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 or treadmill, comfortable pace. Knee-friendly aerobic warm-up.

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

Forearms vertical on the door jambs, elbows at 90° and shoulder height. Step one foot through and lean forward — chest opens, mid-back extends.

2. Mobility ~3–5 min

Joint prep before loading — open up hips, T-spine, and shoulders.

Cross-body knee pull (abductors)

60 s each side

Sit upright, one leg straight in front. Bend the other knee and cross it fully over — bent foot flat on the floor on the FAR side of the straight leg. Hug the bent knee and pull diagonally toward the opposite shoulder. Outer hip / piriformis.

Butterfly stretch (adductors)

60 s · lean + rotations

Sitting, feet together, knees splayed. Hold the stretch; add a gentle forward lean and side rotations.

Half-kneeling adductor rock

8–10 rocks each side

One knee on a pad, the other leg straight out to the side — foot flat, toes forward. Hands on the floor in front, back flat. Rock the hips back toward the kneeling heel (deepens the inner-thigh stretch), then forward. Switch sides.

Open book with overhead reach

8–10 reps each side · slow arc

Side-lying, knees bent 90° and stacked (block between knees keeps them pinned). Bottom arm on the floor. Sweep the top arm in a wide overhead arc — up past the head and down behind you, like a slow backstroke. Eyes follow the hand.

3. Ankle / foot prep ~3 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 a stair edge, heels hang off and drop below the step. Hold 60 s straight-knee (gastroc), then 60 s knees slightly bent (soleus). Repeat single-leg.

Calf raises

2 × 15

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

Kneeling lunge tib raise

30 reps each leg

Half-kneeling lunge: back knee on a pad, back toes tucked under (ball on the floor, heel up). Front foot flat, front knee at 90°, torso upright. Lift the back toes up off the floor toward the back shin, lower under control. Switch legs.

Tib raises (wall)

30 reps each leg

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

4. Knee strength + activation ~12 min

Wall sit

3 × 60 s hold

Back flat on a wall, walk feet out and slide down to 90° knees (thighs parallel, shins vertical). Hold. Arms relaxed. Harder: 90 s+, heels on a folded towel, or single-leg.

Straight leg raises (seated)

30 reps each leg

Sit upright on the mat, one knee pulled tight to chest. Other leg straight — tighten the quad, lift 6–10 inches, lower under control. Switch legs. Post-op: lie supine with the opposite knee bent and foot planted (easier from bed).

Standing single-leg banded knee raise

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

Stand on the middle of a band, loop the other end above the working knee (on the thigh, not the ankle — less knee strain). March the working knee up toward the chest — knee bent, thigh to hip height, shin hanging. Hold, lower under control. Wall hand for balance. Switch legs. Hip-flexor work.

Standing single-leg banded side raise

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

Stand on the middle of a band, loop the other end around the working ankle. Working leg straight, toes forward, torso upright. Lift the leg out to the side against the band, hold, lower. Wall hand for balance. Switch legs. Outer hip (glute med + TFL).

Terminal knee extension (TKE) with band

2 × 15 each leg · hold 3 s at lockout

Anchor a band to a door frame at knee height, loop the other end around the BACK of the working knee. Stand facing the anchor, both feet flat. Soften the knee ~20–30°, then drive to FULL LOCKOUT against the band — squeeze the quad (especially the VMO). Hold 3 s, return slowly. Switch legs.

Step-down (eccentric quad)

2 × 10 each leg · slow 3 s descent

Stand on a low step (6–8 inches), one foot planted on top. Slowly lower the other leg off the side — heel taps the floor (no weight on it), then drive back up. Standing leg controls the descent (3 s down). Hands out for balance. Switch legs.

Step-up + terminal knee extension

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

Plant the working foot on a low step (6–8 inches), press up and LOCK OUT the standing knee — quad fully contracted. Hold 3–5 s, lower under control. The other leg just taps the floor between reps. Bodyweight TKE.

5. Hip / glute ~7 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 with the foot planted in front. Bottom leg straight — lift toward the ceiling, lower under control. Inner thigh; pair to the clamshell.

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.

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, band held shoulder-width, arms straight out at shoulder height. Pull apart by drawing the hands laterally — squeeze the shoulder blades. Return under control.

Wall slides (W → Y)

2 × 10 reps · slow

Back, butt, head flat against a wall, feet 6 inches out. Arms in a W (hands, elbows, forearms touching the wall). Slowly slide overhead to a Y, keeping every contact point pressed. Lower back down.

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.

Single-leg balance

30 s eyes open + 30 s eyes closed · each leg

Stand on one foot, soft knee, other foot lifted slightly. Arms relaxed. 30 s eyes open, then 30 s eyes closed (small wobble is fine). Switch legs.

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.

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.