Exercise guide after patella realignment surgery

In this blog, we look at the types of exercises commonly used after patella realignment surgery, and how they’re progressed.

It has been developed with insights from Jakub Chudy, Managing Partner and Physiotherapist at HBF Physio Cockburn, and reflects his clinical experience supporting people through recovery.

Always follow your care team’s advice

There’s no one-size-fits-all exercise program after patella realignment surgery. Rehabilitation plans are typically guided by your surgeon or physiotherapist, and may vary depending on factors like the type of procedure performed, healing progress and overall health.

Rehab should be guided by both time and how your knee is responding, with exercises introduced and progressed under clinical supervision.

Early-stage exercises: Supporting movement and circulation

In the early phase after patella realignment surgery, exercises are focused on supporting movement and circulation – not building strength quickly.

Common early exercises include:

• Ankle pumps or ankle movements: Often used to support circulation and reduce swelling in the leg
• Quadriceps activation (quad sets): Gentle muscle contractions to help re-engage the thigh muscles
• Heel slides or assisted knee bends: Used to gradually restore knee movement within advised limits
• Straight leg raises (where appropriate): A simple strengthening exercise sometimes introduced early

These exercises may feel basic, but they’re important for restoring movement and preparing the knee for later strengthening.

Mid-stage exercises: Building strength and control

As recovery progresses, exercises are often expanded to support strength, stability and controlled movement. Examples include:

• Stationary cycling (low resistance): Introduced to support range of motion and gentle endurance
• Quadriceps and lower limb strengthening exercises: Helping rebuild strength in the muscles that support the knee
• Hip and glute strengthening exercises: Supporting overall lower limb stability
• Balance and proprioception training: Exercises to improve coordination and knee control

This stage helps build the strength and control needed for more functional, everyday movement.

Later-stage exercises: Moving toward functional strength

As healing continues, rehab often shifts toward more functional, weight-bearing movement. Examples of later-stage exercise types include:

• Progressive strengthening exercises: Gradually increasing resistance to build muscle strength
• Walking progression and endurance activities: Helping return to normal movement patterns
• Step-based or functional movement exercises: Supporting everyday tasks like stairs
• Activity-specific or sport-related exercises (where appropriate): Introduced gradually as strength and control improve

This stage focuses on building confidence in the knee and supporting a return to daily activities or higher-level movement.

Exercise should feel manageable, not overwhelming

As you increase your activity, it’s normal to have some ups and downs – but exercises shouldn’t cause ongoing pain or swelling. If your knee becomes more swollen or painful after an activity, it may be helpful to limit or pause that activity and allow the knee to settle.

How can HBF help?

If you have eligible extras cover with HBF, you may be able to claim benefits for visits to a physiotherapist as part of your recovery after patella realignment surgery.

Physiotherapy can support rehabilitation by:

• Guiding safe exercise progression based on your recovery stage
• Supporting strength, balance and movement control
• Monitoring how your knee responds to activity
• Adjusting your program over time as your capacity improves