Understanding the rehabilitation process

General principles for understanding the rehabilitation process

Exercises need to be done 4 – 5 times per day: little and often is better than an extensive overload period.  Pain, heat and increasing swelling in the knee are potentially bad: any of these symptoms can mean that exercises are being overdone.  This is unlikely to indicate a serious problem, but these symptoms should be discussed with the physiotherapist.


There is a difference between good and bad pain.  After major knee surgery the knee will be sore and it is important to understand that discomfort is normal, particularly when doing some of the stretching exercises.  The knee may also ache after an exercise session.  This is expected and normal so long as it is not associated with any significant increase in swelling.


‘Bad pain’ is usually sharp and severe in nature.  It may be brought on by pushing too hard, and it may be accompanied by an increase in swelling.  Activities causing such a problem should be stopped and advice sought from the physiotherapist.

Summary of rehabilitation phases 

There are various ways to summarise the phases of rehabilitation and the following is one of the suggested approaches.


There are six main rehabilitation phases and example exercises for each phase are given in the sections that follow. Many different exercises are available to achieve the goals and these are tailored to each individual by the physiotherapy team.


  • Phase 1: Preoperative preparation/operative period
  • Phase 2: Initial Post Op Phase 
  • Phase 3: Proprioception (sensory awareness) Phase
  • Phase 4: Strength Phase
  • Phase 5: Early Sport Training
  • Phase 6: Return to Sport


Specific follow-up assessment: Outpatient review takes place at variable time periods depending on local facilities and surgeon preference. As an example the following times and the goals for those stages are detailed in the guidelines:


  • 2 weeks
  • 6 weeks
  • 3 months
  • 6 months
  • 1 year

Work advice and expectations

To expect to be able to return to work as follows: 


  • Desk work at 3 – 4 weeks
  • Light manual work at 6 weeks
  • Heavy manual work (ladder work etc) at 3 – 4 months. 


Driving advice and expectations

  • To expect to return to driving at 3 – 4 weeks depending on knee function.   


All of these timescales are an approximate guide, and can differ on a patient by patient basis.

Latest Statistics

The NLR has been successfully gathering patient data since 2013, after it was launched at BASK.


There are currently:


Number of active users: 712


Number of Pathways: 12098


Total Number of Registered Patients: 11796

(includes patients awaiting surgery)

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