If you’ve had a total knee replacement (TKA), you’ve probably heard this before: “Don’t kneel—it’s bad for the joint!” But here’s the truth: kneeling after a TKA is actually safe for most people. The problem isn’t the joint—it’s the training.
Most modern knee implants are designed to withstand the stress of kneeling. Research and clinical experience both show that kneeling does not damage the prosthesis or increase the risk of loosening. So why do so many people avoid it?
Because initially it hurts, or it feels weird, or someone has been convinced they'll never be able to because their friend/coworker/doctor told them they wouldn't be able to. The sensations are completely valid. Scar tissue, numbness, and sensitivity around the incision—especially near the kneecap—can make kneeling feel everything from incredibly painful to really odd, and seem impossible. This doesn't mean you can’t kneel. It simply means your body needs a little help getting used to it again.
Think of kneeling like any other functional movement—it takes time and gradual exposure to rebuild tolerance. If someone hasn’t kneeled in months (or years), or has their new surgery that has restricted previous kneeling, jumping straight to kneeling on hard ground is like trying to run a 5K without training - it’s going to hurt. It might even cause a setback in the wrong scenario. But that doesn’t mean running, or kneeling, is inherently bad. It just means you skipped the training. ...and this is not just for relatively new knee replacements. People with surgeries from years ago can still train their body and brain to be ok with kneeling, to change it from pain to simply pressure.
Start small, go slow, and listen to your body. Here's a simple progression:
A couch or upright recliner that is not the floor but shorter than a typical bed, and has arm supports, can ease you into the first trial of kneeling by reducing pressure on the new knee while helping your body get used to the position.
A chair, countertop, or stable surface can help you get in and out of kneeling safely, especially early on. Kneel on the non-surgical knee first and then place as much weight as you can tolerate onto the surgical knee.
Just a few seconds at a time, and slowly build up as tolerance improves.
Once you’re comfortable on soft padding, move to carpet, then to thin mats, and eventually firmer surfaces like grass or packed dirt.
The key is consistency and patience—just like you wouldn’t expect a runner to go from the couch to a race without weeks of gradual build-up, you shouldn’t expect your knee to handle full kneeling without a similar progression.
Kneeling after a TKA isn’t off-limits—it’s a functional skill that can be relearned with the right approach and a little patience. Most people can get back to kneeling comfortably. If you’re unsure where to start or want guidance along the way, a physical therapist can help you build a plan that fits your goals.
So next time someone tells you that kneeling is dangerous after a knee replacement, you can tell them the truth: it’s not about the joint—it’s about the journey.
