Recovering Knee Mobility After Total Knee Replacement: Hands-On Physio and Hydrotherapy That Help

At BOOST PHYSIO, our expert physiotherapists help hundreds of patients every year recover movement and confidence after total knee replacement (TKR) surgery. One of the most common challenges we find our patients experience is knee stiffness — that tight, heavy feeling that makes it hard to bend or fully straighten your leg.

The good news? With the right combination of hands-on manual therapy, hydrotherapy and guided home exercises, most people regain excellent knee movement within the first three months.

Why Knee Stiffness Happens After TKR

Some stiffness is completely normal. After surgery, the soft tissues around the knee (muscles, fascia, capsule and skin) react with swelling, inflammation and protective tightness. This limits movement and can make bending or straightening the knee uncomfortable.

Early physiotherapy helps reduce this swelling and stiffness before it becomes long-term restriction.

The Critical Recovery Timeline

At BOOST PHYSIO, we focus on milestones that align with the best-practice evidence for recovery:

  • Weeks 0–6: Aim to achieve full knee extension (straightening) and at least 90° flexion (bending).  Gentle but consistent stretching, manual therapy and regular movement are vital in this window.
  • Weeks 6–12: Work towards 110° flexion or more (this is how much is needed to pedal a bicycle). The goal is to restore smooth, pain-free motion for walking, stairs, getting in and out of a car more easily and returning to everyday activity.
  • Beyond 12 weeks: Continue to strengthen, stabilise and refine movement to optimise long-term outcomes.

Manual Therapy Techniques We Use

Our physiotherapists are trained in a range of advanced, evidence-based manual therapy techniques to reduce stiffness and improve movement:

  • Joint Mobilisations: Gentle oscillations applied by the physio to restore the knee’s glide and roll mechanics.
  • Myofascial Release: Targeted pressure and stretch to release tight scar tissue and improve tissue mobility.
  • MWM (Mobilisations With Movement): Combining therapist-applied joint glide with patient-active movement to retrain normal motion patterns.
  • Hold-Relax (PNF) Techniques: Engaging and relaxing specific muscles to gain extra range safely and reduce guarding.

These hands-on methods are used alongside exercise and movement retraining to ensure improvements last beyond the treatment room.

Hydrotherapy: An Option for Early Recovery

Many patients benefit from working in the pool with one of our physios- doing hydrotherapy (aquatic physiotherapy).  An ideal environment for early movement after knee replacement.

The buoyancy of water supports your body weight, allowing you to move more freely and comfortably. 

Our hydrotherapy sessions may include:

  • Gentle knee bending and straightening under water
  • Supported walking practice and weight transfer
  • Resistance exercises using floats or paddles

Hydrotherapy can be particularly helpful in the first 2–6 weeks when land-based exercise and rehab can feel difficult.

Watch our video reel linked with this post to see examples of manual therapy and hydrotherapy techniques we use to help patients recover safely and confidently after knee replacement.

What You Can Do at Home

Your progress depends not only on therapy sessions, but on the daily exercises you do yourself. Consistency is key.Our physiotherapists will guide you through a personalised home programme that may include:

  • Heel slides for knee bending
  • Prone knee hangs or towel stretches for extension
  • Quadriceps and hamstring activation exercises
  • Regular icing and gentle massage for swelling control

A few short sessions each day can make all the difference.

Expert Same-Day Private Knee Physiotherapy Near Me

At BOOST PHYSIO, we provide expert, same-day private physiotherapy for patients recovering from knee replacement surgery at our 10 physio clinics across London and Hertfordshire, including Hendon, Elstree, Finchley, Muswell Hill, Borehamwood, Hampstead, Swiss Cottage, Kensington, East Finchley and Hampstead Garden Suburb.

Our experienced physiotherapists will guide you every step of the way — from early recovery to full return to activity.

Your Best Recovery – Guaranteed.