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Knee & Hip

Home physiotherapy or clinic physiotherapy: which one, when, and how to choose

Home physiotherapy or clinic physiotherapy: which one, when, and how to choose

Home or clinic? Usually both, in order. How to choose.

Reviewed by Dr. Ramneek Mahajan

This guide was written and clinically reviewed by Dr Ramneek Mahajan, Chairman of Orthopaedics, Joint Replacement and Chief Robotic Joint Replacement, Max SMART Saket, New Delhi. His unit arranges physiotherapy at home where it is appropriate, moves patients to clinic sessions as their recovery allows, and reads the trend at each review. The aim here is the same as it is in clinic, said plainly: what each place can and cannot do, and how to choose the person who supervises you.

~15 min read

· Last reviewed:

In short

After a joint replacement, physiotherapy starts in hospital for everyone. After you go home, it continues with home visits, clinic sessions, or both. Most people have home visits first and clinic sessions later. In Dr Ramneek Mahajan's unit, the team decides the move to clinic sessions with you. The decision depends on how well you move, your balance, the support you have at home, and what your rehabilitation needs. There is no fixed date.

This guide is for you if you are having a knee or hip replacement and need to decide where your physiotherapy will happen. Your surgery may be booked, or you may be about to go home from hospital. The guide is also for the family member who organises care in the first weeks. It is also for patients who come to Delhi for surgery and then go home to another city.

Who it is not for

This guide is not your exercise programme. After a knee replacement, your week-by-week exercises are in the guide "Physiotherapy after knee replacement, week by week". After a hip replacement, your physiotherapy team gives you your exercises. Your surgical team knows your case. If their advice is different from anything you read here, follow your surgical team.

01

What are your physiotherapy options after a joint replacement?

There are three places: the hospital, your home, and a clinic. Most people use all three, one after the other.

Physiotherapy after a knee or hip replacement starts in hospital, for everyone. After you go home, a physiotherapist can visit you at home, or you can go to a clinic. Most people have home visits first, and clinic sessions later, once they are able to travel.

In Dr Ramneek Mahajan's unit, physiotherapy at home can be arranged where it is appropriate, moving to clinic sessions as your recovery progresses.

02

Is this guide for you?

Yes, if you are deciding where your physiotherapy will happen after a knee or hip replacement.

For other questions, read these guides:

03

How does physiotherapy start, before you choose anything?

Physiotherapy starts in hospital, before you choose anything about home or clinic. Most patients stand and take their first steps with support on the day of surgery or the next day.

Physiotherapy starts in hospital - most patients take their first steps with support on the day of surgery or the next.

The first sessions use simple exercises. They get the joint moving, ease stiffness and build your confidence on your feet. Over the next few days, the team helps you with walking, moving and stairs. The aim is that you can move around safely before you go home.

04

When does physiotherapy at home make sense?

In the early weeks, home is usually the safer choice, because the trip to a clinic can be risky at that stage. Home visits continue until the team decides, with you, that you are ready for clinic sessions. Home is usually the better choice in these four situations:

In one hip replacement study, about a third of people exercising alone needed a physiotherapist because recovery was slow.
  • The first days and weeks after you leave hospital.

    When you use a walker, the trip is hard work. You have to get to the car, get in and out of it, and cross the clinic car park. A fall in these first weeks does more harm than a missed session. At this stage, the exercises are simple and you do them often. A physiotherapist needs to check that you do them correctly. You do not need equipment.

  • Walking is still limited, or both joints were replaced together.

    You may not yet be able to walk far safely. Or two joints may be healing at the same time. Then a physiotherapist can come to you, so you do not miss sessions.

  • Other health problems, or being frail.

    A heart or lung condition, poor balance, or weakness before surgery can make the trip itself risky. If this is you, start with home visits, and go to the clinic only when the trip is safe. Some people in this group are not yet ready to leave hospital at all. The team decides this using the three checks before you leave hospital, listed in section 03.

  • No one at home who can help you move safely.

    You need someone who can hold you steady on the stairs and help you get to a car. Your husband or wife may be a great support, and still not be able to steady you on the stairs or help you into a car. If no one at home can help you move, you need extra help for the first weeks. Needing extra help is normal, and Dr Ramneek Mahajan's team plans for it. Tell the team before your surgery date if you live alone, or if the person at home cannot help you move. Published research names living alone as one of several things linked with a less satisfying recovery after a knee replacement.

05

How do you choose - and what should you ask any physiotherapist?

Check five things before you agree to any physiotherapist, whether Dr Ramneek Mahajan's team arranges them or you find your own. If you find your own, make sure the team has their name. You may not want to ask a professional these questions yourself. That is fine. Give the physiotherapist's name to the team before your surgery date, and ask the team for advice.

  1. A qualified physiotherapist.

    The person should have a physiotherapy degree. An assistant or a trainer is not enough. Ask which degree they have. Some states have a physiotherapy council. If yours does, ask whether they are registered with it.

  2. Experience with joint replacements.

    Ask how much of their work is with people recovering from a knee or hip replacement, and how recently they have done this work.

  3. A plan to make the exercises more challenging over time.

    Ask what they measure. Ask how they decide when to make your exercises more challenging. A good physiotherapist will tell you what they measure, and will measure it the same way at every visit. For a knee, they measure how far it bends, how straight it goes, how you walk, and the swelling. For a hip, they measure how you walk, any limp, and the strength around the hip.

  4. Contact with your surgeon.

    Ask how they will tell the surgical team about your progress between reviews. Ask what they would do if you stopped improving. In Dr Ramneek Mahajan's unit, a care coordinator is your point of contact after surgery. If you or your physiotherapist are worried, tell the care coordinator straight away. Do not wait for the next appointment. A physiotherapist outside the unit can call the physiotherapist number on your discharge ticket. If a physiotherapist cannot tell you how they would report a problem, choose someone else.

  5. Knowing the warning signs.

    Ask what they would do about each warning sign listed below. The right answer is that every one of these signs means going to the nearest emergency department at once, and then calling the team.

06

What decides the cost, and what should you confirm before committing?

The cost depends on three things:

  • Where the sessions happen.

    A home visit includes the physiotherapist's travel, so it is priced differently from a clinic session.

  • How often.

    Sessions are most frequent in the early weeks.

  • How long.

    A package is a set number of sessions that you pay for in advance. How long you need physiotherapy depends on your progress, not on the number of sessions in a package.

At the consultation, the team tells you what this means for your own case.

Before you agree to any physiotherapist, or to any package of sessions, get these answers in writing:

  • How many sessions are included, and over what period

  • Whether home visits are available, for how long, and how the move to clinic sessions works

  • Who will supervise the sessions, with their qualification and their experience with joint replacements

  • How your progress is measured, and by whom

  • What happens if a session is missed, by you or by the physiotherapist

  • Whether your insurance covers physiotherapy after surgery, at home, at a clinic, or both

07

Can you manage with just an exercise sheet and no physiotherapist?

Some people manage with just a sheet of exercises. Others do not. You cannot know in advance which group you will be in.

In one study, about a third of patients who managed their own exercises after a hip replacement later needed prescribed sessions because their progress was slow. After a joint replacement, a slow recovery is harder to put right if you find it out late.

This is even more important after a knee replacement. Sometimes a knee stops bending further before it bends far enough. If this happens, treatment works better when it starts early. If your knee does not bend well early on, it is far more difficult to make it bend later.

With only a sheet of exercises, no one sees your mistakes. You may hold your knee still to protect it, when it needs to move. Or you may do an exercise in a way that does not work the joint. A physiotherapist can spot these mistakes at each visit. (If your knee has stopped bending before it bends far enough, read stiff knee after replacement.)

Wherever your sessions happen, Dr Ramneek Mahajan's unit asks you to do three things:

  • do your home exercises every day

  • walk several times a day

  • come to your physiotherapy sessions when they are scheduled

Follow this simple routine every day. It is called the Rule of 20:

Rule of 20: move, ice, rest, repeat.

Twenty minutes of activity. Twenty minutes of icing. Twenty minutes of rest. Through the waking hours, during recovery at the hospital and at home. The Rule of 20 is followed in Dr Ramneek Mahajan's unit. Follow it every day, whether or not a physiotherapist is with you. Your sessions are part of this routine. They do not replace it. Follow the Rule of 20 until your physiotherapist tells you to stop.

Clinic timings for both of Dr Ramneek Mahajan's clinics, and how to book an appointment, are on one page.

By appointment only.

Questions people ask

The same way as with clinic sessions. In Dr Ramneek Mahajan's unit, the physiotherapist leads your day-to-day rehabilitation. Between reviews, a care coordinator is your point of contact after surgery. Are you or your physiotherapist worried? Perhaps the joint is not bending as far as expected, you are not walking well, or you are getting worse. Tell the care coordinator straight away. Do not wait for the next appointment. A warning sign is different. For any warning sign, such as new calf pain or swelling in the leg, sudden breathlessness or chest pain, a fever above 38°C (100.4°F), or a leg that will not take your weight, go to the nearest emergency department first. Then call the team. At your review appointments, starting with the six-week review, your surgeon checks your progress directly. This works the same way at home or at a clinic. It can break down if a physiotherapist outside the unit never reports a problem. So before you choose a physiotherapist, ask how they would contact your surgical team. They can use the physiotherapist number on your discharge ticket.

Five things. First, do they have a physiotherapy degree? Ask which degree. Some states have a physiotherapy council. If yours does, ask whether they are registered with it. Second, how much of their work is with people recovering from a joint replacement, and how recently? Third, how do they decide when to make your exercises more challenging, and what do they measure? Fourth, how would they tell your surgical team about a problem between reviews? Fifth, what would they do about each warning sign? The right answer is that every warning sign means going to the nearest emergency department at once, and then calling the team. The warning signs are these. New calf pain, or tenderness or swelling in the leg. Sudden breathlessness, chest pain or a racing heart. A fever above 38°C (100.4°F), or chills. A wound that is leaking, or redness that is spreading. A sudden jump in pain after you had been improving. Severe pain that never lets up. A leg that suddenly looks shorter or turned the wrong way. Difficulty taking weight, or not being able to take weight at all.

Both. Your family and a physiotherapist do different jobs. Your family can help you keep to your routine: the walks, the icing and your exercise times. That help matters most in the first two weeks. Only a physiotherapist can set your exercises and check how you do each one. They measure the joint the same way at each visit, and make the exercises more challenging when the joint is ready. You need a physiotherapist for these jobs, at home and at a clinic. Home physiotherapy means supervised visits plus your own daily exercises, not a sheet of exercises alone.

Either. Home physiotherapy is arranged through physiotherapists Dr Ramneek Mahajan's unit regularly works with. You can also choose your own physiotherapist, for example because of where you live, or because you already trust someone. If you choose your own, check five things first. Do they have a physiotherapy degree? Do they have experience with joint replacements? Do they plan to make your exercises more challenging over time? Will they report to your surgeon? Do they know the warning signs? Then give the team the physiotherapist's name. Your physiotherapist can call the physiotherapist number on your discharge ticket, and the unit coordinates your progress from there, so your surgeon hears how you are doing at your review appointments.

Plan your physiotherapy before your surgery date, not after you leave hospital. If you know a physiotherapist near your home, bring their name to the consultation. Check them on five things. Do they have a physiotherapy degree? Do they have experience with joint replacements? Do they plan to make your exercises more challenging over time? Will they report to your surgeon? Do they know the warning signs? If you prefer, give the team the physiotherapist's name and ask the team for advice. Your local physiotherapist can call the physiotherapist number on your discharge ticket, and the unit coordinates your progress with them. The unit prefers your six-week review to be in Delhi, so plan to come back for it. Before you leave hospital, check that the team has your physiotherapist's name. At the consultation, also ask whether the unit's own physiotherapists can reach where you will be staying in the first weeks. Ask the team, too, when it is safe to travel home by road, train or air, and what to do on the way to lower the risk of a blood clot.

Tell the team at your consultation, before you go home. Bring the name of the nearest physiotherapist, even if you have doubts about them. Five things make someone the right choice, and they matter more than how near they live. Do they have a physiotherapy degree? Do they have experience with joint replacements? Do they plan to make your exercises more challenging over time? Will they report to your surgeon? Do they know the warning signs? Also ask Dr Ramneek Mahajan's team whether any of the physiotherapists the unit regularly works with can reach where you live. Your daily exercises are most of your physiotherapy, and you can do them anywhere. They work most reliably when a physiotherapist checks how you do them.

There is no fixed timeline. In Dr Ramneek Mahajan's unit, the decision depends on how well you move, your balance, the support you have at home, and what your rehabilitation needs. Therapy shifts to the clinic once you are mobile enough to travel safely and can benefit from more intensive supervised rehabilitation. The team decides this with you at your review.

Not because of the place. How often you need physiotherapy depends on your stage of recovery. In Dr Ramneek Mahajan's unit, sessions typically run 5 to 6 times a week at first, particularly in the first 2 to 3 weeks. That applies at home and at the clinic, and the team tailors it to each patient. The place changes what you can do in a session. It does not change how much physiotherapy you need.

In one published trial after hip replacement, home and clinic rehabilitation showed no measurable difference. But there is one condition. The trial compared home-based and clinic-based rehabilitation. Both groups improved in stair climbing, walking distance, and getting up and moving. The condition is that home physiotherapy works most reliably when a physiotherapist sets your exercises, checks them, and makes them more challenging over time. Another study, also after hip replacement, shows why. It followed over 900 hip replacement patients who managed their own exercises at home. About a third had to be prescribed sessions with a physiotherapist because recovery was slow. You cannot know in advance whether your recovery will be slow. For the knee, research shows that a physiotherapist guiding you makes a difference. After a knee replacement, that guidance matters even more.

Your own exercises matter more than any machine. The machine people ask about most bends the knee for you. It is called continuous passive motion. A large review of the published trials found it adds only around 2 to 3 degrees of bend, which is too little to make a real difference. In hospital, the machine may help your knee bend sooner. It may also help a small group of people whose knees are very stiff or painful. Studies have not shown that it changes how far the knee bends in the end, or how well the knee works. A stationary exercise bicycle and weight machines do help, because they let you do more of your exercise with a physiotherapist watching. They help you do the exercise. They do not do it for you.

Six things. How many sessions are included, and over what period. Whether home visits are available, for how long, and how the move to clinic sessions works. Who will supervise the sessions, with their qualification and their experience with joint replacements. How your progress is measured, and by whom. What happens if a session is missed, by you or by the physiotherapist. Whether your insurance covers physiotherapy after surgery, at home, at a clinic, or both. Ask about the cost separately. It depends on where the sessions happen, how often, and for how long.

Who is telling you this?

This guide was written and clinically reviewed by Dr Ramneek Mahajan, Chairman of Orthopaedics, Joint Replacement and Chief Robotic Joint Replacement, Max SMART Saket, New Delhi. His unit arranges physiotherapy at home where it is appropriate, moves patients to clinic sessions as their recovery allows, and reads the trend at each review. The aim here is the same as it is in clinic, said plainly: what each place can and cannot do, and how to choose the person who supervises you.

Where to See Dr. Ramneek Mahajan

Wherever you come, you see him personally.

Max SMART Super Speciality Hospital
Max SMART Super Speciality Hospital
Saket, New Delhi
Monday to Saturday
12:00 PM to 4:00 PM
See location on Google Maps
See clinic details
Mahajan's Knee & Hip Centre
Mahajan's Knee & Hip Centre
Greater Kailash 1, New Delhi
Wednesday & Friday
4:00 PM to 6:00 PM
See location on Google Maps
See clinic details

Next 3 Days

9 November, MondayToday
Available at Saket
12:00 PM to 4:00 PM
10 November, Tuesday
Available at Saket
12:00 PM to 4:00 PM
11 November, Wednesday
Available at Saket
12:00 PM to 4:00 PM
Available at GK-1
4:00 PM to 6:00 PM
Where to See Dr. Ramneek Mahajan

Wherever you come, you see him personally.

Max SMART Super Speciality Hospital
Max SMART Super Speciality Hospital
Saket, New Delhi
Monday to Saturday
12:00 PM to 4:00 PM
See location on Google Maps
See clinic details
Mahajan's Knee & Hip Centre
Mahajan's Knee & Hip Centre
Greater Kailash 1, New Delhi
Wednesday & Friday
4:00 PM to 6:00 PM
See location on Google Maps
See clinic details

Next 3 Days

9 November, MondayToday
Available at Saket
12:00 PM to 4:00 PM
10 November, Tuesday
Available at Saket
12:00 PM to 4:00 PM
11 November, Wednesday
Available at Saket
12:00 PM to 4:00 PM
Available at GK-1
4:00 PM to 6:00 PM
Where to See Dr. Ramneek Mahajan

Wherever you come, you see him personally.

Max SMART Super Speciality Hospital
Max SMART Super Speciality Hospital
Saket, New Delhi
Monday to Saturday
12:00 PM to 4:00 PM
See location on Google Maps
See clinic details
Mahajan's Knee & Hip Centre
Mahajan's Knee & Hip Centre
Greater Kailash 1, New Delhi
Wednesday & Friday
4:00 PM to 6:00 PM
See location on Google Maps
See clinic details

Next 3 Days

9 November, MondayToday
Available at Saket
12:00 PM to 4:00 PM
10 November, Tuesday
Available at Saket
12:00 PM to 4:00 PM
11 November, Wednesday
Available at Saket
12:00 PM to 4:00 PM
Available at GK-1
4:00 PM to 6:00 PM

Dr. Ramneek Mahajan is Chairman Orthopaedics, Joint Replacement & Chief Robotic Joint Replacement at Max Smart Super Speciality Hospital, Saket. His practice has completed 18,000+ joint replacements and 2,000+ robotic procedures since 2022 - the first MAKO program adopted in Delhi. Senior colleagues refer when their primary work needs revision.

Clinical content on this site was last reviewed on 20 October 2026 by Dr. Ramneek Mahajan, Chairman of Orthopaedics and Joint Replacement, Max SMART Saket.
This site is for scheduled care.

Dr. Ramneek Mahajan is Chairman Orthopaedics, Joint Replacement & Chief Robotic Joint Replacement at Max Smart Super Speciality Hospital, Saket. His practice has completed 18,000+ joint replacements and 2,000+ robotic procedures since 2022 - the first MAKO program adopted in Delhi. Senior colleagues refer when their primary work needs revision.

Clinical content on this site was last reviewed on 20 October 2026 by Dr. Ramneek Mahajan, Chairman of Orthopaedics and Joint Replacement, Max SMART Saket.
This site is for scheduled care.

Dr. Ramneek Mahajan is Chairman Orthopaedics, Joint Replacement & Chief Robotic Joint Replacement at Max Smart Super Speciality Hospital, Saket. His practice has completed 18,000+ joint replacements and 2,000+ robotic procedures since 2022 - the first MAKO program adopted in Delhi. Senior colleagues refer when their primary work needs revision.

Clinical content on this site was last reviewed on 20 October 2026 by Dr. Ramneek Mahajan, Chairman of Orthopaedics and Joint Replacement, Max SMART Saket.
This site is for scheduled care.

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