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Total Knee and Hip Replacement Rehab: Physical Therapy in Brooklyn and Staten Island

By Dr. Jack Engelberg, PT, DPT · · 4 min read

A total knee or hip replacement can be life-changing, giving people relief from years of arthritis pain and a chance to walk, travel and play with their grandchildren again. But the surgery is only the beginning. The work you put in during rehabilitation has a big influence on how well your new joint moves and how confident you feel using it. Physical therapy guides that process from the first weeks home through a full return to the activities you care about.

What Is a Joint Replacement?

In a total knee replacement (TKR), the damaged surfaces of the thighbone and shinbone (and often the back of the kneecap) are resurfaced with metal and plastic components. In a total hip replacement (THR), the arthritic ball and socket are replaced with an artificial ball, stem and socket. Partial knee replacements are also performed for some patients.

These surgeries are most often done for advanced knee osteoarthritis or hip arthritis, though other conditions, such as hip dysplasia or fractures, can also lead to replacement.

Prehab: Getting Ready Before Surgery

If you have time before surgery, a few weeks of "prehab" can help. It typically focuses on:

  • Strengthening the quadriceps, hips and core
  • Maintaining as much range of motion as possible
  • Practicing with a walker or crutches
  • Planning your home setup
  • Learning your early post-op exercises in advance

What Recovery Typically Looks Like

Every surgeon has their own protocol, and recovery varies from person to person, but rehab generally moves through these phases.

Early Recovery (First Few Weeks)

  • Managing pain and swelling
  • Walking with an assistive device, as allowed by your surgeon
  • Gentle range-of-motion exercises (for knees, the focus is especially on bending and fully straightening)
  • Basic strengthening, like quad sets, ankle pumps and glute squeezes
  • Safe transfers in and out of bed, chairs, the car and the shower
  • For hips, following any movement precautions your surgeon gives you

Building Strength and Independence

  • Progressive strengthening of the legs and hips
  • Weaning from walker to cane to independent walking
  • Stair training, including those Brooklyn brownstone steps or walk-up stairs
  • Balance training
  • Stationary cycling for knee motion and endurance

Returning to Full Activity

  • Higher-level strength and endurance work
  • Walking longer distances and on uneven surfaces
  • Returning to work, travel, gardening or low-impact sports like golf, swimming, cycling or doubles tennis, as cleared by your surgeon

Recovery continues for months. Strength and endurance often keep improving well after formal therapy ends.

How Physical Therapy Helps

Your therapist will:

  • Measure your range of motion, strength, swelling and walking pattern
  • Design a progressive program that matches your surgeon's protocol
  • Use manual therapy to help with stiffness and scar tissue mobility
  • Teach you how to manage swelling and pain
  • Train you on walking aids, stairs and getting up from the floor
  • Work on balance and fall prevention, which is especially important in the months after surgery
  • Communicate with your surgeon as needed

What You Can Do at Home

  • Do your exercises every day. Your home program is where most progress happens, especially for knee motion.
  • Keep swelling down with elevation, ice and compression, as directed.
  • Walk regularly in short, frequent bouts.
  • Prevent falls. Remove loose rugs, add night-lights, use a shower chair, and keep frequently used items within reach.
  • Take pain medication as prescribed so you can participate in therapy.
  • Don't keep a pillow under your knee for long periods after a knee replacement. It can make it harder to fully straighten.
  • Follow hip precautions exactly as your surgeon instructs, if you were given any.

When to Call Your Surgeon

Contact your surgeon or seek urgent care if you notice:

  • Increasing redness, warmth, or drainage from the incision
  • Fever or chills
  • Calf pain, swelling or tenderness (possible blood clot)
  • Chest pain or shortness of breath (call 911)
  • A sudden increase in pain or inability to bear weight
  • A feeling that the hip has "popped out" or a change in leg length or position

Frequently Asked Questions

When do I start physical therapy after joint replacement?

Many patients start moving within a day of surgery, often with therapy in the hospital, followed by home or outpatient therapy. Your surgeon decides the timing.

How long will I need outpatient physical therapy?

It varies. Many people attend for several weeks to a few months. Your therapist will track your progress and goals.

Is knee replacement rehab harder than hip replacement rehab?

Many people find knee rehab more demanding, mainly because regaining knee bend takes consistent work. Both require commitment.

Ready to get started? Call the Refuah office nearest you

Schedule an evaluation by phone, or book online at refuahpt.com.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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