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Sleeping After Knee Replacement: Keeping it Simple

sleeping after knee replacement

Sleeping after knee replacement surgery is an important aspect of your healing. Keep reading to learn how you can sleep comfortably and make the most out of your rehab.

Sleeping positions after knee replacement

The best sleeping position after a total knee replacement is on your back. However, you will want to avoid sleeping flat on your back for several reasons:

  1. Sleeping flat on your back can cause muscle tension, soreness, or pain in your lower spine
  2. Immediately after surgery, your knee will not be able to straighten all the way. This means you will not be able to lie completely flat while supporting your knee
  3. Sleeping flat can allow fluid to build up in your leg overnight

The other possible sleeping positions after knee replacement are on your stomach and on your side. Try to avoid sleeping on your stomach. Sleeping on your stomach puts a lot of stress and strain on your neck and upper back. In regards to side sleeping, its probably not going to be an option early on. Typically, sleeping on your side is pretty painful for the first couple of months after surgery.

Pillow placement after TKR

When sleeping after knee replacement surgery, try elevating your legs on a contoured leg elevation pillow. The contours will cradle your legs and calves for maximal comfort. They also support your legs in a way that avoids tender spots and pressure points.

Sleeping after knee replacement

Sleeping with your legs elevated also:

  • Uses gravity to reduce swelling in your leg so you recover faster
  • Aligns your spine properly to prevent back stiffness in the morning
  • Relaxes your back muscles and relieves back pain overnight

Immediately after surgery, you may not be able to lie on a contoured leg wedge with your knee completely straight. That’s okay! You can place a small pillow or towel under the bend of your knee. Over the next several weeks and months as your knee heals, remove the pillows or towels gradually until you can sleep comfortably with your legs elevated on the contoured leg wedge.

After a knee replacement, you do want to avoid lying for extended periods with your knee bent. However, if you are carefully following your physical therapist’s exercise program, you are getting plenty of movement throughout the day. If this is the case, sleeping with a small pillow under the back of your knee at night is generally okay if it is needed for you to sleep. Always check with your physical therapist to see if using an additional pillow on top of the wedge is okay for you, or if they want you to try to just use the contoured wedge.

Other sleeping positions after knee replacement surgery

As your knee continues to heal, you may want to venture back into side sleeping. To do this comfortably, you must have a leg separator pillow. Otherwise, the pressure of your knees resting on top of each other is oftentimes unbearable.

Side Sleeping after knee replacement

Make sure that the leg separator pillow is supportive enough to keep your top leg parallel to the bed. This takes any tension off your low back and hips. You also want to make sure that it is long enough to run from your pubic bone to past your feet. This length makes sure your leg is getting the support it needs.

Sleeping after knee replacement surgery can be difficult at first, but as your body heals and your leg is supported correctly, you will be sleeping soundly before you know it!

-Hillary Blare, Doctor of Physical Therapy

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4 responses to “Sleeping After Knee Replacement: Keeping it Simple”

    • Hi, Ann!

      Having pain at night four months after having a total knee replacement is not unusual- especially the more and more active you are during the day as you recover. You’ll also notice more pain and soreness at night the first time you do certain activities during the day. For instance, the first time you go up a few stairs, it may not hurt at the time, but you will likely be pretty sore that night. It can take up to a year to feel like your knee is “back to normal!”

      To manage night pain, watch your activities during the day. Don’t add too much too fast. Manage your swelling by elevating your legs consistently. And as always, listen to your body! If you feel like the pain you are having is abnormal, talk to your surgeon or physical therapist so they can make sure that your pain is due to soreness, and not anything else!

  1. Hi Hillary! My total knee surgery is scheduled to take place in a month and I am going to give this contoured leg pillow a try! Do you have any other tips? I’m a little nervous and want to do everything I can to heal correctly

    • Hi Eric! I’m glad you are going to try the contoured leg pillow, it will really help you in your recovery! Some of my other tips would be to 1. Work hard initially to regain your range of motion, especially straightening your knee. 2. Find the sweet spot between hard work and working too hard. You want to work hard, but not so hard that your knee gets excruciatingly sore! Find the balance early on so you know how far to push yourself. 3. Be patient. A lot of times it takes 1 year before you will feel back to “normal.” It just takes the body a while to heal, so don’t ever get discouraged! I hope this helps. GOOD LUCK! Keep me posted 🙂

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