Your questions, answered

What patients ask us most about rehab before and after surgery, in plain words.

What is prehab?

Rehabilitation before your operation: exercises to build strength, movement and confidence, plus preparing for the first days after surgery. You go into the operation in better shape, which usually means an easier recovery.

When should I start?

As soon as surgery is planned. Even a few weeks help. After an ACL injury, we aim to settle the swelling and regain full movement and good strength before the operation.

When does rehab start after surgery?

Usually within days, following your surgeon's protocol. Early on we focus on swelling, pain and gentle movement, then build strength and function in stages.

Do I really need physiotherapy after surgery?

Surgery repairs or replaces the structure; rehab rebuilds the strength and movement around it. After knee replacement, for example, exercise-based physiotherapy improved function and pain in the first months compared with minimal physiotherapy.

Will you work with my surgeon?

Yes. We follow your surgeon's instructions and restrictions, and keep them updated on your progress when needed.

How long does recovery take?

It depends on the operation: a few weeks after some keyhole procedures, several months after a joint replacement, and at least nine months before pivoting sports after ACL reconstruction.

What the research shows

Key findings from systematic reviews, randomised trials and major studies indexed on PubMed. Numbers link to the full references below.

Prehab before orthopaedic surgery

Meta-analysis · 48 trials

Across 3,570 patients, prehab improved function and strength before knee replacement, quality of life and strength before hip replacement, and reduced back pain before spinal surgery (high-certainty evidence). After surgery, it improved function at 6 weeks after knee replacement and at 6 months after spinal surgery.[1]

Hip and knee replacement

Meta-analysis · 35 trials

Exercise and education before hip or knee replacement improved function after surgery and shortened the hospital stay.[2]

Better together: before and after spinal surgery

Randomised trial · 60 patients

Combining prehab in the two months before lumbar surgery with intensive early rehab afterwards meant patients reached recovery milestones sooner and went home earlier (5 days instead of 7), without more complications and with higher satisfaction.[3]

ACL reconstruction

Comparative study · two cohorts

Patients who completed extended rehab before ACL reconstruction had better knee function two years after surgery, and more of them returned to their pre-injury sport (72% compared with 63%).[4]

After knee replacement

Meta-analysis · 18 trials

Physiotherapy exercise after knee replacement improved physical function and pain at 3 to 4 months compared with minimal physiotherapy, and home-based programmes worked as well as outpatient ones.[5]

How we use it at Dr. Phyx

Before surgery, we build a short prehab plan around your operation date. After it, we follow your surgeon's protocol and take you through each stage: from swelling and pain control, to strength, and back to work, daily life or sport.

Hands-on care settles stiffness and pain, and exercise rebuilds strength, so we use both at every stage.

Always by a qualified specialist, after a full assessment, because your health comes first.

When we are careful

After surgery, call your surgeon or get medical care promptly if you notice:

Fever, or a wound that is red, hot, leaking or opening
A painful, swollen, hot calf, or sudden shortness of breath: seek urgent care
Pain that suddenly gets much worse, or a new change in shape of the joint
Numbness or weakness that was not there before
A fall onto the operated area

Surgery coming up, or just done?

Send us a message on WhatsApp. We will tell you honestly whether it suits your case, and book a first assessment if it does.

Ask on WhatsApp

References

Punnoose A, Claydon-Mueller LS, Weiss O, Zhang J, Rushton A, Khanduja V. Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis. JAMA Netw Open. 2023;6(4):e238050. PubMed · doi:10.1001/jamanetworkopen.2023.8050
Moyer R, Ikert K, Long K, Marsh J. The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis. JBJS Rev. 2017;5(12):e2. PubMed · doi:10.2106/JBJS.RVW.17.00015
Nielsen PR, Jørgensen LD, Dahl B, Pedersen T, Tønnesen H. Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial. Clin Rehabil. 2010;24(2):137-148. PubMed · doi:10.1177/0269215509347432
Failla MJ, Logerstedt DS, Grindem H, et al. Does extended preoperative rehabilitation influence outcomes 2 years after ACL reconstruction? A comparative effectiveness study between the MOON and Delaware-Oslo ACL cohorts. Am J Sports Med. 2016;44(10):2608-2614. PubMed · doi:10.1177/0363546516652594
Artz N, Elvers KT, Lowe CM, Sackley C, Jepson P, Beswick AD. Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC Musculoskelet Disord. 2015;16:15. PubMed · doi:10.1186/s12891-015-0469-6

This article is general information reviewed by a physiotherapist. It is not a diagnosis or a personal treatment plan.