How to Train Clients With a Knee Replacement | Learn: Your Fitness Business Resource

How to Train Clients With a Knee Replacement

Training clients with knee replacements can open up a new client base for a personal trainer. But, it's important that you have the proper tools to train someone with a knee replacement effectively. Using certain personal training software features can help you train clients with knee replacements.

Thomas Barnett is a writer for and a Professor of Exercise Science at Keiser University. He has over eight years of experience working in rehabilitation, personal training, and strength and conditioning. Additionally, Thomas holds a Master's Degree in Human Performance, a Bachelor's Degree in Exercise Science, is an NSCA Certified Strength and Conditioning Specialist (CSCS), a Certifi...

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UPDATED: Jul 16, 2021

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Get the Basics...
  • Personal trainers should have a strong understanding of lower extremity mechanics when training clients with a knee replacement.
  • Postoperative exercises for knee replacements start by restoring stability and eventually promote a functional range of motion.
  • Incorporating mobile workout and assessment software can help improve the rehabilitative process for clients with a knee replacement.

Breaking into training special populations, like training clients with a knee replacement, can be a rewarding way for personal trainers to add a new stream of revenue to their fitness businesses.

To train clients with a knee replacement, it’s important that you’re not only well-versed in knee replacements, but that you have the tools in place to make your training as effective as possible; that’s where personal training software comes into play.

By taking advantage of the features that personal training software has to offer, you can train clients with knee replacements in a way that works for them, not against them.

To learn more about the personal training software platform, book a demo today.

How to Train Clients With a Knee Replacement

To learn how to train clients with a knee replacement, it’s imperative that you have a thorough understanding of what a knee replacement is and why it’s important to follow certain procedures with these clients.

What is a knee replacement?

A knee replacement, or knee arthroplasty, is a surgery that replaces all or some of the bones and soft tissues that form the knee joint. Most notably, the distal end of the femur (femoral condyles), the meniscus, and the proximal end of the tibia will be replaced with material to help provide a more articulate joint after years of wear and tear.

Patients who opt to undergo knee replacements are usually experiencing significant pain due to friction between the worn surfaces of the femur and the tibia. Over time, the cartilaginous tissue between the two bones wears down. When this happens, everyday movements like walking, climbing stairs, and even getting dressed can become a task.

With so much pain and inflammation, many people will succumb to a more sedentary lifestyle and experience atrophy in surrounding muscles such as the quadriceps, hamstrings, and calves. Beyond this, the sedentary lifestyle could further contribute to obesity or other problems.

There are even some age and gender factors that suggest an increased likelihood of knee replacements for some. For these reasons, it’s valuable to have extensive knee knowledge when working with clients following a knee replacement.

Do you need to be certified to train clients with a knee replacement?

The rehabilitation process for knee replacements has come a long way over the years. Nowadays, knee replacement surgeries can be outpatient procedures in which patients will walk on the same day. There will be some proprioceptive changes, but patients won’t have to relearn how to walk after knee surgery.

Before you can effectively train someone with a knee replacement, it’s important to get credentialed to optimize your program design. It would be preferred to have an advanced certification such as:

  • ACSM Clinical Exercise Physiologist (EP-C)
  • ACE Medical Exercise Specialist
  • NSCA Special Populations Specialist (CSPS)

With any of the above certifications, you’ll learn how to handle clients with a myriad of musculoskeletal disorders like rheumatoid or osteoarthritis. While not identical, these conditions present many of the same symptoms and limitations that affect clients who have recently had knee replacements.

In any case, if you want to expand your potential outreach with clients, you’ll want to be prepared to accommodate clients who have had a knee replacement. A big component of your preparation will be learning exercises to perform before a total knee replacement and how they differ from exercises performed after a knee replacement.

Training Clients After a Knee Replacement

Assuming a client has experienced chronic knee pain, there’s a good chance they’ve been informed they should perform certain exercises before knee replacement. Many surgeons provide patients with a total knee replacement exercise guide, similar to OrthoInfo.

The truth is, early postoperative exercises, or phase 1 total knee replacement exercises, will be similar to the exercises you’ll do before a knee replacement. Most total knee replacement exercises are designed to maintain the stability or strength in nearby muscles. Some of those exercises include:

  • Straight Leg Raises (Hip Flexors/Quadriceps)
  • Ankle Pumps (Calves)
  • Knee Straightening (Quadriceps)
  • Knee Bends (Hamstrings)

There are different ways to perform these exercises depending on a client’s abilities. Some clients won’t be able to get on the floor. As a trainer, you’ll have to have alternative methods to perform many of these low-intensity leg exercises if you want to train clients with knee replacements.

Not all clients will progress at the same rate, so you’ll need to use caution before getting to other advanced total knee replacement exercises. You’ll see above that most of the phase 1 knee replacement exercises use bodyweight and limited range of motion.

Advanced knee replacement exercises will further emphasize restoring strength throughout a more complete range of motion. This would include more traditional movements, albeit at lower intensities, to help get back to everyday life. Examples could be chair squats, leg presses, low step-ups, and other exercises, as tolerated.

If a client experiences pain throughout a specific range of motion, terminate that exercise and move on to something more appropriate. To minimize these instances, there are a handful of knee replacement exercises to avoid, such as:

  • Jump Squats
  • Running
  • Jumping Jacks
  • Skipping
  • Agile Sports

In short, when you’re training a client with a knee replacement, especially a recent one, you’ll need to minimize the impact on that knee. Keeping your clients safe can prolong their time with you for more stable revenue and a more satisfying result.

Learn more about's custom workout software.

Train clients with knee replacements.

Software Tools for Training Clients With a Knee Replacement

When you’re learning how to train someone with a knee replacement, you’ll need to be more prepared than you would if you were working with your average Joe.

Workout Software for Clients With a Knee Replacement

The day in the life of a personal trainer isn’t for the faint-hearted. Most trainers work long days with less planning than they truly need. This leads to prescribing random exercises on the go instead of truly prescribing the best program for your clients.

It’s not as effective, or as safe, to create workouts without preparation for clients with special needs. Thankfully,’s versatile workout software allows trainers to create workouts and schedule them to be delivered at a more opportune time.

This software also allows trainers and clients to log and track workouts, all with complimentary analysis features so you can see progress or regression. Workout software can help improve your organization, reliability, and accountability for your clients.

Fitness Assessments for Clients With Knee Replacements

Workouts are important, but fitness assessments help prepare you to program for your clients. This is especially important when working with someone who’s had a knee replacement. offers functional fitness assessment software that helps trainers create and implement fitness assessments to better gauge a client’s abilities.

When assessing a client with a knee replacement, you’ll be able to measure and track things like range of motion, balance, strength, and anything else you feel fit for your client. As they progress, you can even automate assessments so that your clients can conduct and log them on their own.

Expense is a concern for clients, this is why many clients end physical therapy to work with a personal trainer. Eventually, they might want to cut costs even further. By providing accessible resources like fitness assessments and personalized workouts, you’ll be able to maximize retention and overcome financial barriers.

Customizable Exercise Library for Clients With a Knee Replacement

If your knee replacement client does decide to work more independently, it doesn’t necessarily mean there has to be a major downgrade in the quality of training they receive. Sure, distance training isn’t quite as personal, but personal trainers can provide their clients the resources they need to continue being successful. Happy clients stick around.’s customizable exercise library offers clients a written and visual description of any exercise you want to prescribe. This is important when prescribing exercises after a knee replacement. With generic names like “knee bends” and “leg lifts”, clients could easily become confused about the desirable technique used to perform these movements.

They’ll be able to access your exercise library from a custom-branded fitness app anywhere, anytime. This helps improve accessibility and functionality to continue serving your clients, even if you aren’t around to help. These supplemental resources help to prevent many of the common barriers to exercise.

Training Clients With a Knee Replacement: The Bottom Line

Training clients with a knee replacement requires a lot more than just general knowledge. It requires education, empathy, and a host of software tools built with customization and adaptation in mind.

To learn more about how can help you train senior clients, book a demo today.


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