Short answer: yes. Scope, knee replacement, ACL reconstruction, fracture repair, a bursa flush-out, all of it.
Doesn’t matter what the surgeon called it. If someone cut into your knee, you need rehab afterward.
The myth: rest and walking will sort it out
The instructions are usually the same. Take it easy, keep the leg moving, walking will do the rest. It sounds like something the knee can handle on its own.
It can’t. Surgery is traumatic, even the “easy” procedures, and your body responds to that trauma by protecting the area whether you want it to or not.
The truth: your knee is inhibiting itself
There’s a name for this: arthrogenic muscle inhibition, or AMI. Pain, swelling, and the trauma of surgery send a signal that tells your quad to partially switch off. That’s your nervous system protecting the joint. The muscle itself is usually fine.
Walking around on it doesn’t fix AMI. You can walk for weeks and still have a quad that won’t fire properly, a knee that won’t fully straighten, or a bend that’s stuck 10 degrees short of where it should be.
The priorities after any knee surgery are the same, regardless of the procedure:
- Get swelling and pain under control early.
- Get full knee extension back. This is the one people miss most, and it’s the hardest to recover once you’ve lost it for a few weeks.
- Work on knee bend.
- Reactivate the quad specifically. Passive movement alone won’t switch it back on.
- Get back to being athletic if this is important to you
How much work this takes depends on your history. Two years of knee issues before surgery usually means more entrenched range and strength deficits than an acute injury fixed within weeks of it happening.
This is also why “the surgery went well” and “you’re recovering well” aren’t the same statement. A surgeon can tell you the joint itself looks great on the inside and still have no idea whether your quad has switched back on or whether you’re missing the last few degrees of extension. That’s specifically what a physio session checks for, separate from how the incision or the x-ray looks.
What to do this week
Book at least 1 or 2 sessions with a physio, even if you feel like you’re managing fine. That’s usually enough to catch a stuck extension or a quad that’s not firing before it turns into a long-term habit. You may need more work, but this will put you on the right track.
If you’re a few weeks out and still can’t fully straighten the knee, or the quad still won’t switch on properly, address it directly rather than waiting to see if it resolves on its own. A physio can measure quad strength against your other leg, rather than guessing from how the knee looks or feels. Ideally they use a force dynamometer and give you an actual number reading of your strength- don’t rely on how they ‘feel’ without using any data.
We see this constantly at The Physio Hub in Collingwood: people who were told surgery went well and just needed time, sitting on a stuck extension or a dead quad for months longer than necessary. A session or two early catches it before it becomes a habit your knee has to unlearn.
If you have undergone knee surgery- let us know and get a detailed idea of where you are and what you need to do to make it succesful.
Matt Sheldon, Registered Physiotherapist, The Physio Hub- Collingwood.