Knee-Prehab Routine

Home setup: bike, slant board, bands, foam roller, Theragun, anchor points. Travel kit: bands, foam roller, Theragun. No bike, no anchor points. Travel light: nothing portable — walls, doorways, chairs, stairs only.

1. Warm-up ~15 min + 45 min bike~10 min + 45 min walk~5 min + 45 min walk

Raise core temp, lubricate joints, ease soft tissue before loading anything.

Bike

45 min · easy spin

Comfortable cadence, low resistance. Keep the knee tracking straight over the toe.

Walking

45 min · easy pace

Outdoor walk or hotel-gym treadmill. Comfortable, knee-friendly aerobic warm-up. Mix of surfaces and gentle inclines if you can find them.

Theragun pass

3–5 min · quads + glutes + calves

Light pressure on the operative-side quad. Skip directly over the patella.

Foam roller — legs, lats, hips, glutes

5–7 min

Slow passes; longer dwell on tender spots. Avoid rolling directly on the operative knee joint line.

T-spine extension on roller

3 spots × 5 extensions

Roller under upper-mid back, hands behind head. Lengthen, don't crank.

Door-frame T-spine + pec stretch

3 × 30 s

Stand in an open doorway. Place both forearms vertically against the frame jambs at 90° elbows, shoulder height. Step one foot forward through the doorway and lean gently into the open space — chest opens, mid-back extends. Roller-free thoracic mobility.

2. Ankle / foot prep ~5 min

Calves and shin balance — pairs stretch + strength on the ankle joint.

Stair-edge calf stretch

60 s holds · 2 legs / 1 leg · straight + bent

Balls of the feet on the edge of a stair, curb, or threshold. Heels hang off; let them drop below the step level. Hold 60 s straight-knee (gastrocnemius), then 60 s with knees slightly bent (soleus). Repeat single-leg. Any step works — travels everywhere.

Calf raises

2 × 15

Stand near a wall for balance. Rise slowly to toes, lower in control. Knees soft.

Tib raises

30 reps each leg

Back flat against the wall. Step one foot slightly forward with the heel planted on the floor; soft knee. Lift just the toes of the front foot up toward your shin, then lower. Heel stays glued down. Switch legs.

3. Knee strength + activation ~10 min

Wall sit

3 × 60 s hold

Back flat against a wall, walk your feet out and slide down until your knees are at 90° (thighs parallel to the floor, shins vertical). Hold. Arms relaxed at your sides or crossed on your chest. Heavy quad isometric work, knee-friendly, zero setup. Make it harder: hold 90 s+, heels elevated on a folded towel, or single-leg.

Straight leg raises (seated)

30 reps each leg

Sit upright on the mat. Pull one knee in tight to your chest and clasp it. Other leg straight on the floor — tighten the quad, lift the straight leg 6–10 inches off the mat, lower under control. Switch legs. Post-op: switch to the supine version (on your back, opposite knee bent foot planted) for the first few weeks — easier to do in bed, less hamstring pull on the incision.

Standing single-leg banded knee extension

2 × 15 each leg · hold 3–5 s at lockout

Stand on the middle of a long band with your support foot. Loop the other end around the ankle of the working leg. Lift the working leg in front of you to about 60° of hip flexion, then slowly straighten the knee fully against the band — lock out, hold, lower under control. Hand on a wall for balance if needed. Switch legs.

Step-up + terminal knee extension

2 × 15 each leg · hold 3–5 s at the top

Stand a low stair or step (6–8 inches). Plant the working foot on the step, press through it and stand fully up — LOCK OUT the standing knee, quad fully contracted. Hold 3–5 s, lower under control. The trailing leg just taps the floor between reps. Bodyweight version of the banded knee extension — works anywhere with a stair.

4. Hip / glute ~10 min

Hip stability + posterior chain. Frontal-plane and sagittal-plane work, both sides.

Clamshell with band with band

2 × 30 each side

Side lying, knees bent and stacked. Open the top knee while keeping the heels together. Outer hip (abductors). Band looped just above the knees for resistance.Band looped just above the knees for resistance.Bodyweight only — slow tempo, pause at the top, focus on the squeeze.

Side-lying adductor raise

30 each side

Side lying. Top leg bent, foot planted on the mat in front. Bottom leg straight; lift it toward the ceiling, lower under control. Inner thigh (adductors) — the pair to clamshells.

Single-leg glute bridge

2 × 20 each leg

One foot planted, the other straight out. Drive through the heel; ribs down.

Lateral walk with band with band

1 min

Small steps sideways in a quarter-squat, knees tracking over the toes, hips level. Band above the ankles for resistance.Band above the ankles for resistance.Bodyweight — sink lower in the squat and stay low through the whole minute to load the glutes.

Single-leg RDL with band with band

2 × 20 each leg

Hinge at the hip, back leg straight behind you, slow tempo. Band held in both hands, anchored under the standing foot.Band held in both hands, anchored under the standing foot.Bodyweight — arms reaching toward the floor. Slow eccentric is the load; balance is half the work.

5. Mobility ~10 min

Long-hold stretches once the system is warm and worked.

Sit and reach

60 s each leg · both legs

Reach to the toe, breathe into the back of the hamstring.

Butterfly stretch (adductors)

60 s · lean + rotations

Sitting, feet together, knees splayed. Hold the stretch; add a gentle forward lean and side rotations. (Your routine called this "abductor stretch" — it's actually targeting the adductors / inner thigh.)

Cross-body knee pull (abductors)

60 s each side

Sit upright on the mat with one leg straight out in front. Bend the other knee and cross it over the straight leg — the bent knee sits above the straight thigh, the bent foot planted flat on the outside of the straight leg. Wrap both arms around the bent knee and pull it diagonally across your body toward the opposite shoulder. The full crossover deepens the outer-hip stretch. Paired with the butterfly above.

Knee drops (windshield wipers)

30 s each side · 4–6 cycles

Lie on your back, knees bent 90° with feet flat on the mat near your glutes. Arms out in a T for stability, palms down. Slowly drop both knees together to one side, hold, return through center, drop to the other side. Shoulders stay flat. One hip gets external rotation, the other gets internal rotation — the knee-friendly replacement for 90/90 (no floor pressure on the knees).

Open book

8–10 reps each side · 5–10 s hold at end

Lie on your side, knees bent 90° and stacked together (a yoga block or rolled towel between the knees keeps them pinned). Both arms extended in front of your chest at shoulder height, palms together. Bottom arm stays on the floor. Slowly sweep the top arm up and over to the opposite side until the back of the hand reaches the floor behind you — head and eyes follow the hand the whole way. Knees and hips don't move. Pairs with the T-spine extension on the roller in the warm-up.

6. Posture / upper ~5 min

Shoulder + mid-back. Independent of the knee but part of the standard daily flow.

Rotator cuff rotations

10 reps each side

Elbows pinned to ribs, 90° at the elbow. Rotate the forearm out then in.

Band pull-aparts

100 reps · 1 set

Stand tall, hold the band shoulder-width with arms straight out in front at shoulder height. Pull the band apart by drawing the hands laterally, squeezing the shoulder blades together. Return under control.

Wall slides (W → Y)

2 × 10 reps · slow

Stand with your back, butt, and head flat against a wall, feet about 6 inches out. Arms in a goalpost (W position) with backs of the hands, elbows, and forearms TOUCHING the wall. Slowly slide both arms up overhead toward a Y position, keeping every contact point pressed to the wall. Lower back down. Mid-back + pec mobility — no band needed.

7. Core ~5 min

Anti-flexion + lateral stability. Quiet isometric work; no knee load.

Front plank

60 s hold

Forearms under shoulders, toes tucked. Body in one straight line from head to ankles. Ribs down, glutes squeezed, no hip sag and no hip pike.

Side plank

60 s hold each side

Supporting elbow under shoulder, feet stacked. Lift the hip clear of the mat; reach the top arm to the ceiling. Don't let the bottom hip drop. Switch sides.

8. Cool-down ~5 min

Long holds, downshift the nervous system.

Standing QL stretch

60 s each side

Reach the same-side arm overhead, side-bend away. Breathe into the ribs.

Couch stretch (kneeling lunge)

60 s each side

Back foot up on a wall or couch, front leg planted at 90°. Front-rack the hip.

Hamstring stretch (band) (band) (towel)

60 s each leg

On your back, hook a bandbandtowel or belt around the arch of the foot, pull the straight leg toward the ceiling. Opposite knee bent, foot flat on the mat.

Toe touches

10 reps

Slow exhale on the way down, soft knees, no bounce.

Pathway exercises set aside (consider as additional)

These are Pathway's recommendations that were dropped from the main routine because your existing exercises already cover the same purpose. Add them back if the duplication concern doesn't hold for you.

Heel slides

2 × 10 · hold 5 s

Dropped pre-op — the 45-min bike pedals through full knee flexion every revolution. Re-add post-op when the bike isn't possible (knee can't yet bend through a pedal stroke). Essential for the first few weeks after surgery.

Gentle walking

20–30 min daily

Pulled out of the routine block because the 45-min bike already covers low-impact aerobic + knee ROM. Keep as a separate daily walk if you can fit it in — walking adds impact loading and the heel-strike-to-toe-off gait pattern your knee will face post-op.

Mini wall squats

2 × 10 · hold 5–10 s

Same wall-isometric pattern as the wall sit, but shallower (not past 90°) and briefer holds. Re-add post-op as the gentler version while you're rebuilding to a full 90° wall sit — easier dose for early recovery.