A Physiotherapist-Guided Approach to Preparing for Hip and Knee Replacement Surgery
If you’re preparing for joint replacement surgery, the weeks before your operation may matter just as much as the weeks after it. After months, or even years, of grinding hip or knee pain, surgery can feel like the finish line. But the real difference in how well and how quickly you recover is often decided before you ever set foot in the operating room.
That’s the idea behind prehabilitation, or prehab for short. Prehab is structured, physiotherapy-guided exercise and education in the weeks before your joint replacement surgery. It’s the opposite of what most people do, which is wait until after surgery to start rehabilitation. The stronger, more flexible, and better informed you are going in, the more prepared your body will be to recover coming out.
Key Takeaways
- Prehab Builds Reserve – Structured exercise before joint replacement surgery helps you go into the operating room stronger, so there’s less ground to regain afterward.
- Strength Predicts Recovery – Pre-operative quadriceps and hip strength are strongly linked to how quickly patients regain function after knee or hip replacement.
- Education Lowers Anxiety – Understanding what surgery involves and what recovery looks like helps you approach the procedure with realistic, calibrated expectations.
- Wait Time Isn’t Wasted Time – Time spent on a surgical wait list can be used to build the strength and mobility that will carry you through joint replacement and recovery.
What Is Prehabilitation for Joint Replacement?
Prehabilitation is structured, physiotherapy-guided exercise and education you complete before your hip or knee replacement surgery date. Instead of waiting until after surgery to begin rebuilding strength, prehab gets you working in advance, on a plan built around your body and your timeline. The stronger and more prepared you are heading into joint replacement surgery, the better positioned your body is to recover once it’s over.
Why Prehab Works: Strength, Mobility, and Fitness
Several mechanisms explain why prehab makes a difference before joint replacement. Surgery is a significant physical event for the body, and afterward, patients reliably lose quadriceps, gluteal, and hip muscle strength, often substantially. If you start from a stronger baseline, you lose less ground and regain function faster. Pre-operative quadriceps strength is one of the strongest predictors of post-operative function after knee replacement.
- Muscle Strength – A stronger baseline means less strength lost after surgery and a faster path back to normal function.
- Range of Motion – Your hip or knee flexibility before surgery is a reliable indicator of your flexibility afterward, so improving it ahead of time gives your rehab team more to work with.
- Cardiovascular Fitness – Better aerobic fitness supports wound healing and can help shorten recovery timelines. Low-impact activities like stationary cycling, pool walking, and using an elliptical are ideal for building fitness without loading a painful joint.
- Education and Preparation – Understanding what to expect before and after surgery helps you approach joint replacement with confidence instead of uncertainty. Fear and unrealistic expectations are common barriers to a smooth recovery, and prehab addresses both.
What a Prehab Program Looks Like at South Island Physiotherapy in Victoria
At South Island Physiotherapy, we begin every prehab program with an assessment of your current strength, range of motion, and function. From there, your program is individually designed around your surgery date and your goals. Our physiotherapists are registered with the College of Physical Therapists of British Columbia, and patients have rated our clinic five stars across 250+ Google reviews. A typical pre- and post-surgical care plan for joint replacement includes:
- Hip, Quadriceps, and Glute Strengthening – Targeted exercises to build the muscle groups that support your new joint.
- Flexibility and Joint Mobility Work – Movement-based exercises to maintain and improve your range of motion before surgery.
- Balance and Proprioception Training – Exercises that improve stability and reduce fall risk before and after your procedure.
- Low-Impact Cardiovascular Guidance – Safe ways to maintain fitness without stressing a painful joint.
- Education on Recovery – Guidance on post-operative precautions, scar management, and setting up your home for a smoother return.
We typically recommend starting prehab 6-12 weeks before your surgery date, though even 2-4 weeks of focused preparation can produce a measurable benefit. Practicing your post-operative exercises ahead of time also means they feel familiar from day one of recovery, rather than being one more new thing to learn while you’re healing.
Making the Most of Your Time on the Surgical Wait List
Wait times for joint replacement surgery vary across Canada. According to the most recent data from the Canadian Institute for Health Information, 65% of hip and knee replacements were completed within the recommended 6-month benchmark in 2025, which means many patients spend real time waiting for their procedure. That wait doesn’t have to be lost time. We regularly work with patients on the surgical wait list, keeping them functional, managing their pain, and improving their readiness for the joint replacement surgery ahead.
Related: For more ways to stay strong between now and your surgery date, see our guide to exercise for injury prevention.
Frequently Asked Questions
- How Soon Before Joint Replacement Surgery Should I Start Prehab?
Most people benefit from starting 6-12 weeks before surgery, though even 2-4 weeks of focused preparation can help. The sooner you start, the more time your body has to build strength and mobility. - Will Prehab Guarantee a Faster Recovery From Knee or Hip Replacement?
No program can guarantee an outcome, but entering surgery stronger, more mobile, and better informed gives your body more to work with during recovery. Your physiotherapist builds a plan around your current function and your surgery date. - Can I Do Prehab While I’m on the Surgical Wait List?
Yes. Many of our patients begin prehab while waiting for their surgery date. It helps keep you functional, supports pain management, and means you arrive at surgery in better condition than if you’d waited. - Do I Need a Doctor’s Referral to Start a Prehab Program?
In most cases, you can book directly with a physiotherapist. It’s worth confirming with your extended health plan whether a referral affects your coverage.
If you have a joint replacement surgery date on the calendar, or you’re waiting for one, the team at South Island Physiotherapy in Victoria BC can help you prepare. Book a prehab assessment through our contact page or call (778) 433-4900.
