same day. Redness can be harder to see on brown or black skin. If you feel very unwell, go to an emergency department. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- Same day: in the days or weeks after your operation you are getting more and more tired, breathless doing everyday things such as walking to the toilet or getting dressed, dizzy or lightheaded, your heart is racing, or your skin looks paler than usual. Contact your surgical team or get medical advice the same day. Tiredness and breathlessness that build up like this are not part of the usual recovery. Blood loss during and after a knee replacement can leave you short of red blood cells (anemia), which is treatable, and a slow bleed or an infection can show up the same way. If breathlessness comes on suddenly, or you get chest pain, call emergency services, as the emergency line above explains.
- Same day: since your operation, the redness, warmth, swelling or pain in your knee is not getting better or is getting worse, for example the knee pain keeps building both when you move and when you rest. Contact your surgical team or get medical advice the same day, as this can be a sign of infection around the new joint. If you feel very unwell, go to an emergency department.
- Same day: you suddenly cannot straighten your knee or lift your leg straight when you could before, often after a pop, a tearing feeling or a stumble, or you notice a dip just above or below your kneecap, or you suddenly cannot put weight on the leg, even without a fall. Keep your weight off it and contact your surgical team the same day. If you cannot reach them that day, go to an emergency department. A tendon at the front of the knee may have torn, and a repair works better when it is done soon.
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. Until it has been checked, use your walking aid, hold a rail on stairs and keep off uneven ground, because a foot that catches trips you and a fall onto a new knee can damage it. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: new numbness, tingling or burning in your lower leg or foot, beyond the numb patch of skin around your scar. Contact your surgical team or get medical advice the same day. If it started after a fall or an injury, or your foot or toes turn cold, pale, blue or gray, call emergency services or go to an emergency department straight away, and do not drive yourself.
- Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, call emergency services, even if you come round quickly, because the NHS says to call them when someone faints while exercising or is badly hurt, and a fall onto a new knee can damage it.
- Same day: dizziness or feeling faint during or after exercise, other than the brief lightheadedness as you stand up covered in the line above, without any of the emergency signs above. Stop the exercises and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
Book an appointment
- Within a few days: your knee is not bending or straightening any further from week to week, is getting stiffer, or feels unstable or gives way when you stand or walk. This is not an emergency, but contact your physio or surgical team within the next few days rather than waiting for your next routine appointment, and keep using your walking aid until they have checked it. A stiff knee is easier to free up early than late: where it has to be freed up under anesthetic, doing that earlier, generally within about 6 to 12 weeks of the operation, is associated with regaining more movement than doing it later, although how much any one knee gains also depends on how stiff it was to begin with, on who is suitable and on the rehabilitation afterward. So the date you raise it matters (Hosanee and colleagues, 2026). If the knee has given way and let you fall, or it gives way on stairs, hold a rail and use your walking aid every time, and stay off stairs on your own until you have been seen.
- Within a few days: you have had a fall, even if you were not hurt, or you keep tripping, stumbling or feeling that your legs might give way. Book an appointment with your doctor within a few days and ask about a falls assessment. Tell them about every fall, even the ones where you were not hurt.
- Routine: pain in your new knee that had settled and has come back, or pain that is getting worse month by month, for example pain that starts as soon as you stand up and begin to walk. This is not an emergency, but ask your surgical team for a review, as the parts of a new joint can loosen or wear over the years. Get medical advice the same day instead, not a routine appointment, if the knee also becomes hot, red or swollen, or you have a high temperature or feel hot, cold or shivery, or the pain is building week by week rather than month by month. A new joint can become infected years after the operation, and the two can feel similar at first.
Common questions
What exercises should I do after 2 weeks following a knee replacement?
Loading exercises. Movement work carries on, but it is no longer the whole job. On this site they are stage 2 of the total knee replacement rehab program: thigh work through more range, standing up from a chair with the armrests, two weight shifts that teach the operated leg to take your weight again, calf raises, a mini squat at the counter, and walking with a cane when your team says you are ready for one. The program carries the doses and the readiness signs, and this page carries the reasons. Start stage 2 when your team is happy for you to, not on a date.
What should I expect 4 weeks after a knee replacement?
Less drama and more grind than week one, and often less obvious progress than you were getting then. Soreness is still around: OrthoInfo describes some pain with activity and at night as common for several weeks after surgery. Most people in this window are walking further, managing more of their own day, and finding mornings stiffer than they expected. What should not be happening is movement going backward or a knee getting hotter or more painful at rest, and both of those are in the warning signs below.
Why does it feel like I have gone backward in week 3?
Because the thing you were measuring stopped moving. In the first fortnight the changes are large and daily, so progress is visible. From about week three the changes are small and weekly, while the amount you are attempting goes up, so you feel more tired and more sore for what looks like less return. That is practice experience rather than a research finding, but it is the single most common conversation in this window. The test that matters is the direction over a few weeks, not the difference between Tuesday and Wednesday.
Why is my knee stiffer in the mornings now than it was?
Mornings are stiff after hours of not moving, and in this window you are also asking more of the knee during the day, so there is more to recover from overnight. Most people find it loosens within the first part of the morning once they start moving, and that it eases over the following weeks. What is different, and worth a call rather than patience, is stiffness that is increasing from week to week, or a knee that is no longer bending or straightening any further. Raising that early matters, because a stiff new knee is easier to deal with early than late (Hosanee and colleagues, 2026), and it is in the warning signs below.
Can I go back to work or drive yet?
Both belong to your surgical team, and both have more than one person's opinion attached to them. For work, the NHS ties it to feeling ready and to the type of work you do, so a desk job and a job on your feet all day are different questions, and the 6 week check-up is a good place to raise it. For driving, the NHS asks you to wait at least 6 weeks after a total knee replacement, or 3 weeks after a partial one, and to check with your doctor that you are fit to drive, and your insurer may have its own position, so ask your team before you get back in a car rather than after.
References
- NHS. Recovering from a knee replacement. Page last reviewed 9 September 2026. https://www.nhs.uk/tests-and-treatments/knee-replacement/recovery/
- American Academy of Orthopaedic Surgeons. Total knee replacement. OrthoInfo. https://www.orthoinfo.org/en/treatment/total-knee-replacement/
- American Academy of Orthopaedic Surgeons. Infection after joint replacement. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/joint-replacement-infection/
- South Tees Hospitals NHS Foundation Trust. Post total knee replacement management. Patient information, 26 February 2025. https://www.southtees.nhs.uk/resources/post-total-knee-replacement-management/
- National Institute for Health and Care Excellence. Joint replacement (primary): hip, knee and shoulder. NICE guideline NG157. Published 4 June 2020. https://www.nice.org.uk/guidance/ng157
- Chartered Society of Physiotherapy. NICE recommends rehab on same day as surgery for joint replacement patients. 10 June 2020. https://www.csp.org.uk/news/2020-06-10-nice-recommends-rehab-same-day-surgery-joint-replacement-patients
- Hosanee S, Elebo N, Sikhauli N, Pietrzak JRT. Reluctant knee: understanding and managing stiffness after total knee arthroplasty. International Orthopaedics. 2026;50(9):2337-2346. https://doi.org/10.1007/s00264-026-06905-0
- NHS. Anticoagulant medicines. Page last reviewed 9 September 2024. https://www.nhs.uk/conditions/anticoagulant-medicines/
- NHS. Rivaroxaban. Page last reviewed 5 August 2026. https://www.nhs.uk/medicines/rivaroxaban/
- NHS. Sepsis. Page last reviewed 14 May 2026. https://www.nhs.uk/conditions/sepsis/
- NHS. Falls. https://www.nhs.uk/conditions/falls/
- NHS. Low blood pressure (hypotension). Page last reviewed 11 July 2023. https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
- NHS. Fainting. https://www.nhs.uk/symptoms/fainting/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-17.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.