Prepare for a Better Recovery: Why Pre-Operative Physical Therapy Matters
At Live Better Physical Therapy, we often hear this question: “Why would I need physical therapy before surgery?”
It’s a fair question—most people associate physical therapy with post-surgical rehab. But what many don’t realize is that pre-operative physical therapy, often called “prehab,” can significantly improve your recovery and may even help you avoid surgery altogether in certain cases.
Whether you're planning a total knee or hip replacement, or facing surgery for a soft tissue injury, prehab is a powerful tool to set yourself up for the best possible outcome.
What Is Pre-Operative Physical Therapy?
Pre-operative physical therapy is a customized exercise and education plan developed by your PT—like our very own Mary South—to prepare your body for the demands of surgery and recovery. It’s about more than just getting stronger. Prehab identifies muscle imbalances, improves joint mobility, enhances circulation, and sets realistic expectations for the recovery process.
1. Faster, Easier Recovery
A 2022 study published in the Journal of Orthopaedic & Sports Physical Therapy found that patients who received prehab before a total knee or hip replacement reduced their need for post-operative care by as much as 29%. That’s a huge win in both time and healthcare costs. Best of all? Many patients see results from just one to two sessions before surgery.
Mary focuses these prehab sessions on:
Identifying your current joint alignment and strength deficits
Addressing tight or weak muscle groups that will affect your post-op function
Teaching you how to safely move and exercise after surgery
These steps ensure you and your physical therapist have a clear rehab roadmap before the surgery even happens.
2. Better Strength and Balance
Surgery often leads to temporary inactivity, which can cause muscle atrophy and balance issues. Mary works with patients to strengthen the core, legs, arms, and back—so your body is more resilient heading into recovery. I would like to add something about muscle memory here.
Muscle memory refers to the body’s ability to “remember” past training, allowing muscles to regain strength and size more quickly after a period of inactivity. Muscle memory ensures that the nervous system has a better understanding of the movements involved in rehabilitation,making it easier to re-learn and execute them.
Before surgery, prehabilitation helps build and maintain muscle mass, providing a foundation for faster recovery post-surgery. This is because the body does not need to start from scratch when regaining strength and size after surgery, making the process more efficient.
Improving your balance is just as important. Did you know that 24.7% of total knee replacement patients fall within the first year after surgery? Prehab helps you reduce that risk by enhancing your stability before the surgery takes place. Balance exercises are important to build on after surgery. After your new joint your body needs to rebuild its proprioception (awareness of body position) which is crucial for preventing falls and creating stability around the new joint. Balance also builds on core stability which is vital in order to have distal mobility. Think of it like building a house: you need a solid foundation before you can build the walls and roof. A weak core can lead to compensations in movement, increasing the risk of injuries in the joints and muscles further down the chain. OR A strong, stable core provides a stable base for the body to move from, allowing for more efficient and controlled movement of the legs and arms.
Insert research article? Patel, M. S., & Mishra, N (2024). Effect of core stability exercises on knee proprioception, function, and quality of life in chronic total knee replacement patients. International Journal of Community Medicine and Public Health, 11(5), 1852-1857.
3. Lower Risk of Complications
Your overall fitness level plays a big role in how well you recover from surgery. Poor cardiovascular health and tissue quality can lead to complications like blood clots, infection, or delayed healing.
By improving your strength, circulation, and mobility ahead of time, prehab helps your body better handle the physical stress of surgery. As Mary often says, “Better in means better out.”
4. Improved Mental Readiness and Confidence
Facing surgery can feel overwhelming. Working with Mary before your operation gives you the chance to learn what to expect—what movements will be safe, what milestones to aim for, and what challenges may arise.
This preparation helps reduce fear and anxiety. You’ll feel more informed and in control, and that positive mindset can play a huge role in how motivated and engaged you are during recovery.
5. You Might Avoid Surgery Altogether
In some cases—especially with soft tissue injuries—Mary may discover that conservative care like physical therapy is enough to restore function and reduce pain without surgery at all.
While this won’t apply to everyone (especially those with bone-on-bone arthritis), it’s an important reminder that physical therapists are experts in restoring movement—whether or not surgery is part of your journey.
Ready to Prepare for a Stronger Recovery?
Whether you’re scheduled for joint replacement or exploring options for other surgical procedures, pre-operative physical therapy is your opportunity to take control of your recovery before it even begins.
At Live Better Physical Therapy, Mary South designs prehab programs tailored to each individual—helping you feel stronger, safer, and more confident heading into surgery.
Live Better. Live Well. Start with Prehab.