Pilates Exercises For Those With Knee Replacements

 

For clients with knee replacements (total or partial), Pilates can be extremely beneficial — but it must prioritize alignment, controlled range of motion, and joint stability.

General Guidelines for Knee Replacement Clients

• Stay within pain-free range

• Avoid deep loaded knee flexion (especially early post-op)

• Focus on hip and glute strength (reduces knee load)

• Emphasize neutral alignment

• Avoid twisting through the knee (rotate from hip instead)

• Check surgeon/PT precautions (especially within first 12 weeks)

Best Pilates Exercises

Supine Heel Slides (Gentle Mobility)

Goal: Improve knee flexion safely

• Supine, foot on mat or sliders

• Slowly slide heel toward glutes

• Stop before strain

• Control return

Excellent early-stage mobility exercise

Quad Sets + Straight Leg Raises

Goal: Rebuild quadriceps strength

• Supine, leg straight

• Tighten quad, press back of knee down

• Lift leg 6–12 inches

• Lower slowly

 Supports joint stability

Glute Bridges (Neutral Spine)

Goal: Strengthen posterior chain

• Feet hip-width, not too close

• Avoid excessive knee bend

• Lift through hips, not knees

 Reduces knee load by strengthening glutes

Clamshells (Side-Lying)

Goal: Strengthen glute medius

• Knees bent comfortably

• Keep pelvis stable

• Small, controlled movement

 Helps reduce valgus strain on knee

Seated Leg Extensions (Light Resistance)

Goal: Quad control

• Sit tall

• Extend knee to comfortable range

• Control down

Avoid locking aggressively

Standing Weight Shifts

Goal: Balance + joint awareness

• Feet hip-width

• Shift weight side-to-side slowly

• Progress to mini single-leg stance

 Builds confidence post-surgery

 Reformer Footwork (Modified)

If using a reformer (Balanced Body or similar):

• Medium/light springs

• Parallel stance

• Limit knee bend depth

• Slow tempo

 Avoid deep squats or heavy resistance early

 Exercises to Avoid or Modify

• Deep squats

• Kneeling work (unless well-padded and cleared)

• Lunges with deep flexion

• Jumpboard

• Twisting under load

• Knees past toes under heavy load

 Programming Tips 

For clients 3+ months post-op:

• Emphasize glute strengthening

• Add balance challenges gradually

• Focus on gait mechanics

For long-term joint health:

• Train hips more than knees

• Improve ankle mobility (reduces knee stress)

• Add core stability to reduce compensations

  
  

  Here at JMP, our pilates instructors are equipped to work with all types of bodies, whether fully capable or having ailments and limitations, we are here for you! Our main priority is client safety and wellness and we want to help every single client with their goals and needs! We are open 7 days a week and offer private pilates for 30 mins or 60 mins and group classes! 

  
  

  Jupiter Massage and Pilates, LLC 
  125 W. Indiantown Road Suite#102 Jupiter, FL 33458
  561-529-2093
  www.jupitermassageandpilates.com