How to Prepare for a Joint Replacement: What Physiotherapy Can Do Before and After Surgery

A hip or knee replacement is a major step, but your recovery does not have to begin on the day of your operation.There are practical things you can do while waiting for surgery to improve your strength, prepare your home and understand what rehabilitation will involve. Physiotherapy can help you build a plan for both sides of the operation: getting ready beforehand and rebuilding confidence afterwards.

If you are waiting for a hip or knee replacement in Hexham or the wider Tyne Valley, you may already be finding everyday activities difficult. Walking to the shops, climbing stairs or getting out of a chair might be painful. The thought of exercising when your joint already hurts can feel counterintuitive.

The aim is not to force a painful joint to work harder. It is to find manageable ways to maintain your strength, keep moving where possible and prepare for the demands of recovery.

This process is often called prehabilitation before surgery, followed by postoperative rehabilitation afterwards. Both have a role in helping you approach your operation with greater knowledge and a clearer plan.

Why preparing before joint replacement matters

Preoperative physiotherapy helps you prepare physically and practically for surgery. It can include strengthening exercises, advice on managing daily activities, and planning for the first few weeks at home.

The National Institute for Health and Care Excellence (NICE) recommends that people listed for hip or knee replacement receive advice about preoperative rehabilitation. This includes exercises, lifestyle considerations, wellbeing and ways to maintain independence before and after surgery.

You do not need to become exceptionally fit before an operation. Instead, the goal is to work on what is realistic for you, given your current pain, mobility and general health.

Consider someone who has gradually stopped walking outdoors because their knee hurts. They may now find their thigh muscles weaker, their balance less confident and everyday tasks more tiring. Surgery addresses the damaged joint, but the surrounding muscles and the person’s ability to move still need attention.

Preparing beforehand gives you an opportunity to practise useful movements, understand how to manage discomfort and become familiar with the exercises you may be asked to perform after surgery.

It also gives you time to ask questions and arrange practical support, rather than trying to work everything out when you are tired and recovering from an operation.

What can physiotherapy do before a hip or knee replacement?

Preoperative physiotherapy focuses on maintaining the abilities you will rely on during recovery. The programme should reflect your symptoms, your current level of activity and the operation you are having.

1. Build strength in the muscles around your joint

The muscles around your hip and knee help you stand, walk, climb stairs and get up from a chair. When joint pain limits your activity, these muscles may lose strength.

Strengthening exercises can help maintain the muscle capacity you have and improve your ability to perform everyday movements. Depending on your assessment, these might include:

These are examples, not a universal pre-surgery exercise prescription. Some people will need smaller movements, additional support or alternatives because of pain, balance difficulties or other health conditions.

A physiotherapist can help you choose the right starting point and adjust the amount of exercise as your tolerance changes.

2. Maintain movement without repeatedly aggravating your symptoms

Joint stiffness can make movement feel difficult, particularly after sitting for a while. Keeping the joint moving within a tolerable range may help maintain mobility and make daily tasks easier.

You might benefit from short, regular walks, gentle knee movements or appropriate hip mobility exercises. The best choice depends on the joint being replaced and your individual restrictions.

There is a difference between challenging a muscle and repeatedly provoking a painful joint. An exercise that leaves you significantly more uncomfortable for the rest of the day may need to be reduced or changed.

Try spreading activity throughout the day rather than attempting one long session. If walking for 15 minutes leaves you struggling afterwards, several shorter walks may be a more manageable starting point.

The aim is consistent activity that you can recover from, not pushing through pain to prove you are making progress.

3. Practise the movements you will need after surgery

Some of the most useful preparation involves ordinary activities rather than formal exercise.

Getting in and out of bed, standing from a chair, using stairs and walking with an appropriate aid may all feature in your early recovery. Practising relevant movements beforehand can help you become familiar with the techniques and identify where you might need support.

Your physiotherapist may also discuss how to use walking aids safely, depending on your needs and the advice from your surgical team.

This is particularly valuable if you live alone, have stairs at home or already struggle with transfers because of pain or weakness.

4. Understand what your recovery will involve

Knowing what to expect can make the process feel less uncertain. Preoperative physiotherapy provides an opportunity to discuss likely rehabilitation tasks, how exercises are progressed and what help you may need when you return home.

It is also a chance to identify difficulties in advance. If balance is a concern, for example, you may need more support when practising standing activities. If your other knee or hip is painful, that may affect how you use walking aids after the operation.

These details matter because recovery is not simply about the new joint. It also depends on how comfortably and safely you can move while the rest of your body adapts.

What if exercising before surgery makes my joint hurt?

It is understandable to worry that exercise will make an already damaged joint worse. However, appropriately selected exercise does not automatically damage an arthritic joint, and avoiding movement altogether can contribute to reduced strength and fitness.

Some discomfort may occur when you begin or change an exercise programme. That does not mean every painful response is harmless, or that you should continue regardless of symptoms.

Start with an amount you can manage. Notice how your joint responds during the activity and later that day. If symptoms remain significantly worse, reduce the repetitions, range of movement or overall amount of activity and seek advice if needed.

You may find that a short session of seated exercises is more manageable than a longer walk. Someone else may tolerate cycling or walking better than strengthening exercises. There is no single approach that suits everyone.

If pain is severe, changes suddenly or prevents you from putting weight through the leg, seek appropriate medical advice rather than trying to exercise through it.

Getting your home ready for recovery

A little preparation can make everyday tasks easier when your mobility is temporarily reduced. You do not need to transform your home, but it helps to think through the activities you will need to manage.

Before your operation, consider the following:

Your requirements will depend on your operation, home layout and mobility. Do not buy equipment simply because someone else needed it after their surgery. Ask your care team what is appropriate for you.

It is also worth planning for the less obvious tasks, such as changing bedding, taking out rubbish or getting a pet outside safely.

How to prepare your general health for surgery

Your physical preparation involves more than exercises. General health, nutrition, smoking, alcohol intake and existing medical conditions can all affect surgical risk and recovery.

Eat a balanced diet and include adequate sources of protein to support muscle maintenance and tissue repair. If you have lost weight unintentionally, have a poor appetite or follow a restricted diet, discuss this with your GP or preoperative team.

If you smoke or vape, ask your healthcare team for support with stopping before surgery. Reducing alcohol intake may also be advised.

Continue to manage long-term health conditions with the professionals responsible for your care. If you have diabetes, heart or lung problems, or another condition that may affect your operation, follow the advice of your surgical and preoperative assessment teams.

Do not start supplements, change prescribed medicines or make major dietary changes without checking whether they are suitable for you.

These steps are not about achieving a perfect level of health before your operation. They are about identifying what can realistically be improved and making use of the time available.

What happens after a joint replacement?

After surgery, rehabilitation usually begins in hospital. For people having a planned hip or knee replacement, NICE recommends physiotherapy or occupational therapy rehabilitation on the day of surgery where possible, and no later than 24 hours afterwards.

Early rehabilitation generally includes getting moving, practising relevant daily activities and learning a home exercise programme. Your team will also explain any precautions, weight-bearing instructions or movement restrictions that apply to your operation.

You will usually be given advice about using walking aids and managing tasks such as getting out of bed, standing from a chair and using stairs.

The early aim is to help you move safely and become sufficiently independent for discharge, according to your circumstances and the hospital’s criteria. It is not to regain all your strength or return immediately to your previous activity levels.

Once you are home, the work continues.

The first few weeks: establish a manageable routine

Pain, swelling, tiredness and stiffness are common during early recovery. Your symptoms may fluctuate, and you may have days when you feel more capable than others.

Follow the exercise programme provided by your hospital team. Short, regular periods of movement may be easier to manage than trying to complete everything in one session.

Balance activity with rest, but avoid remaining still for prolonged periods unless your clinical team has advised otherwise. Gentle walking and prescribed exercises help you work towards the movement and strength needed for daily life.

Your recovery plan should also reflect your surgical instructions. Hip replacement precautions, for example, vary according to the operation and surgeon’s advice. Do not assume that instructions given to another person apply to you.

Building strength and confidence over time

As your recovery progresses, rehabilitation usually shifts towards improving strength, movement quality, balance and endurance.

You may initially concentrate on standing comfortably and walking safely. Later, you might work towards climbing stairs more confidently, walking for longer, returning to gardening or managing a full day of everyday activities.

The progression should match your recovery rather than follow a rigid timetable. If an exercise becomes easier, your physiotherapist may increase the repetitions, resistance or complexity. If it causes a sustained increase in symptoms, the programme may need adjusting.

Feeling less pain does not necessarily mean your strength and balance have fully recovered. Equally, a temporary increase in discomfort does not automatically mean something has gone wrong.

Your surgical team should explain which symptoms are expected and which require assessment. Follow their advice and contact them promptly if you develop concerning symptoms.

When should I expect to feel normal again?

There is no single recovery timeline for everyone after hip or knee replacement. Progress depends on factors such as your general health, preoperative mobility, the type of operation, complications and the demands of your daily life.

You may notice meaningful improvements in everyday function before you feel ready for more demanding activities. Walking around the house comfortably, for example, is a different task from walking several miles over uneven ground.

Returning to work, driving, sport or strenuous hobbies requires separate consideration. Follow your surgeon’s advice and make sure you meet the relevant safety requirements before resuming these activities.

A useful measure of progress is not simply how the joint feels. It is whether you are gradually doing more of the things that matter to you, with appropriate control and confidence.

Why rehabilitation should be tailored to you

Two people can have the same operation and need different rehabilitation programmes.

One person may have good general strength but struggle with balance. Another may be confident on their feet but have weak thigh muscles after months of limited activity. Someone else may have arthritis in the other knee, back pain or a long-term condition that affects exercise tolerance.

A suitable programme takes these factors into account rather than treating the replaced joint in isolation.

Physiotherapy may include progressive strengthening, mobility exercises, balance work, walking practice and advice on managing activity. The emphasis changes as your abilities improve.

You may not need additional private physiotherapy if your hospital pathway provides the support you need. If you are struggling to progress, uncertain about exercise or finding everyday activities difficult, an individual assessment can help establish what support would be appropriate.

Joint replacement physiotherapy in Hexham: support before and after surgery

At InSync Therapy in Hexham, rehabilitation can focus on helping you maintain your abilities before surgery and rebuild movement, strength and confidence afterwards.

Our new Joint Replacement Classes start on Monday 2nd November 2026. These physiotherapist-led classes are intended for people preparing for joint replacement surgery and those recovering afterwards.

A supported class environment offers an opportunity to work on relevant exercises and develop confidence in movement alongside others with similar rehabilitation goals. Your suitability will depend on your operation, current stage of recovery and any advice or restrictions from your hospital team.

The classes are linked with the Adapt Healthcare Community but are open to everyone. If you are unsure whether a group is right for you, contact InSync Therapy to discuss your circumstances before booking.

You do not have to wait until after surgery to think about rehabilitation. Preparing now can help you understand the process, identify what you need to work on and make practical plans for the weeks ahead.

Frequently asked questions about joint replacement physiotherapy

Preparing for your joint replacement in Northumberland

You cannot control every part of your surgical recovery, but you can take steps to prepare. Maintaining manageable activity, working on strength where possible, organising your home and understanding your rehabilitation plan can all help you approach the process with greater confidence.

If you are preparing for a hip or knee replacement in Hexham or the wider Tyne Valley, InSync Therapy can discuss your rehabilitation options, including our new Joint Replacement Classes. Get in touch if you would like to find out more about support before or after surgery.