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Why Isn’t My Knee Getting Better After Surgery?

Updated: Aug 15

By Emma Glynn - The Hip & Knee Physio


a woman with a knee swelling after surgery

Still swollen, stiff, or limping months after your knee replacement?

You’re not alone and no, you’re not broken. It’s incredibly common to feel stuck during knee replacement recovery. Maybe your surgeon said everything looks fine. Maybe your friends bounced back faster. But here you are, still swollen after short walks, still hesitant on stairs, still not back to the life you pictured.


Too often, the advice is vague or dismissive:

  • “Just give it more time.”

  • “Everyone heals differently.”

While technically true, that kind of advice doesn’t help. Because time alone doesn’t fix poor movement patterns, weak muscles, or a knee that still swells with basic activity.


Signs Your Recovery Might Be Stalling

You might be plateauing in your recovery if:

  • Your knee still swells at rest or after short walks

  • You can’t walk 30+ minutes without discomfort

  • You’re still limping or feel stiff when standing

  • Stairs feel risky or difficult (especially going down)

  • You haven’t returned to sport or hobbies you enjoy

If any of these sound familiar, it’s not a failure. But it is a sign your knee needs more than rest.


Why Recovery Can Plateau

  1. Not Enough Progressive Loading

Muscles and joints need challenge to improve. Many patients stick with gentle exercises too long, never progressing to strength-based or dynamic rehab (Pozzi et al., 2013).

  1. Fear-Based Avoidance

Were you told to never squat again? Or to avoid stairs forever? These well-meaning warnings can create long term fear that limits recovery (Monticone et al., 2016).

  1. Weak Quads or Poor Single-Leg Control

The quadriceps, glutes, and calf muscles are key for walking, stairs, and sport. Weakness here causes compensation, fatigue, and joint overload (van der Esch et al., 2004).

  1. No Structured Rehab Plan

A few exercises on a sheet of paper isn’t enough. Without progression, testing, and supervision, it’s easy to get stuck in a loop of “just enough” but not optimal rehab (Patterson et al., 2022).

  1. Not Knowing What’s Normal

Is swelling normal? Is limping still OK? Uncertainty creates anxiety and makes people more likely to do too little, or too much.


What You Can Do: Recovery Reset

It’s never too late to get your rehab back on track. Here’s where to focus:

  • Build strength: Prioritise the quads, glutes, and calves with targeted resistance work

  • Improve movement control: Focus on step-downs, lunges, and single-leg balance

  • Use sport-based drills: If walking feels easy, progress to light drills (e.g. golf swings, gentle cycling)

  • Train with a plan: Milestone-based rehab is more effective than guessing


Time alone doesn’t equal recovery. Progress needs to be earned through smart rehab.


When to Get Help

Book a review with a physio who understands joint replacements if:

  • Your knee is still swollen >24 hours after light activity

  • You limp or avoid stairs

  • You feel dismissed despite ongoing concerns

  • Your rehab hasn’t progressed in weeks


What’s Next?

What’s Next?

If you’re not sure whether your knee is ready or you feel stuck between recovery and return, it’s time for clarity.


✅ Download the Return to Sport Post TKR Protocol now and see what a safe, evidence-informed pathway actually looks like.




Ready To Book

Returning to sport after a knee replacement doesn’t have to be confusing or risky. The key is having the right plan- and knowing when your body is ready.


If you're unsure what your next step should be, Book a consult with me, Emma, at The Hip and Knee Physio to get a tailored recovery plan that suits your goals.


👉 Call now on 9978 9833 or book online to take the first step toward pain-free movement.




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Disclaimer

The content provided on this website is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.

While The Hip and Knee Physio strives to present accurate and up-to-date information, we do not guarantee results or outcomes based on the information provided. Any exercises, strategies, or recommendations featured on this site should not be considered a personalised treatment plan.

Always seek the advice of a qualified healthcare provider before starting any exercise program, particularly if you are experiencing pain, injury, or a pre-existing medical condition.

Use of this website does not create a physiotherapist–patient relationship. The Hip and Knee Physio accepts no responsibility for any injury or loss arising from reliance on or use of this information.

By using this website, you agree to these terms.


References

  • Monticone M et al. (2016). Recovery of sport participation after total knee replacement. Eur J Phys Rehabil Med.

  • Pozzi F, Snyder-Mackler L, Zeni J. (2013). Physical exercise after TKR: a systematic review. Clin Rehabil.

  • Patterson M et al. (2022). Individualised rehab for post-operative knee recovery. J Orthop Sports Phys Ther.

  • van der Esch M et al. (2004). Quadriceps strength and function in knee osteoarthritis and replacement. Ann Rheum Dis.

 
 
 

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