Pre-Surgical Physical Therapy (Prehabilitation): How Getting Stronger Before Surgery Cuts Recovery Time in Half

Pre-Surgical Physical Therapy (Prehabilitation): How Getting Stronger Before Surgery Cuts Recovery Time in Half

By Dr. Rob, Spectrum Therapeutics of NJ | Reading time: 23 minutes | Last updated: January 3, 2025

If you're scheduled for knee replacement, hip replacement, or ACL reconstruction surgery in Wayne, NJ, the work you do before your procedure may be just as important as your post-operative rehabilitation. Research shows that patients who complete pre-surgical physical therapy—called prehabilitation or "prehab"—experience 30-40% faster recovery times, reduced post-operative pain, and significantly better functional outcomes compared to patients who go into surgery without preparation.

At Spectrum Therapeutics of NJ in Wayne, we've seen firsthand how prehabilitation transforms surgical outcomes for patients throughout Passaic County, including Totowa, Pequannock, Pompton Lakes, and Franklin Lakes. This comprehensive guide explains what prehabilitation is, why it works, and how to maximize your surgical success through strategic pre-operative preparation.

If you're preparing for knee or hip replacement surgery in Wayne, NJ, call us at 973-689-7123 or contact us online to schedule your pre-surgical evaluation today.

What Is Prehabilitation (Prehab)?

Prehabilitation is a structured physical therapy program completed before orthopedic surgery to optimize your physical condition, strengthen supporting muscles, improve range of motion, and prepare your body for the demands of post-surgical recovery. Think of it as athletic training before a major event—except the event is your surgery, and the prize is a faster, more complete recovery.

Unlike traditional rehabilitation that begins after surgery, prehabilitation addresses physical deficits and builds functional capacity when your body is still at its strongest. This proactive approach creates a "physiological reserve" that significantly improves your ability to tolerate surgery and accelerates your return to normal activities.

The Science Behind Prehabilitation

A 2022 systematic review published in the Journal of Orthopaedic & Sports Physical Therapy analyzing patients with total knee arthroplasty found that prehabilitation significantly improved knee functioning before and up to 3 months after surgery compared to surgery alone. The researchers concluded that preoperative exercise programs should be considered standard practice for all elective knee replacement patients.

Similarly, research from a comprehensive 2023 systematic review demonstrates that patients who engage in prehabilitation before hip or knee replacement may experience increased strength, reduced length of hospital stay, and achieve better pain control—allowing them to return to daily activities earlier than patients who don't participate in prehab programs.

Why Prehabilitation Works: The Four Core Benefits

1. Stronger Muscles Mean Better Support and Faster Recovery

Surgery and the subsequent period of reduced activity cause rapid muscle atrophy—you can lose up to 20% of muscle mass in the first two weeks after joint replacement. Patients who enter surgery with stronger quadriceps, hamstrings, and hip muscles have more "muscle reserve" to lose, which means they maintain better function throughout the recovery period.

Research demonstrates that preoperative quadriceps strength is a strong predictor of functional performance after total knee replacement—stronger than age, BMI, or surgical technique. Building strength before surgery creates a foundation that helps you maintain better mobility even during the initial recovery period when some muscle loss is inevitable.

2. Improved Range of Motion Reduces Post-Surgical Complications

Limited range of motion before surgery typically means even more limited range of motion after surgery. Prehabilitation addresses joint stiffness, capsular restrictions, and soft tissue tightness before they become compounded by surgical trauma and post-operative inflammation.

Research shows that patients with better pre-surgical knee flexion (ability to bend the knee) achieve better post-operative range of motion and are less likely to require manipulation under anesthesia—a secondary procedure needed when scar tissue prevents adequate joint movement.

3. Better Neuromuscular Control Prevents Falls and Re-Injury

Prehabilitation programs include balance training, proprioceptive exercises, and gait retraining that improve your brain's ability to control muscle activation patterns. This neuromuscular training continues to benefit you throughout recovery, reducing fall risk and protecting your new joint from compensatory movement patterns that can cause problems.

Studies show that patients who complete balance and proprioceptive training before surgery have significantly lower rates of post-operative falls—a leading cause of complications after joint replacement.

4. Psychological Preparation Reduces Anxiety and Improves Compliance

Surgery is stressful. Prehabilitation gives you a preview of post-operative exercises, builds confidence in your physical therapist relationship, and reduces anxiety about what to expect during recovery. Studies show that patients who complete prehab programs report feeling more prepared, more confident, and more motivated during their post-surgical rehabilitation—factors that directly correlate with better outcomes.

Research has found that psychological readiness before surgery is associated with improved pain outcomes and patient satisfaction scores following major surgical procedures.

Who Benefits Most from Prehabilitation?

Ready to build your strength before surgery? Our Wayne, NJ prehabilitation program has helped hundreds of patients throughout Passaic County achieve faster, more complete recoveries. Call 973-689-7123 or schedule your pre-surgical evaluation online to get started.

While every surgical patient benefits from prehabilitation, certain populations see particularly dramatic improvements:

Patients with Significant Preoperative Weakness or Deconditioning

If you've been avoiding activities due to joint pain for months or years, you've likely lost considerable muscle strength and cardiovascular fitness. Prehabilitation helps rebuild this physical capacity before surgery, giving you a much stronger foundation for recovery.

Patients Scheduled for Total Knee Replacement

Knee replacement patients benefit more from prehabilitation than any other surgical population. The quadriceps muscle—which is critical for standing, walking, and stair climbing—atrophies rapidly after knee surgery. Building quadriceps strength before surgery is directly linked to faster walking speeds, better stair climbing ability, and earlier hospital discharge. Learn more about the complete knee replacement recovery timeline.

Patients Over Age 65

Older adults have less physiological reserve and slower healing capacity than younger patients. Prehabilitation is especially valuable for this population because it optimizes physical function before the physiological stress of surgery and anesthesia. Research shows that prehabilitation reduces hospital readmission rates in older adults by up to 35%.

Patients with Multiple Health Conditions

Diabetes, heart disease, obesity, and other chronic conditions increase surgical risk and complicate recovery. Prehabilitation programs can include not just exercise but also weight optimization, blood sugar management education, and cardiovascular conditioning—all of which improve surgical outcomes and reduce complication rates.

What Does a Prehabilitation Program Include?

At Spectrum Therapeutics of NJ, our prehabilitation programs are customized based on your specific surgery, current physical condition, and individual limitations. However, most programs include these core components:

Strengthening Exercises

Progressive resistance training targets the muscles that will support your joint after surgery. For knee replacement, this means quadriceps, hamstrings, and hip muscles. For hip replacement, we focus on hip abductors, extensors, and core stabilizers. Exercises are carefully selected to build strength without aggravating your existing joint pain.

We typically use a combination of bodyweight exercises, resistance bands, and light weights to progressively overload muscles and stimulate strength gains. The goal is to maximize strength without causing joint inflammation that could delay your surgery date.

Range of Motion Work

Joint mobilizations, stretching, and active range of motion exercises address stiffness and improve flexibility before surgery. For knee replacement patients, we work to achieve at least 110-120 degrees of knee flexion before surgery, as this baseline strongly predicts post-operative range of motion outcomes.

For hip replacement patients, we address hip flexor tightness, ITB restrictions, and capsular stiffness that commonly limit movement and can complicate surgical approaches.

Cardiovascular Conditioning

Improved cardiovascular fitness helps you tolerate the stress of surgery and anesthesia more effectively. We use low-impact activities like stationary cycling, swimming, or walking programs to build aerobic capacity without overloading painful joints.

Even modest improvements in cardiovascular fitness—measured by VO2 max or 6-minute walk test performance—are associated with faster post-operative mobilization and shorter hospital stays. Research demonstrates that preoperative cardiopulmonary fitness is a significant predictor of post-surgical complications, with better fitness correlating to fewer adverse events and faster recovery trajectories.

Balance and Proprioceptive Training

Single-leg balance exercises, tandem walking, and controlled perturbation training improve neuromuscular control and reduce fall risk. This is especially critical for older adults and patients with pre-existing balance deficits.

We also teach assistive device use (crutches, walkers, canes) during prehabilitation so these tools feel familiar and comfortable immediately after surgery.

Functional Movement Training

Practicing the movements you'll need after surgery—sit-to-stand transfers, bed mobility, stair climbing—builds movement patterns and confidence. This "rehearsal" of post-operative activities reduces anxiety and improves your ability to perform these tasks when pain and surgical restrictions are present.

Education and Home Exercise Programming

Understanding what to expect during recovery, learning pain management techniques, and developing a home exercise routine are critical components of prehabilitation. We teach you the exercises you'll be doing after surgery so they're familiar rather than intimidating when you're managing post-operative pain.

How Long Should Prehabilitation Last?

Time is of the essence. Whether your surgery is 2 weeks or 2 months away, we can create a prehabilitation program tailored to your timeline. Call our Wayne clinic at 973-689-7123 or schedule your consultation online.

Research shows significant benefits from prehabilitation programs as short as 2-4 weeks, though 6-8 weeks of pre-surgical training produces optimal results for most patients. The ideal duration depends on several factors:

Your current fitness level: Patients who are severely deconditioned benefit from longer prehabilitation periods (8-12 weeks) to build adequate strength and endurance. Patients who are relatively active may see excellent results from 3-4 weeks of focused training.

Time until surgery: If your surgery is scheduled 3 months away, you have time for a comprehensive program. If you're only 3 weeks out, a focused intensive program can still provide meaningful benefits.

Your goals and motivation: Patients who are highly motivated and able to complete home exercises between PT sessions progress faster and may achieve their targets in less time.

At our Wayne, NJ clinic, we typically recommend starting prehabilitation as soon as surgery is scheduled—whether that's 2 weeks or 3 months in advance. Every session provides incremental benefits that compound over time.

Prehabilitation vs. Traditional Pre-Op Physical Therapy: What's the Difference?

Traditional pre-operative physical therapy often focuses on pain management and maintaining current function while you wait for surgery. Prehabilitation is different—it's performance-oriented, goal-driven, and designed to actively improve your physical capacity before surgery.

While traditional pre-op PT might use modalities like heat, ice, and electrical stimulation to manage symptoms, prehabilitation prioritizes progressive exercise, functional training, and measurable improvements in strength, range of motion, and endurance.

Think of it this way: traditional pre-op PT tries to prevent decline while you wait for surgery. Prehabilitation actively builds you up so you're in the best possible condition when you go into the operating room.

Real Results: What Our Wayne, NJ Patients Experience with Prehabilitation

Margaret from Pequannock came to us 6 weeks before her scheduled total knee replacement with significant quadriceps weakness and limited knee flexion. After completing our prehabilitation program, she entered surgery with 40% stronger quadriceps and 125 degrees of knee flexion—compared to 90 degrees when she started. Post-operatively, she was walking independently within 3 days, discharged home after a 2-night hospital stay, and returned to her gardening activities 8 weeks after surgery—3 weeks earlier than her surgeon's typical timeline.

James from Totowa participated in prehabilitation before his hip replacement surgery after reading about the benefits online. His program focused on hip abductor strengthening, ITB stretching, and cardiovascular conditioning. He entered surgery 25 pounds lighter than when he started, with significantly improved single-leg balance and hip strength. His post-operative pain was well-controlled with minimal opioid use, and he was able to discontinue his walker after just 10 days—compared to the typical 3-4 week timeline.

Insurance Coverage for Prehabilitation

Want results like Margaret and James? Start your prehabilitation journey today. Our team in Wayne serves patients throughout Totowa, Pequannock, Pompton Lakes, and Franklin Lakes. Call 973-689-7123 or contact us to schedule your evaluation.

Most insurance plans, including Medicare, cover pre-surgical physical therapy when it's medically necessary and prescribed by your physician. Prehabilitation is typically coded as standard physical therapy, making it accessible under most benefits.

We recommend checking with your insurance provider about your specific coverage, deductible status, and any authorization requirements. Our administrative team at Spectrum Therapeutics of NJ can help verify your benefits and explain your expected costs before you begin treatment.

Getting Started: What to Expect in Your First Prehabilitation Visit

Your initial prehabilitation evaluation includes a comprehensive assessment of your current physical status and surgical readiness:

Strength Testing: We measure baseline strength in the muscles that will be most critical for your recovery—typically using manual muscle testing and functional strength assessments like sit-to-stand repetitions or single-leg press performance.

Range of Motion Assessment: We document your current joint mobility using goniometry (precise angle measurements) to establish baseline values and set improvement targets.

Functional Testing: The Timed Up and Go test, 6-minute walk test, and stair climbing assessment provide objective measures of your current functional capacity and help us track improvement throughout the program.

Balance and Gait Analysis: We identify balance deficits and movement compensations that could increase fall risk or limit function after surgery.

Goal Setting and Program Design: Based on your assessment results, we collaboratively establish specific, measurable goals for your prehabilitation program and design your individualized treatment plan.

Most patients attend prehabilitation sessions 2-3 times per week, with home exercise programs designed to complement clinic visits. Sessions typically last 45-60 minutes and progress in intensity as your strength and tolerance improve.

Common Questions About Prehabilitation

Will exercising before surgery make my joint pain worse?

Properly designed prehabilitation programs strengthen supporting muscles without aggravating joint inflammation. We carefully select exercises that build strength and function while respecting your pain levels. Some temporary muscle soreness is normal with any strengthening program, but sharp joint pain or increased swelling indicates we need to modify your exercises.

The key is working with a physical therapist who understands how to progressively load damaged joints without causing flare-ups that could delay surgery.

Is it too late to start prehabilitation if my surgery is only 2 weeks away?

While 6-8 weeks of prehabilitation is ideal, even 1-2 weeks of focused preparation provides measurable benefits. Research shows that intensive short-duration prehabilitation (5-10 sessions over 2 weeks) still improves strength, reduces anxiety, and familiarizes you with post-operative exercises.

If your surgery is scheduled soon, contact us immediately at 973-689-7123 or schedule online—we can design an intensive program that maximizes your readiness in the time available.

Can I do prehabilitation on my own without physical therapy?

While any exercise is better than none, research consistently shows that supervised prehabilitation programs produce superior results compared to unsupervised home programs. A physical therapist ensures you're performing exercises correctly, progressing appropriately, and addressing your specific deficits rather than following generic exercise lists.

Additionally, insurance coverage typically requires supervision by a licensed physical therapist, making professional prehabilitation programs more cost-effective than paying out-of-pocket for gym memberships or equipment.

What if I'm already pretty active—do I still need prehabilitation?

General fitness is valuable, but prehabilitation targets the specific muscles, movements, and functional capacities that predict surgical success. Even athletic patients benefit from prehabilitation that addresses surgical-site-specific strength, range of motion deficits around the affected joint, and familiarization with post-operative movement restrictions and assistive devices.

Think of prehabilitation as sport-specific training for the "event" of surgery and recovery—you wouldn't train for a marathon by just staying generally fit; you'd follow a structured running program. The same principle applies here.

How do I balance prehabilitation with my surgeon's advice to "rest and avoid aggravating the joint"?

This is a common concern and highlights the importance of communication between your surgical team and your physical therapist. Modern orthopedic surgery increasingly recognizes that appropriate pre-surgical exercise improves outcomes rather than jeopardizing them.

We work closely with orthopedic surgeons throughout Passaic County and can coordinate with your surgical team to ensure your prehabilitation program aligns with their protocols and preferences. Most surgeons enthusiastically support prehabilitation when they understand the program design and evidence base.

Will prehabilitation reduce the amount of physical therapy I need after surgery?

Prehabilitation doesn't typically reduce the number of post-operative physical therapy sessions you'll need, but it dramatically improves what you can accomplish in those sessions. Patients who complete prehabilitation progress faster through post-operative protocols, achieve functional milestones earlier, and experience fewer complications that would otherwise extend their care.

The real value isn't fewer PT visits—it's faster return to work, earlier resumption of recreational activities, and better long-term joint function. Explore our post-surgical rehabilitation services to understand how prehabilitation integrates with your recovery plan.

Combining Prehabilitation with Other Pre-Surgical Optimization Strategies

While physical therapy is the cornerstone of prehabilitation, comprehensive pre-surgical optimization often includes additional interventions that further improve outcomes:

Weight Management

Even modest weight loss (5-10% of body weight) before joint replacement surgery reduces surgical complications, improves anesthesia safety, and enhances long-term implant survival. We can coordinate with nutritionists and weight management specialists to support your pre-surgical goals.

Smoking Cessation

Smoking dramatically increases infection risk, impairs bone healing, and compromises soft tissue repair. Most orthopedic surgeons require 6-8 weeks of smoking cessation before elective joint replacement. We can connect you with cessation resources and support programs.

Blood Sugar Optimization

Poorly controlled diabetes (HbA1c above 8%) increases infection risk and delays wound healing. Pre-surgical diabetes management—often involving endocrinology consultation—significantly reduces these risks. Studies show that every 1% reduction in HbA1c decreases post-operative infection risk by approximately 15%.

Dental Clearance

Dental infections can seed joint prostheses, causing devastating complications. Most surgeons require dental evaluation and treatment of any active infections before joint replacement surgery. This is typically completed during your prehabilitation period.

The Return on Investment: Why Prehabilitation Is Worth Your Time

Prehabilitation requires commitment—attending physical therapy sessions, completing home exercises, and investing time when you're already managing pain and anticipating surgery. Is it worth it?

Consider the alternative: going into surgery unprepared means longer hospital stays, extended use of assistive devices, delayed return to work, and potentially months of additional recovery time. Research shows that for every 1 hour invested in prehabilitation, patients save an average of 3-4 hours of post-operative rehabilitation needed to achieve the same functional outcomes.

Studies have shown that patients who complete prehabilitation average fewer days in the hospital and return to work weeks earlier than patients who don't complete prehab—outcomes that translate to thousands of dollars in reduced healthcare costs and lost wage recovery.

Beyond the numbers, prehabilitation provides peace of mind. You'll enter surgery knowing you've done everything possible to optimize your outcome, and you'll have confidence in your ability to handle the challenges of recovery because you've already practiced the movements and built the strength you'll need.

Special Considerations for Different Surgical Procedures

Prehabilitation for Total Knee Replacement

Knee replacement prehabilitation emphasizes quadriceps strengthening (especially the vastus medialis oblique), hamstring flexibility, and restoration of knee extension. We focus heavily on achieving full knee extension (0 degrees) before surgery, as preoperative extension deficits are extremely difficult to correct post-operatively and significantly limit functional outcomes.

Gait training to reduce antalgic (pain-avoiding) walking patterns is also critical, as abnormal gait mechanics can persist after surgery even when pain has resolved.

Prehabilitation for Total Hip Replacement

Hip replacement prehabilitation targets hip abductor strength (gluteus medius and minimus), hip extensor strength (gluteus maximus), and core stability. We also address hip flexor tightness and ITB restrictions that commonly limit hip extension and can persist after surgery if not treated pre-operatively.

Stair climbing and single-leg balance receive particular attention, as these functional activities are often significantly limited after hip replacement and predict long-term satisfaction with surgical outcomes. Review our complete hip replacement recovery guide for more details on post-operative expectations.

Prehabilitation for ACL Reconstruction

ACL reconstruction prehabilitation focuses on reducing knee swelling and inflammation (which interferes with quadriceps activation), restoring full knee extension and flexion range of motion, and rebuilding quadriceps and hamstring strength that was lost during the period between injury and surgery.

Neuromuscular training is especially important for ACL patients, as restoring proper landing mechanics, cutting techniques, and jump-landing control reduces the risk of re-injury after return to sport.

When Prehabilitation Might Not Be Recommended

While prehabilitation benefits most surgical patients, certain circumstances may warrant delaying or modifying exercise programs:

Acute infection or significant joint inflammation: Active infection requires medical treatment before exercise. Severe inflammatory flares may need to settle before beginning aggressive strengthening programs.

Unstable cardiovascular conditions: Uncontrolled hypertension, recent cardiac events, or unstable angina require medical clearance before starting exercise programs.

Urgent/emergent surgical timelines: If your surgery is scheduled within days due to fracture, dislocation, or rapid joint deterioration, prehabilitation may not be feasible—though even one or two sessions can provide valuable education and psychological preparation.

Your physical therapist and surgeon will work together to determine if prehabilitation is appropriate for your specific situation and modify programs as needed to ensure safety.

Taking the Next Step: Start Your Prehabilitation Journey in Wayne, NJ

Your surgical success starts now—not after your procedure. Don't go into surgery unprepared. Call Spectrum Therapeutics of NJ today at 973-689-7123 or schedule your prehabilitation evaluation online.

If you're scheduled for knee replacement, hip replacement, ACL reconstruction, or another orthopedic surgery in Passaic County, prehabilitation at Spectrum Therapeutics of NJ can dramatically improve your surgical outcome and accelerate your return to the activities you love.

Our experienced team specializes in pre-surgical optimization for patients throughout Wayne, Totowa, Pequannock, Pompton Lakes, and Franklin Lakes. We work closely with orthopedic surgeons at St. Joseph's University Medical Center, Chilton Medical Center, and Valley Hospital to ensure your prehabilitation program aligns perfectly with your surgical plan.

Don't wait until after surgery to start your recovery. The most important work happens before your procedure, when your body is strongest and most capable of building the physical foundation that will carry you through rehabilitation and beyond.

Ready to optimize your surgical outcome? Call us today at 973-689-7123 or schedule your prehabilitation consultation online. We're currently offering comprehensive pre-surgical evaluations for patients scheduled for joint replacement or orthopedic surgery—let us show you how the right preparation can transform your recovery.

For more information about post-surgical care and what to expect during your recovery, visit our post-surgical orthopedic rehabilitation page or explore our detailed recovery timelines for knee replacement and hip replacement procedures.

Frequently Asked Questions About Prehabilitation

Still have questions about prehabilitation? Our physical therapy team is here to help. Call 973-689-7123 to speak with a specialist, or request a consultation online.

What is prehabilitation and why is it important?

Prehabilitation is a structured physical therapy program completed before orthopedic surgery to optimize your physical condition, strengthen supporting muscles, and improve range of motion. It's important because research shows patients who complete prehabilitation experience 30-40% faster recovery times, reduced post-operative pain, and significantly better functional outcomes compared to patients who go into surgery without preparation. Prehabilitation creates a "physiological reserve" that helps you better tolerate surgery and accelerate your return to normal activities.

How long before surgery should I start prehabilitation?

Ideally, you should start prehabilitation 6-8 weeks before your scheduled surgery to maximize strength gains and functional improvements. However, even 2-4 weeks of prehabilitation provides significant benefits. Research shows measurable improvements in surgical outcomes from programs as short as 2 weeks, though longer programs produce optimal results. Start as soon as your surgery is scheduled—whether that's 2 weeks or 3 months in advance—because every session provides incremental benefits that compound over time.

Does insurance cover prehabilitation?

Most insurance plans, including Medicare, cover pre-surgical physical therapy when it's medically necessary and prescribed by your physician. Prehabilitation is typically coded as standard physical therapy, making it accessible under most benefits. Check with your insurance provider about your specific coverage, deductible status, and any authorization requirements. Many physical therapy clinics can help verify your benefits and explain expected costs before you begin treatment.

What exercises are included in a prehabilitation program?

Prehabilitation programs typically include progressive resistance training to strengthen muscles that support your joint, range of motion exercises and stretching to improve flexibility, cardiovascular conditioning using low-impact activities like cycling or swimming, balance and proprioceptive training to reduce fall risk, and functional movement training to practice activities you'll need after surgery. Programs are customized based on your specific surgery type, current physical condition, and individual limitations.

Can prehabilitation reduce my recovery time after surgery?

Yes, research consistently shows that prehabilitation reduces recovery time by 30-40% compared to patients who don't complete pre-surgical preparation. Patients who complete prehabilitation programs return to daily activities 3-4 weeks earlier, achieve functional milestones faster during post-operative rehabilitation, and experience fewer complications that would extend recovery. Studies show that for every 1 hour invested in prehabilitation, patients save an average of 3-4 hours of post-operative rehabilitation needed to achieve the same functional outcomes.

Is prehabilitation only for joint replacement surgery?

No, prehabilitation benefits patients preparing for many types of orthopedic surgeries including joint replacement (knee, hip, shoulder), ACL reconstruction, rotator cuff repair, spinal surgery, and other procedures. While joint replacement patients see particularly dramatic benefits—especially for knee and hip replacements—the principles of pre-surgical optimization apply to almost any elective orthopedic procedure. Patients undergoing major abdominal, thoracic, or cardiac surgeries also benefit from prehabilitation programs.

What happens during my first prehabilitation appointment?

Your first prehabilitation visit includes a comprehensive physical assessment: strength testing of muscles critical for recovery, range of motion measurements using goniometry, functional testing like the Timed Up and Go test and 6-minute walk test, balance and gait analysis to identify fall risks, and collaborative goal setting to design your individualized treatment plan. Most initial evaluations last 60 minutes and establish baseline measurements that help track your progress throughout the program.

Can I do prehabilitation at home without seeing a physical therapist?

While any exercise is better than none, research consistently shows that supervised prehabilitation programs produce superior results compared to unsupervised home programs. A physical therapist ensures you're performing exercises correctly, progressing appropriately, and addressing your specific deficits rather than following generic exercise lists. Additionally, insurance coverage typically requires supervision by a licensed physical therapist, making professional programs more cost-effective than paying out-of-pocket for gym memberships or equipment.

Will prehabilitation make my joint pain worse before surgery?

Properly designed prehabilitation programs strengthen supporting muscles without aggravating joint inflammation. Physical therapists carefully select exercises that build strength and function while respecting your pain levels. Some temporary muscle soreness is normal with any strengthening program, but sharp joint pain or increased swelling indicates exercises need to be modified. The key is working with a therapist who understands how to progressively load damaged joints without causing flare-ups that could delay surgery.

How often should I attend prehabilitation sessions?

Most prehabilitation programs involve 2-3 supervised physical therapy sessions per week, complemented by home exercise programs designed to be completed on non-clinic days. Sessions typically last 45-60 minutes and progress in intensity as your strength and tolerance improve. The specific frequency depends on your timeline until surgery, current fitness level, and how quickly you're progressing toward your strength and functional goals.

What is the difference between prehabilitation and regular physical therapy?

Traditional physical therapy often focuses on pain management and maintaining current function. Prehabilitation is different—it's performance-oriented, goal-driven, and designed to actively improve your physical capacity before surgery. While regular PT might use modalities like heat, ice, and electrical stimulation to manage symptoms, prehabilitation prioritizes progressive exercise, functional training, and measurable improvements in strength, range of motion, and endurance. Prehabilitation builds you up so you're in the best possible condition when you enter the operating room.

Do I still need physical therapy after surgery if I do prehabilitation?

Yes, you'll still need post-operative physical therapy after surgery. Prehabilitation doesn't replace post-surgical rehabilitation, but it dramatically improves what you can accomplish during those sessions. Patients who complete prehabilitation progress faster through post-operative protocols, achieve functional milestones earlier, and experience fewer complications that would otherwise extend their care. The real value isn't fewer PT visits—it's faster return to work, earlier resumption of recreational activities, and better long-term joint function.

What should I eat during my prehabilitation program?

Nutrition plays a critical role in building muscle strength and optimizing your body for surgery. Focus on adequate protein intake (0.8-1.0 grams per pound of body weight daily) to support muscle growth during your strengthening program. Include anti-inflammatory foods like fatty fish, leafy greens, berries, and nuts to manage joint inflammation. Stay well-hydrated, especially during exercise sessions. If you're working on weight loss as part of pre-surgical optimization, your physical therapist can coordinate with a registered dietitian to ensure you're losing weight while still building strength and maintaining adequate nutrition for healing.

Can prehabilitation help if I'm anxious about surgery?

Absolutely. One of the most underappreciated benefits of prehabilitation is psychological preparation and anxiety reduction. Working with a physical therapist before surgery gives you a clear understanding of what to expect during recovery, builds confidence in your ability to handle post-operative challenges, and establishes a trusted relationship with your rehabilitation team. Many patients report that prehabilitation significantly reduces their pre-surgical anxiety because they feel prepared and empowered rather than passive and uncertain. The familiarity with exercises, movements, and your therapist's guidance creates a sense of control that translates to better emotional well-being both before and after surgery.

Will my surgeon support me doing prehabilitation?

Most orthopedic surgeons enthusiastically support prehabilitation, as the research clearly demonstrates improved surgical outcomes. In fact, many surgeons now actively recommend or even require prehabilitation for their elective joint replacement patients. At Spectrum Therapeutics of NJ, we work closely with orthopedic surgeons at St. Joseph's University Medical Center, Chilton Medical Center, and Valley Hospital, and regularly coordinate pre-surgical care plans. If your surgeon hasn't mentioned prehabilitation, bring it up at your pre-operative appointment—most will be supportive once they understand you're working with a qualified physical therapist who will communicate with their office about your program and progress.