If you’ve got a joint replacement scheduled, you’ve probably thought about the post-surgical rehab that comes after it — the exercises, the follow-up visits, the weeks of building back strength. What most people don’t think about is starting physical therapy before the surgery even happens. That’s called prehab, and it’s one of the more underused tools available to someone preparing for a planned surgery.

Here’s what prehab actually involves, why going into surgery stronger can make a real difference in how your recovery goes, and what to expect on both sides of a planned procedure.

What Prehab Actually Is

Prehab before joint replacement is a structured exercise program done in the weeks leading up to a planned surgery, most commonly a hip or knee replacement, aimed at building strength, mobility, and overall physical readiness before the procedure. The logic is straightforward: if your muscles and joints are stronger and more mobile going into surgery, you have more capacity to draw on during the recovery period that follows, when temporary weakness and swelling are unavoidable.

It’s a different mindset than the traditional approach of waiting until after surgery to start any rehabilitation work at all — and it treats the weeks before surgery as valuable time rather than a holding pattern.

Why Going in Stronger Actually Matters

A systematic review and meta-analysis of randomized controlled trials, published in the peer-reviewed journal BMJ Open, looked specifically at whether prehabilitation before joint replacement surgery improves outcomes. The review found that, compared with no prehabilitation, prehab before knee replacement may increase strength and reduce the length of hospital stay, though results for pain, range of motion, and daily activities were more comparable between groups. Importantly, the review found no evidence that prehabilitation increases the risk of harm.

That combination — a real potential upside with no indication of added risk — is exactly why it’s worth discussing physical therapy before surgery with your surgical team if you have a joint replacement on the calendar. A shorter hospital stay in particular can make a meaningful difference in how quickly you’re back in a familiar environment, which some patients find speeds their overall sense of recovery even beyond the physical measures researchers track.

What Pre-Op Physical Therapy Looks Like at The Summit PT

If you have a scheduled surgery date, pre-op physical therapy typically starts several weeks beforehand and focuses on the muscles that will matter most during your recovery — for a knee or hip replacement, that usually means the muscles around the hip, thigh, and core that support you during early post-surgical mobility, like getting in and out of a chair or navigating stairs. A prehab session often includes:

  • Strength assessment and targeted exercise for the muscles most involved in your specific procedure and recovery.
  • Mobility work for the joint being operated on, when appropriate, since better pre-surgical range of motion can make early post-op mobility easier to regain.
  • Practicing equipment and movement strategies you’ll need immediately after surgery — using a walker or cane, safely getting in and out of a car, or navigating stairs — so you’re not learning them for the first time while also recovering from the procedure itself.
  • Education on what to expect, including a realistic timeline for the different phases of recovery, so the post-surgical period feels less unfamiliar when it arrives.

What Post-Op Rehab Looks Like After Surgery

Once surgery has happened, treatment shifts to managing pain and swelling, restoring range of motion, and progressively rebuilding the strength that surgery and the recovery period temporarily take away. Early post-op sessions often focus on gentle movement and swelling management, followed by a gradual progression into strengthening as healing allows, and eventually functional and activity-specific training to get you back to your normal routine. We stay in regular communication with your surgeon throughout, so your progress lines up with what’s expected at each stage of healing, whether you’re recovering from a joint replacement, ligament reconstruction, or spine surgery.

Who Should Consider Prehab

Prehab is most relevant if you have a surgery date already scheduled, particularly for joint replacements, since that’s where most of the current evidence is focused. If your surgery is a few weeks or more out, that’s typically enough runway to see a meaningful benefit — the sooner you loop in a physical therapist after your surgery is scheduled, the more prehab time you have to work with. It’s a conversation worth having with your surgeon at the same appointment where your procedure gets scheduled, rather than something to look into afterward.

Starting Stronger, Not Just Recovering Later

Surgery recovery isn’t only about what happens afterward — how prepared your body is going in plays a real role too. If you have a joint replacement or other planned surgery on the calendar, it’s worth asking whether prehab makes sense for your situation. Contact us to schedule an evaluation at our Fresno, Clovis, Reedley, or Selma location, whether you’re preparing for surgery or already recovering from one.

This post is educational and doesn’t replace an in-person evaluation by a licensed physical therapist — always coordinate any pre- or post-surgical rehab plan with your surgeon.

FAQ

How many weeks before surgery should prehab start?

It varies, but starting several weeks before your surgery date generally gives enough time to build meaningful strength gains. Ask your surgeon or physical therapist what makes sense for your timeline.

Does insurance cover prehab visits?

Coverage varies by plan. It’s worth checking with your insurance and our office before starting, the same way you would for any physical therapy visit.

Is prehab only for joint replacements?

Most of the current research focuses on hip and knee replacement, but the general concept — building strength and readiness before a planned procedure — can apply to other surgeries too. Ask your care team what’s appropriate for your specific situation.

Will prehab guarantee a faster recovery?

No single factor guarantees an outcome, but current evidence suggests prehab may improve strength and reduce hospital stay length for joint replacement, without added risk.

Do I need a referral to start prehab?

Not usually. California allows direct access to physical therapy, so you can typically schedule an evaluation once your surgery is scheduled, without waiting on a referral first.

How is prehab different from the exercises my surgeon’s office might give me?

Some surgical practices provide a general handout of exercises, but a physical therapist evaluation builds a program specific to your current strength and mobility, and can adjust as your surgery date approaches.