Pilates After a Knee Replacement: What You Need to Know

Knee replacements are on the rise – especially among women in their 60s, 70s, and beyond. In fact, there are over 85,000 total knee replacements (TKRs) done in the UK every year. That’s a lot of new knees!

If you’ve had a knee replacement (or are preparing for one), Pilates can play a big role in your recovery – helping you move more freely, regain strength, and feel confident in your body again.

Here’s what to expect – and how we adapt in class to keep things safe and effective.

What is a knee replacement?

A total knee replacement (also called total knee arthroplasty) is when the worn-out parts of your knee joint are replaced with a new, artificial joint – usually made from a mix of metal and plastic. It’s designed to mimic natural movement and reduce pain from arthritis or injury.

Sometimes, if only one part of the knee is damaged, a partial knee replacement may be done instead.

Why do people have it?

Most commonly due to severe osteoarthritis, but also:

- Rheumatoid arthritis

- Injury-related damage

- Long-term joint wear and tear

- Stiffness and pain that affects daily life – walking, stairs, even standing up

If physio, exercise, or medication no longer helps, surgery is often the next step.

What does recovery look like?

Recovery takes time and comes in stages:

Phase 1: Early days (0–2 weeks)

- Focus: Healing, managing swelling, basic movement

- Exercises: Ankle pumps, glute squeezes, gentle heel slides

Phase 2: Regaining mobility (2–6 weeks)

- Begin walking (with crutches or a stick)

- Seated knee bends, straight leg lifts, supported standing

Phase 3: Building strength (6–12 weeks)

- More confident walking, light exercise

- Step-ups, mini squats, hamstring curls

Phase 4: Long-term strength & balance (3–12 months)

- Return to regular movement and low-impact exercise

- Focus on stability, posture, and avoiding future issues

Pilates after knee replacement – absolutely!

With the right adjustments, Pilates can help you build strength, improve balance, and regain joint control – all at your pace.

Great exercises to include:

- Seated or lying down work

- Sit-to-stand, heel raises, wall slides

- Gentle balance work with support

- Mobility for spine and shoulders

Exercises to avoid:

- Deep squats or lunges

- Anything kneeling

- High resistance or impact

- Unstable balance work too early

My approach in class:

I always check about surgery date, recovery phase, and whether physio has signed off. I focus on core, glutes, and posture – all of which take pressure off your knees. I use chairs, blocks, mats and give lots of options so you always feel supported.

If you’ve had a knee replacement and you’re ready to move again, I’d love to help you build strength and feel steady on your feet.

You're never too old (or too new) to start.