Prehabilitation — exercises to prepare for hip or knee surgery

Prehabilitation — or “prehab” — means preparing your body before surgery rather than waiting until afterwards to start. The principle is simple and well supported: the stronger and fitter you are going into a joint replacement, the better and faster you tend to recover from it.

The waiting period before surgery is not dead time — it is your best opportunity to set up a faster recovery.

Why it works

Surgery is a physical challenge, and recovery depends heavily on the strength of the muscles around the joint. Patients who go into surgery with better muscle strength, mobility and general fitness have a head start: they regain function sooner, often need less help, and tend to find rehabilitation easier. Starting from a stronger baseline simply makes the whole process smoother.

For knee replacement

The quadriceps — the muscles at the front of the thigh — are central to knee recovery, and they weaken quickly with arthritis. Useful exercises include quadriceps sets (tightening the thigh muscle), straight-leg raises, gentle range-of-motion work, and stationary cycling if comfortable. Building quadriceps strength before surgery pays off directly afterwards.

For hip replacement

The muscles around the hip and buttock, and core stability, are the focus. Gentle strengthening of the gluteal muscles, hip range-of-motion work within comfort, and low-impact cardiovascular fitness such as stationary cycling or water-based exercise all help. Good upper-body and arm strength is also useful for managing a walking aid afterwards.

Beyond exercise

Prehabilitation is broader than just exercises. Optimising weight reduces load on the new joint and lowers surgical risk. Stopping smoking improves wound healing. Getting blood pressure, diabetes and iron levels in good order reduces complications. Good nutrition, with adequate protein, supports healing. Practising how you will get around at home — stairs, bathroom, bed — makes the first days back smoother.

How to start safely

The right programme depends on your joint, your arthritis and your general health, so it is best guided by a physiotherapist. Exercises should be done within comfort — the aim is to maintain and build, not to aggravate the arthritic joint. Even a few weeks of focused preparation can make a meaningful difference.

The bottom line

You cannot change the arthritis before surgery, but you can change how prepared your body is. Prehabilitation is one of the few things genuinely within a patient's control, and it consistently helps. Use the time before your operation well.