Walking is an important part of recovery after total knee replacement. But once you start moving more, it can be surprisingly hard to know how much is enough—and whether you're overdoing it.
There isn't one walking distance or number of steps that's right for everyone after knee replacement. Your activity should generally increase gradually as your strength, mobility, and endurance improve. Your surgeon and physical therapist should guide your specific progression.
One of the most useful clues is how your knee responds to what you're doing.
For more details on recovering after a knee replacement, see Knee Replacement Recovery Milestones: What to Expect Week by Week.
Your walking plan depends on where you are in recovery, your health before surgery, your strength and balance, and your surgical team's recommendations.
Walking usually starts very early after knee replacement. At first, you may walk short distances using a walker or crutches. As strength and endurance improve, walking generally becomes easier and activity gradually increases.
That makes “How is my walking progressing?” more useful than trying to hit an arbitrary number of steps.
Pay attention to what happens during and after your activity.
Some discomfort and swelling can occur after walking or exercise during knee replacement recovery. AAOS notes that swelling can remain for months after surgery and that activity can temporarily increase pain or swelling.
What matters is the pattern.
If increasing your walking leaves your knee substantially more painful or swollen, affects how well you're walking, or repeatedly makes it harder to complete the activities and exercises your rehabilitation plan calls for, discuss the pattern with your physical therapist or surgical team.
Your body's response can help them determine whether your current activity level is appropriate.
It can be.
Swelling is common after total knee replacement, and activity can make it more noticeable. AAOS says moderate to severe swelling may occur during the first days or weeks, with milder swelling potentially lasting several months.
That doesn't mean every increase in swelling should be ignored.
Look at the overall pattern. Does the swelling increase after activity and then settle? Or is it becoming progressively worse or accompanied by other concerning symptoms?
We'll cover this more specifically in Why Does My Knee Swell More After Walking After Knee Replacement?
Don't use pain as something you simply need to defeat.
Some discomfort with walking and rehabilitation can be expected after knee replacement, but your surgeon and physical therapist should guide how much activity is appropriate for your stage of recovery.
The goal isn't to walk as far as possible.
It's to gradually rebuild mobility without letting today's activity interfere with your ability to keep progressing.
Feeling better is encouraging, but it can also make it easy to increase activity quickly.
You may have a good morning, walk farther than usual, spend more time on your feet, and then notice more soreness or swelling later.
One harder day doesn't necessarily mean you've damaged your knee. Recovery after knee replacement can include better and worse days even while the overall trend is improving. AAOS recommends gradually increasing activity rather than doing too much too soon.
If you're consistently tolerating your current activity well, ask your physical therapist how they want you to progress.
Don't stop using an assistive device simply because you can take a few steps without it.
The goal is safe, increasingly normal walking—not getting rid of the walker or cane as quickly as possible.
AAOS recommends progressing away from walking aids as strength and endurance improve and you can walk without relying on the device for support.
Your physical therapist or surgical team can help you decide when you're ready.
Contact your surgical team if pain or swelling is becoming progressively worse rather than following the recovery pattern they told you to expect, or if you're concerned about a significant change in your knee.
After knee replacement, increasing redness, tenderness or wound swelling, drainage, fever, increasing pain at rest and with activity, or new calf pain/swelling can require medical evaluation. Sudden shortness of breath or chest pain requires urgent medical attention.
Follow the specific warning signs and contact instructions provided by your own surgical team.
Not sure what comes next?
Recovery doesn't always happen in a straight line. Download the free SurgiNav Surgery Recovery Roadmap to understand the stages of healing and know what to expect after surgery.
Walking is important after knee replacement, but more isn't automatically better.
Rather than chasing a particular step count, follow your rehabilitation plan and increase walking gradually. Pay attention to how your knee responds during and after activity, and use that information with your physical therapist or surgical team to guide what comes next.
Recovery doesn't always happen in a straight line. The free SurgiNav Surgery Recovery Roadmap walks you through the stages of healing so you know what to expect and when to reach out to your care team.
Download the Free Surgery Recovery RoadmapThis article provides general educational information and is not a substitute for medical advice. Always follow the instructions provided by your healthcare team.
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Educational information only. Always follow your surgeon's instructions.