knee extension machine exercises prehab guys

Knee Extension Exercises for Terminal Knee Extension

Regaining full terminal knee extension is paramount following any knee surgery. The ability to fully extend the knee equal to the other side is usually one of the most important early goals in knee rehab. While there are a ton of knee extension exercises you can do, the most important variable for regaining full terminal knee extension is the amount of volume and time spent working on knee extension. That is undeniably the most important concept to grasp. 3 sets of 1 min of stretches for a total of 3 minutes (out of 1440 minutes in a day aka 0.2% of the day) is just not enough end range stretching to regain full knee extension! Aim for a total of 10 minutes of knee extension exercises at first, then slowly keep adding time until you’re spending at least 30 minutes a day working on terminal knee extension.


Knee Extension Exercises & Tips

Knee extension exercises, especially after surgery, are not going to be comfortable. If they are comfortable, it probably means you’re not doing them correctly! Regardless of the surgery, there will be joint swelling, or effusion, in the knee that will not only cause more pain and discomfort but also limit the amount of motion available at the knee joint. Furthermore, the muscles around the knee will most likely be tense and guarded, meaning soft tissue work and stretching are also warranted. When working on terminal knee extension during your knee extension exercises, try to hold the position or stretch for as long as possible. That may be a few minutes or just 20 seconds! The goal is to work to that uncomfortable phase, then let your knee bend and relax for a minute or two, and then go right back to the knee extension exercise again. The more time you can spend in that end range stretch the better!

READ: Knee Surgery [P]Rehab Exercises

knee surgery prehab exercises prehab guys


Passive Knee Extension Exercises

First, work on regaining full passive knee extension. Passive knee extension is the amount of knee extension/straightening that your knee has if you prop up your foot on a table or chair, letting your knee be suspended in the air.


Seated Knee Extension PROM

Sample Knee Extension Overhaul [P]Rehab Program Exercise


Knee Extension with Overpressure


Bang Hangs Knee Extension

Sample Knee Extension Overhaul [P]Rehab Program Exercise


Do You Need Guidance On How To Achieve Knee Extension?

This program is for anyone looking to truly [P]Rehab their knee before surgery OR work on regaining their knee extension after a surgery or injury. It’s appropriate for anyone regardless of current fitness level and will build you from the ground up to tolerate the end ranges of knee extension. For more about this program click HERE.


Active Knee Extension Exercises

It’s extremely important to follow up any passive knee extension exercise with active knee exercise exercises to “lock-in” that hopefully newly acquired knee extension range. While the standing terminal knee extension (TKE) is the classic go-to exercise for active knee extension, there are a plethora of other options as well. The key component to every single one of them is to fire your quadriceps muscle and squeeze it as hard as you can. Your goal should be to try to feel a stretch behind the knee. Think of standing tall with each repetition! Below you will find a plethora of our favorite active knee extension exercises, which are all a part of our Knee Extension Overhaul [P]Rehab Program that is proven to restore your knee extension!

Standing 3-Way Terminal Knee Extension

Sample Knee Extension Overhaul [P]Rehab Program Exercise


Sled Pushes


Down Dog Knee Extension TKE


Retro Walking

Sample Knee Extension Overhaul [P]Rehab Program Exercise


Quad Sets with a Strap


knee extension getting back to the gym prehab guys


Prone Hips Supported TKE


Cueing for TKE with any closed chain knee exercise (squats, lunge, step-up)

Closing Thoughts

Having adequate knee extension is crucial for knee health and function. Moreover, if it is something that is not worked on early after surgery, it becomes very difficult to regain! There are a plethora of options in regards to exercises that are excellent for regaining knee extension, many of which we have exemplified in this article. Find what works best for you, and stick with it! Consistency is key. as you continue to have a better tolerance to these exercises, try to hold positions longer to have better carry over and ultimate improvements in range of motion!


Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

  • Rebecca Macijowsky
    Posted at 06:23h, 16 December Reply

    I had my left knee replaced in October 2017 & the right in May 2018. I walk every day, & I will admit don’t do enough exercise. My knees feel “tight” some days, would these classes help with that.

    • Michael Lau
      Posted at 19:34h, 13 January Reply

      Yes they would! movement is medicine! Give them a shot and let us know how it goes!

  • Linda Sumner
    Posted at 15:35h, 01 August Reply

    I’m curious about the step back into a low lunge and then back to 1 legged stance (last video) – why step back at a 45 degree angle? Seems this might twist the front knee and is not a good idea for a “hinge” joint? But am eager to hear your rationale!
    Thank you, these are great videos/tutorials.

    • Michael Lau
      Posted at 17:54h, 14 September Reply

      Totally fine! The movement is primarily in the sagittal plane as the knee joint is a hinge joint. However, there will always be some rotation as the knee moves from extensino to flexion that is normal!

  • Mert Sarıışık
    Posted at 14:03h, 18 September Reply

    I had acl surgery 2 years ago. At first i regained full symmetrical knee extension. But after 2 months i lost the progress and never get back. Now i have full knee extension on my acl leg but not symmetrical with other leg. Also i have pelvic instability. My right knee is locked in valgus position and feet laterally rotated. I sometimes feel if this position (alignment) limits the extension range. Can it be?

    Also, is it possible to regain symmetrical knee extension back after a long time from the surgery? İ heard that it is not possible to get VMO muscle back if you don’t have symmetrical extension. İs this correct?

    • Michael Lau
      Posted at 16:28h, 18 September Reply

      Hi Mert,

      Yes, it can be possible to regain full symmetrical knee extension even after a long period after surgery – you won’t know until you try! VMO is just a muscle…you have it! Everyone has it. Any active extension exercise will hit it! We have a knee extension prehab program with tons of programming if youre interested in learning more:

  • Dana Twombly
    Posted at 15:44h, 17 February Reply

    I had an acl avulsion and never gained full extension after surgery. It has now been 5 months since the surgery. Is it too late to get full extension back? I feel like there is something impeding me from being able to lock the knee

    • Sherif Elnaggar
      Posted at 06:39h, 18 February Reply

      Hello, thank you for your question! Unfortunately we are not allowed to give medical advice on this platform due to legality. We would advise following up with your healthcare provider or physical therapist who can guide you in-person with your treatment. Each individual will recover from surgeries different, which is ok! Stay consistent with your exercises and stay positive!!! Best of luck!

  • Mercy
    Posted at 16:56h, 07 June Reply

    Hi! I had 3 of my 4 quads resected/removed in surgery, and only have my rectus lateralis muscle remaining. As a result I lost my knee extension. I’ve been doing physio the last 3 months since surgery but still haven’t regained any sort of knee extension (I can’t lift my leg straight up when laying down or sitting up). Would these exercises help?

    • Sherif Elnaggar
      Posted at 09:47h, 08 June Reply

      Hello! Sorry to hear about your surgery, we hope you are recovering well! In regards to your question, we unfortunately are unable to give direct medical advice on this platform due to legality. We would suggest discussing various options for improving knee extension with your physical therapist in-person, as there are many strategies to regain knee extension, it all depends on what each individual can tolerate best. Stay positive and consistent, as stringing together days of consistency focusing on exercising will help with outcomes in the long-term. We wish you the best with recovery!!!

  • Ismaaeel
    Posted at 07:28h, 24 September Reply

    Is regaining TKE a prerequisite to perform isotonic movements?

    • Team [P]Rehab
      Posted at 14:21h, 26 September Reply

      Hello! Fantastic question. Generally speaking after a surgery or major knee injury, the priorities are to regain an active quad set, functional knee range of motion (flexion and extension), reduce swelling, and restore gait. It is beneficial to regain knee extension with an active quad set before moving to more isotonic movements, especially so improper motor control of particular movements is not learned. An example of this would be walking without a straight knee (if knee extension is not regained adequately), which is not the most functional way to walk. Hope this answers your question!

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