What is the recommended time to wait before swimming after knee surgery?

When to Resume Swimming After Knee Surgery

Patients should wait 3-4 weeks after knee surgery before swimming, once the surgical wound has completely healed. 1

Post-Knee Surgery Swimming Timeline

Early Phase (0-3 weeks)

• Swimming is contraindicated until surgical wounds are completely healed (typically 3-4 weeks)
• Risk factors during this period:
  • Open wounds can become infected in pool water
  • Weight-bearing limitations may make pool entry/exit hazardous
  • Inability to properly execute swimming movements due to pain/limited range of motion

Intermediate Phase (3-6 weeks)

• Aquatic therapy may begin once wounds are fully healed (typically at 3-4 weeks) 1
• Benefits during this phase:
  • Improves subjective knee function
  • Provides low-impact environment for rehabilitation
  • Reduces joint loading compared to land-based exercises

Advanced Phase (6+ weeks)

• Full swimming activities can typically resume
• Swimming is among the recommended activities at this stage 2
• Breaststroke should be approached with caution due to higher joint loads 3

Swimming Styles and Joint Loading Considerations

Different swimming styles place varying loads on the knee joint:

• Breaststroke generates higher knee loads (93-145% of body weight) 3
• Crawl kick produces less knee stress than breaststroke kick 3
• Swimming velocity directly correlates with joint loading (higher speed = higher load) 3

Evidence-Based Recommendations by Surgery Type

After ACL Reconstruction

• Wait until wound is completely healed (3-4 weeks minimum) 1
• Begin with gentle aquatic therapy before progressing to swimming strokes
• Avoid breaststroke initially due to rotational forces on the knee

After Total Knee Arthroplasty (TKA)

• Swimming is among the five activities recommended within the first 6 weeks post-TKA by European Knee Associates 2
• However, wound healing must be complete before water immersion
• Swimming has shown benefits for rehabilitation outcomes in TKA patients 4

Important Considerations and Precautions

1. Wound Healing: Complete healing is non-negotiable before water immersion
2. Entry/Exit Strategy: Plan safe pool entry/exit to avoid falls or strain
3. Swimming Style: Begin with crawl kick rather than breaststroke to minimize knee stress
4. Intensity: Start with low-velocity swimming and gradually increase as tolerated
5. Duration: Begin with short sessions (10-15 minutes) and progressively increase

Common Pitfalls to Avoid

• Entering water before wounds are completely healed (infection risk)
• Starting with breaststroke (creates higher knee loads) 3
• Swimming at high velocity too soon (increases joint forces) 3
• Neglecting proper pool entry/exit techniques (fall risk)
• Ignoring pain signals during swimming activities

Swimming provides excellent low-impact exercise for knee rehabilitation when properly timed and executed. The 3-4 week waiting period ensures wound healing while allowing early benefits of aquatic therapy once safe to begin.