Physical Therapy After Knee Arthroscopy: What to Expect from Recovery

Medically reviewed by Misty Seidenburg

If you are scheduled to have arthroscopic knee surgery, you’re probably wondering what the road to recovery will look like. If you undergo a procedure for a torn meniscus, cartilage damage, or another sports-related knee injury, physical therapy after knee arthroscopy will play a central role in helping you regain strength and stability.

Although every recovery journey is different, understanding the general phases of rehabilitation can help you feel more prepared, motivated, and engaged throughout your healing journey.

What Happens After Knee Arthroscopy?

Knee arthroscopy is a minimally invasive procedure used to diagnose and treat various joint problems. It generally involves a small camera and specialized instruments inserted through tiny incisions.

Common procedures include:

• Meniscus trimming or repair: Damaged cartilage is removed and/or repaired.
• Cartilage debridement: This “clean-up” surgery also removes damaged bone and/or cartilage.
• Synovial tissue removal: Areas of the synovial membrane that have become bulky and inflamed are removed.
• Loose body removal: Fragments of bone, cartilage, or other tissue that have broken free and may cause knee clicking or popping are removed.

Because it’s less invasive than open surgery, arthroscopy typically allows for a quicker return to movement. Still, knee surgery recovery takes time, and a structured rehabilitation plan is the key to ensuring the best possible outcome.

Phase 1: Controlling Swelling and Getting Moving (Days 0–7)

During the first week post-surgery, the primary focus is on protecting the knee, reducing swelling, and gently reintroducing movement.

Key goals include:

• Restoring knee extension and gentle flexion
• Managing pain and inflammation
• Preventing muscle atrophy

Phase 1 early recovery tips:

1. P.E.A.C.E. & L.O.V.E. protocol to reduce swelling and promote healing
2. Ankle pumps and heel slides to promote circulation and mobility
3. Short bouts of walking as tolerated, often with crutches for support
4. Begin quad activation exercises like isometric quad sets, glute squeezes, and gentle straight-leg raises to wake up the muscles

Typically, patients also begin post-operative physical therapy within the first few days after their procedure. Your physical therapist will help guide your early movements, ensure proper alignment, and give you feedback to prevent setbacks.

Phase 2: Restoring Motion and Building Strength (Weeks 1–3)

As pain and swelling begin to subside, the rehabilitation process becomes more active and focused. During this phase, regaining a full range of motion and establishing a foundation of strength are the top goals.

Improving knee flexion and extension is also essential, as restoring normal joint movement sets the stage for more advanced exercises later on. At the same time, efforts shift toward re-establishing normal walking patterns, or gait, to promote proper mechanics and reduce compensations.

Quad activation exercises continue to play a crucial role, but this stage also introduces increased engagement of the hip and core muscles to support overall lower body stability and function.

Common therapy strategies at this phase are:

• Seated assisted flexion and prone knee bends
• Short-arc quads, bridges, and straight-leg raises with light resistance
• Supported squats or mini-squats (up to 45°)
• Balance and proprioception work, such as weight shifting or using a wobble board

You may also begin with low-impact cardio, such as using a stationary bike or walking in water, depending on your comfort and your provider’s guidance.

Phase 3: Strength and Control (Weeks 3–6)

This stage of meniscus surgery rehab and healing from other knee arthroscopy procedures focuses on rebuilding strength and improving joint stability through more challenging activities.

What to expect in physical therapy:

• Heavier resistance in exercises (leg press, step-ups, resistance bands)
• Dynamic balance training (e.g., single-leg stands)
• Neuromuscular re-education to help the knee respond better to movement demands
• Continued cardiovascular conditioning through a walking program or biking.

At this point, many patients transition away from crutches or walking aids completely. Your therapist will help monitor your progress and adjust the intensity to support recovery without overloading the joint.

Phase 4: Return to Activity (Weeks 6–12+)

As strength and stability continue to improve, your physical therapy will gradually shift to focus on the demands of everyday activities. For athletes, that means sport-specific movements. The focus during this phase is on achieving near-normal muscle strength and symmetry between the two legs, which is critical for preventing reinjury and supporting smooth movement.

Physical therapy also helps you regain confidence in your knee’s ability to handle daily tasks or athletic drills without hesitation. This is also the point at which you can safely begin incorporating more dynamic activities, such as light impact or agility exercises, based on your progress and your therapist’s guidance.

For example, you might start:

• Light jogging on a treadmill or track (if cleared), or a walking program for non-athletes
• Plyometric drills: jumping, hopping, bounding
• Sport simulation: cutting, pivoting, or directional change movements
• Functional tests to evaluate readiness for return-to-play

At this stage, your therapist may use benchmarks like a Limb Symmetry Index (LSI) or hop testing to help determine when you’re ready to resume full activity.

The Role of Physical Therapy After Knee Arthroscopy

When it comes to rehabilitation after surgery, it’s not just about healing the knee. It’s about helping you return to doing what you love. Whether you want to get back on the field, keep up with your kids, or walk without knee pain, physical therapy after knee arthroscopy is designed to guide your recovery through every phase.

Physical therapists provide:

• Personalized, adaptive exercise and stretching programs
• Strategies to address swelling, stiffness, or gait issues
• Education to reduce fear and promote safe movement
• Encouragement, structure, and support when motivation dips
• Prevention tips to protect the knee and avoid future injury

While no two recovery journeys are the same, engaging in physical therapy can help you take an informed, empowered approach to healing.

Taking the Next Step

Recovery from arthroscopic knee surgery is more than just rest and time. It’s an active process that benefits from patience, consistency, and expert guidance. A strong partnership with your physical therapy team can support your goals and help you move forward with confidence.

If you’re unsure where to start, talk to your surgeon or physical therapist about a plan tailored to your needs, and take the first step toward a stronger, more stable knee. Find a physical therapy clinic near you to schedule your post-surgery rehab screening today.

FAQ’s

How long does it take to fully recover from knee arthroscopy?

Most patients return to regular activity within 2–3 months, though more demanding sports or job tasks may take 4–6 months. Timelines vary based on the type of surgery, your activity level, and your body’s healing process.

Can I drive after arthroscopic knee surgery​?

Whether you can drive after knee arthroscopy depends on several factors, including which leg was operated on, your pain levels, and whether you’re still taking pain medication that could impair reaction time.

For surgeries on the right knee, driving is generally not recommended until you can fully bear weight, have regained adequate strength and mobility, and can safely perform an emergency stop. This typically takes 1–2 weeks for minor procedures but may be longer for more complex cases. Always check with your surgeon and physical therapist before getting behind the wheel.

Can I sleep on my side after arthroscopic knee surgery​?

Yes, you can usually sleep on your side after knee arthroscopy, but it’s important to do so in a way that supports the healing knee. If you sleep on the non-operated side, placing a pillow between your knees can help keep your recovering leg in a comfortable, neutral position.

If sleeping on the same side as your operated knee, be cautious not to twist or torque the joint. Some people find it most comfortable to sleep on their back with the leg slightly elevated during the early stages of recovery to help manage swelling. Check with your surgeon and physical therapist for specific guidance.

Do I also need to do exercises at home?

Absolutely. Post-op knee physical therapy is most effective when clinic-based care is supported by regular home exercise. Your physical therapist will provide a customized plan that includes daily or every-other-day exercises.

What are the signs I should slow down?

New or increasing swelling, sharp pain, or catching/locking in the joint should be discussed with your care team. It’s better to progress steadily than rush and risk reinjury.