Exercising Before Joint Surgery

By Jane Farrell

By the Cleveland Clinic

Replacing worn body parts has become pretty common today. Of course, none of us are The Six Million Dollar Man of 1970s TV fame, and if you’re facing major joint surgery like hip or knee replacement or reconstruction, you may be concerned about what happens after the surgery.

In thinking about what to expect from the recovery process, you may wonder how quick your recovery will be or how much pain you’ll experience.

But research has shown that the speed and success of your recovery has a lot to do with your activity level before surgery. (Editor’s note: Be sure to talk with your physician about the right level of pre-surgery activity for you.)

“Stay as active as you can before surgery,” says orthopedic surgeon Michael Bloomfield, MD. “It will speed along your recovery and prepare you to deal with therapy afterwards.”

Bloomfield acknowledges that it can be tough to convince patients who are awaiting joint surgery — and are already experiencing a lot of pain — to exercise beforehand.

“Let pain be your guide,” he says. “Be as active as you can within the limits of your pain.”

He recommends:

Pre-surgical exercises – These strengthen muscles that support the knee and hip, including short arc quad exercises and straight leg raises.

Abdominal exercises – “The core is the foundation of everything,” Dr. Bloomfield says. “It’s important for general conditioning, posture and balance.”

Low impact exercises – Stay low-impact with joint-friendly swimming, cycling or elliptical conditioning. High-impact activities like running, basketball or tennis subject your joints to five times your body weight in force.

Pre-op visit with a physical therapist – “One pre-operative visit with a physical therapist is a good idea,” Bloomfield says. “You’ll get instruction about the best way to perform the exercises and a frame of reference of what therapy will be like after surgery.”

Numerous studies have documented the benefit of preconditioning or “prehabilitation” before joint surgery.

One 2011 study from the University of Louisville showed that four to eight weeks of exercise before knee reconstruction helped people return to normal activities faster after surgery and experience less pain during recovery.

A 2006 study by the American College of Rheumatology showed that six weeks of pre-surgical exercise reduced the chances that inpatient rehabilitation would be needed.

A 2007 study conducted at Thomas Jefferson University found that preconditioning before minimally invasive hip reconstruction was beneficial to recovery time and pain levels, regardless of the size of the surgical incision.

Reprinted with permission of health.clevelandclinic.org. For more information, visit health.clevelandclinic.org,