Physical activity is vital for a successful knee replacement recovery. However, there is a fine line between healthy activity and harmful stress.

While modern implants are durable, high-impact activities can accelerate wear or risk injury.

This guide outlines the exercises to avoid after knee replacement and safe alternatives to keep you active and healthy.

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The Golden Rule of Post-Op Exercise

Low Impact = High Longevity.

The goal is to build muscle strength and cardiovascular health without subjecting the knee joint to excessive pounding or twisting forces.

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Exercises to Avoid Completely

These activities place high stress on the prosthetic joint and should generally be avoided for the long term.

1. Running and Jogging

The repetitive impact of running transfers significant force—up to several times your body weight—through the knee with every step.

• Risk: Accelerated wear of the polyethylene spacer, early loosening of the implant.
• Alternative: Brisk walking, elliptical trainer.

2. High-Impact Sports

Sports that involve jumping, sudden stopping, or collision are risky.

• Avoid: Basketball, football, volleyball, singles tennis, squash.
• Risk: sudden twisting leading to ligament injury or fracture around the implant.
• Alternative: Doubles tennis (less court coverage), golf, swimming.

3. Deep Squats and Heavy Leg Presses

While partial squats are great for strengthening, deep squats (past 90 degrees) under heavy load can be harmful.

• Risk: Excessive pressure on the joint mechanics.
• Alternative: Mini-squats, wall slides, seated leg extensions.

4. High-Impact Aerobics / Jumping Jacks

Any exercise requiring both feet to leave the ground simultaneously creates high impact upon landing.

• Risk: Jarring the implant interface.
• Alternative: Low-impact aerobics, cycling, water aerobics.

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Exercises to Be Cautious About

Some activities are not strictly forbidden but require caution and good technique.

1. Yoga and Pilates

Excellent for flexibility, but avoid positions that force the knee into extreme flexion (bending) or twisting, such as the Lotus position or Child’s pose if it feels tight.

• Tip: Use props and modify poses to stay within a comfortable range of motion.

2. Hiking

Walking on uneven terrain increases the risk of falls and twists.

• Tip: Stick to flat, well-groomed trails and use trekking poles for stability.

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Safe and Recommended Exercises

To maintain your knee health, focus on these low-impact activities:

1. Walking: The best and simplest exercise.
2. Cycling: Stationary bikes are fantastic for range of motion and quad strength with zero impact.
3. Swimming / Water Aerobics: The buoyancy of water reduces load while providing resistance.
4. Golf: Safe, provided you use smooth rotational mechanics (avoid spiking the feet).
5. Doubles Tennis: Reduces the need for sudden sprints.

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Why Avoiding High Impact Matters

Even though you may feel capable of running or jumping, the physics of the implant doesn't change.

• Wear and Tear: Just like a car tyre, the more aggressive the driving, the faster the tread wears out.
• Loosening: Repetitive high impact can weaken the bond between the bone and the implant.
• Fracture: The bone around the implant can fracture if subjected to sudden, extreme trauma.

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Expert Guidance for an Active Life

Dr. Abhijit Kale encourages patients to lead active, fulfilling lives after surgery. The aim isn't to restrict you, but to preserve your knee for 20-25 years or more.

Always clear new activities with your surgeon or physiotherapist before starting.

Read more about sports after knee replacement and physiotherapy.

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FAQs: Activity Restrictions

Can I ever run again?

Sprinting or long-distance running is discouraged. However, a short jog to catch a bus or cross a street is fine.

Is kneeling allowed?

Yes, kneeling is safe for the implant but might feel uncomfortable. Use a kneeling pad.

Can I lift weights?

Upper body weights are fine. For legs, focus on lower weights with higher repetitions rather than maximum heavy lifting.

When can I start cycling outdoors?

Once you have good balance and range of motion, usually after 6-12 weeks. Start with a stationary bike first.

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Takeaway

• Avoid: Running, jumping, contact sports, and heavy deep squats.
• Embrace: Walking, cycling, swimming, and golf.
• Listen to your body: If it hurts or swells, stop and rest.

By choosing the right activities, you protect your investment in your health and ensure your knee replacement lasts a lifetime.