Heel Slide Exercise After Knee Replacement Surgery (Benefits and Tips)

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What are the benefits of heel slides? You’ll be pleased to know that heel slides will help with range of motion. I had to do a lot of these after my knee replacement surgery and I have some tips.

This article shares my pains and gains with heel slides. My home therapist and my offsite therapist both assigned heel slides for me and they emphasized that I should do them several times a day.

Heel slides were by far the most painful exercises that I did post TKR surgery but they were also the most rewarding exercise. The benefits outweighed the pain.

For all total knee replacement patients, increasing range of motion is of utmost importance.

Throughout my rehab I was tempted to skip or cheat on heel slides because I knew they caused temporary pain. I’m thankful that I persevered because I made dramatic gains in my range of motion.

Like me, I think you’ll find that heel slides are tough but well worth the effort when you reap the reward of increasing your range of motion (flexion). Tough it out when it comes to doing your heel slides.

The result will be rewarding and you will feel good when you see the results.

What Are Heel Slides

Heel slides are an essential leg exercise you’ll be instructed to do after knee surgery.  While this website is dedicated to knee replacement recovery, heel slides are just as important for any type of knee reconstruction, even small surgeries like ligament (acl, mcl, pcl) and cartilage surgery.

The most simple definition of heel slides is to slide your foot/heel against a surface toward your butt.  The heel slide exercise bends the knee joint, increasing range of motion while strengthening the muscles and ligaments around the leg.

Next I’ll share more specific information on the exercise. Be sure to watch the video below.

What Parts Of The Body Do Heel Slides Work (How Often Will I Do Them)

Heel slides help strengthen the muscles around your knee. They also help stretch and exercise your ligaments and tendons, making them more flexible.  Heel slides will help you increase your range of motion in the knee joint and if you don’t do them you’re at risk for limited joint mobility and flexion.

For me, the heels slides were the most important exercise I was assigned, especially early on.

When you arrive in the hospital room after TKR you’re barely able to flex your surgical knee. The incision is stapled and the knee is wrapped tight with a dressing and another Ace bandage. Your leg will be very swollen.

You have an ice cuff on your knee to reduce swelling and an air cuff on each leg to promote circulation (read why I bought the Cryo Cuff Ice Pack). My first opportunity to do heel slides was 4 hours after the surgery when the physical therapist took the equipment off my leg and had me do standing heel slides (marching) with the aid my walker.

During my first physical therapist session I was assigned heel slides.  The heel slides were to be done in two positions:

  1. On my bed
  2. While sitting in a chair

On her second visit she assigned an additional heel slide exercise from the standing position.

Once I began offsite physical therapy I was assigned even more ankle slides. Both therapists always took my flexion measurements during a heel slide exercise.

The first week I strained to get a 70-degree flexion measurement. After 6 weeks I was still straining but I had increased to 120 degrees.

The increase came with a lot of hard work and pain. The results boosted my confidence and encouraged me to stay focused and continue the exercises.

Equipment For Heel Slides Found Around The House

Equipment I found useful during my heel slide exercises:

  • Plastic bag
  • Bathrobe belt (or regular belt or rope)
  • Upright chair that will stay secure on the floor

There are a few aids that can help you with your heel slides. When you are on the bed or sitting in a chair, a plastic bag over your foot will make your heel slide much easier.

My home therapist had me use a belt from my wife’s bathroom robe to gently pull on my foot during ankle slides on my bed. You can also use a belt and make a loop and pull from either side.

I like the robe belt best because you are centered on your foot and you are pulling with both hands and not pulling from a single side of your leg. If you do chair slides it is best to use a stable chair with arms.

I always had a good grip on the arms as I tried to slide my heel back as far as I could. Try to avoid carpet, it is easier to do chair slides on a tile surface or on a wood floor.

How To Do A Heel Slide: Positions and Steps

Position 1: Lying Down

Step 1: Lay down on your bed flat. I did not use a pillow so that I was completely flat on my back.

Step 2: Warm up by gently sliding your heel towards your butt. Don’t jerk and try not to do rapid fire heel slides. Start slowly and increase the flexion during 20 repetitions.

heel slide exercise 4

Step 3: After the warm-up, slide your heel as far as you can towards your butt and hold for 5 seconds. Return your leg to full extension after each heel slide. Do 10 repetitions.

Step 4: Do 5 more of the same heel slides using the robe belt to help you pull and hold even farther. The quality of your heel slides is more important than the amount you do.

Once I started going to the offsite therapist he always massaged my knee with Free Up for 5 to 7 minutes before he had me do heel slides. It seemed to loosen up the knee and it made the heel slides less uncomfortable.

From then on, I asked my wife to massage my knee at home or I massaged it myself before doing heel slides. I made the massage part of my warm-up.

Position 2:  Sitting Down

Step 1: My home therapist picked out an old heavy wooden chair with arms for my sitting heel slides. She positioned the chair on one of our floors that had tile for easier sliding.

Step 2: She then placed a small plastic bag over my foot to make it even easier to slide my foot.

Step 3: My good leg was positioned at 90 degrees for stabilization.

Step 4: I gripped the arms of the chair and slid my heel back towards the chair as far as I could keeping my thigh firmly on the chair and held it for a 5 second count.

Step 5: After 10 repetitions I used my good foot to help push my ankle back even further. I did this 2 times for a total of 12 slides.

The home therapist always measured my flexion on the 10th chair heel slide. My 1st flexion measurement was 70 degrees, my 2nd visit 88 degrees, my 3rd visit 95 degrees and the final home therapy visit (9th) was 110 degrees.

Position 3: Standing Up (Variation)

The standing position is a variation of the heel slide.  I call it a modified heel slide because I’m not sliding it on the ground.

To do this exercise my therapist had me place my hands on the kitchen counter for balance.

I was instructed to bend my leg (foot) back towards my butt, keeping my knees even while standing on my opposite leg.  I bent my leg with my foot towards my butt and held for 5 seconds.

I alternated legs and did 10 repetitions. Then she had me lift my knee up to the counter (marching) and hold for 5 seconds.

Again, I alternated legs and did 10 repetitions using the kitchen counter for balance.

Are Heel Slides Painful After Knee Replacement

I won’t kid you. Heel slides on the bed and in the chair are very painful (7-10 out of 10). They were the most painful exercises I did.

I always kept my eyes closed and did better when nobody else was in the room. I tried listening to music with earphones but that didn’t seem to help.

I focused on the flexion and knew I needed to push myself to increase my range of motion. I kept telling myself that these exercises were the most beneficial for me and that I did not want to cheat and shortchange myself.

I had to tell myself that the gains far outweighed the pain. I did a lot of talking to myself during heel slides.

Heel Slide Tips For Better Flexion

There are different ways that you can do heel slides on a bed which will focus on developing different muscles. You can point your toe in various directions:

  • turned outward
  • turned inward
  • pointing away from your face
  • pointing toward your face

heel slide exercise

My therapist explained the muscle benefits of each and said that I should incorporate those different variations in to my later workouts.

Both therapists instructed me to do traditional heel slides with my toe straight up.


Check with your doctor and physical therapist to see if heel slides are right for you.

Whether I liked it or not heel slides were crucial for my recovery from TKR surgery.

They will be painful but the gains you make in flexion will encourage you to continue to give 100 percent while doing your therapy exercises. I have mentioned some tips, plastic bags, a robe belt, smooth floors and massage that will enhance your heel slides.

When I began my workouts each time I dreaded the heel slides. When they were done though, I felt like I had accomplished something.

After the last workout of the day I was glad that I could relax until the next morning. If you are prescribed heel slides of any kind give them top priority in your workout.

Suck it up and tough it out. You will be glad that you did.

16 thoughts on “Heel Slide Exercise After Knee Replacement Surgery (Benefits and Tips)”

  1. Really, really no fun.😎

    I was able to squat to parallel before surgery and worked very hard on leg flex pre-surgery….that has helped a bit so far I think.

  2. I had a TKR 6/14/19 your blog has helped me very much I have had several different types of surgeries to include brain, back for scoliosis and spondylitis stenosis degenerative disk and neck C-3 thru C-7 disk replacements just to name a few and I still suffer from lower back pain especially on my sciatic nerve and this is by far the most I painful surgery I ever had.. I agree the heel slides are very painful to do but have helped out a few times afterwards ICE is my friend since I have low back and this surgery to contend with it’s been doubly hard on me .. I want to know I have terrible deep rooted pain in my calf and thigh muscle it’s hurts at time just to have touch the pillow like my skin has been burned, the therapist and Dr’s try to explain to me what was entailed in my surgery but don’t quite understand the pain I am having saying everyone ‘s surgery is different and we all heal differently the pain is worst at night which has caused me more loss of sleep did u have these types of pain in your calf (back side and shin side ) and thigh anyone out there have something similar I am trying Blue Stop he massaging cream and the Emu cream ice any suggestions thanks

  3. I just came upon your blog. It’s been very helpful. My TKR was March 20. Going into the surgery, I had problems with extension…I could not flatten the knee out without a great deal of pain, so I always propped it up which made it worse, I’m sure. Also could not raise my foot to my butt before surgery either. I’m now 3.5 months out from the surgery. PT has been working mostly on my extension, which is now at a -2 (much better than before), but I am still struggling with the bending. Slides are very painful. I can get to about 114 on my own, but cannot get to 120 without help. The pain is very real and I thought I’d be in less pain by now (although I’m told it’s normal). In addition, I have had problems with my IT band. This is most bothersome and my biggest complaint right now. I struggle to go down stairs without IT band pain, and still cannot ride my bike. Do you have any experience with IT band pain after TKR or any advice with this? Thank you.

  4. Ken
    Thanks for you blog. You have helped me stay positive. I had a total knee replacement on 11/4/2019 day 16 and having a really tough time with bending. I get very disappointed. I feel I’m a little behind in recovery because I can only get to 70 degrees. I had my first outpatient therapy today and My Therapist says my knee is very stiff and I have lots of work to do. I don’t want to have a knee manipulation. So I read your blog and try to stay positive. Thanks.

    • Thanks for visiting and for the comment. I understand it’s hard to stay positive but there are many of us going through the pain of rehab..work hard and, in most cases, it will be worth it. Keep that knee joint moving when possible.

  5. Hi Ken, I found your blog searching the net to find a solution to my frustration with heel slides. TKR done 12/11/19 and left the hospital able to negotiate a 15 step stairway on 12/13/19. I continue to progress with all the exercises with the exception of the heel slide. I found your experience both enlightening and encouraging. Thanks.

    • The heel slide..much more difficult than it appears. I was not a fan of it but pushed through. Seems as though you’re doing well only a week out. The first 3-4 weeks were frustrating and painful. Work hard early on and it will pay off. Stretch, strengthen, massage, ice, repeat. Thanks for stopping by, best wishes!

      • Hi Ken
        I found the heel slides in the bed useless, just did not get any bend. I found the chair slides much more useful. I am gradually increasing at 7 1/2 weeks post surgery can just get to 80 degrees and a bit more assisted. Strangely still no assisted increase when lying down.

  6. Hi I had TKR 6 months ago.
    My physio didn’t really start me on heel slides until about 2 months after op
    I cannot still do a full heel slide after 6 months .
    When I stand I can bend it right up , I can squat I can sit very well
    But still suffer a lot of discomfort when walking ( which I do a lot of )
    I also do 15 per day ( since about 6 weeks after op ) on a bike in the gym .
    But am frustrated not being able to do the full heel slide …… almost there but not quite ! Is this a worry
    I do exercises still morning and night !
    Thank you

    • It seems like a simple exercise but the heel slides are tough. Keep working. Yoga and/or stretching might help with flexibility and strength as you continue to recover. Best wishes!

  7. Hello Ken
    I am scheduled to undergo TKR in July I discovered your blog in my research. Thank you for sharing your experience. I will incorporate heel slides in the pre surgery exercises given to me. Thanks again. Ruth

    • Thanks for visiting and for the comment. Prepare well going in and you’ll have a good opportunity for a speedy recovery. Wish you well!

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