Pre- and post-operative physiotherapy significantly improves recovery, reduces pain, enhances mobility and strength, and can even decrease the need for surgery in certain conditions. Many patients don’t realise how important physiotherapy is before an operation, yet research shows meaningful improvements in surgical outcomes for procedures such as hip and knee replacement and ACL reconstruction (see here). Post-operatively, physiotherapy is essential for restoring function, returning to daily activities, and preventing long-term complications. This page explains the full benefits of prehab and rehab, what to expect, and how physiotherapy compares with non-surgical options.
Preparing for surgery, and recovering afterwards can be challenging, both physically and mentally. Whether you’re undergoing shoulder surgery, spinal procedures, hip or knee replacement, ligament reconstruction, or ankle surgery, physiotherapy plays a crucial role in maximising your recovery and long-term outcomes.
While post-operative physiotherapy is well-recognised as essential, fewer people realise the importance of physiotherapy before surgery. Research shows that pre-operative rehabilitation (“prehab”) can positively influence surgical outcomes in strength, mobility, recovery speed, and post-operative pain, particularly for hip and knee replacements and ACL reconstruction (see here).
This page provides a complete overview of how physiotherapy supports you through every stage of surgery and why many conditions may even improve with high-quality physiotherapy alone, without needing an operation.
Most people associate physiotherapy with the recovery process, but in many cases, preparing your body before surgery is equally important. Pre-operative physiotherapy focuses on improving strength, joint mobility, movement mechanics, and overall conditioning ahead of your procedure
When your body is stronger and more functional going into surgery, it is better equipped to heal and adapt afterwards. Research has shown that pre-operative physiotherapy can improve surgical outcomes after:Hip joint replacement
Knee joint replacement
ACL (anterior cruciate ligament) reconstruction
Less post-operative pain
Better mobility sooner after surgery
A smoother rehabilitation process
Improved confidence and understanding of recovery
Shorter recovery timelines
A tailored prehab programme may involve:Strengthening the muscles surrounding the surgical area
Improving joint range of motion
Enhancing balance and movement control
Learning post-surgery exercises in advance
Education on what to expect immediately after surgery
This education piece alone can reduce anxiety and improve adherence to post-operative protocols, ultimately supporting faster recovery.
Whether you’ve had shoulder, hip, knee, ankle, or spinal surgery, postoperative physiotherapy is a critical component of recovery. Without proper rehabilitation, patients risk prolonged pain, stiffness, weakness, compensatory movement patterns, and limited long-term function.
Pain and discomfort
Swelling/inflammation
Stiffness and loss of joint mobility
Muscle weakness and atrophy
Balance and gait issues
Difficulty returning to work, sport, or daily activitiesPhysiotherapists guide you through each stage of healing, protective and early mobility phases, strengthening, functional retraining, and eventually sport- or work-specific conditioning.
The goals of post-operative physiotherapy include:Restoring joint movement safely
Improving muscle strength and endurance
Preventing scar tissue restrictions
Ensuring proper healing and tissue loading
Reducing long-term complications
Helping you return to your previous level of activity
Surgery may correct a structural problem, but rehabilitation restores function. The two must work together for the best possible outcome.
Many people assume surgery is their only option, especially for knee and shoulder problems, but research increasingly shows that physiotherapy can be just as effective as surgery for many conditions (see here).
Rotator cuff tears
Meniscal tears
Knee osteoarthritis
Subacromial shoulder pain
Certain back and neck conditions
Hip labral injuries
Improve pain and function
Build strength and stability
Correct movement patterns
Reduce the need for surgery altogetherThis is why it is crucial to discuss both surgical and non-surgical pathways with a healthcare professional. You should always fully understand the benefits, limitations, and risks of each option before making a decision.
If you’re unsure whether surgery or rehabilitation is right for you, booking an assessment with a physiotherapist can help. We can provide an unbiased opinion based on:Your symptoms and history
Strength and mobility testing
Functional assessment
Relevant imaging
Current clinical evidenceWe also work closely with local orthopaedic surgeons and can refer you for a specialist opinion if needed.
Includes rotator cuff repair, stabilisation, decompression, and labral procedures. Physio helps restore mobility, reduce pain, and rebuild shoulder stability and strength.
Rehabilitation supports safe movement, strength, neural mobility, and return to daily function.
Such as total hip replacement or hip arthroscopy. Physiotherapy restores gait, hip strength, and long-term mobility.
Including ACL reconstruction, meniscus repair, and total knee replacement. Rehab helps restore knee movement, quadriceps strength, and functional movement.
Post-operative physio improves balance, mobility, tendon loading, and walking mechanics.
Strength and mobility assessment
Tailored exercise programme
Education about the surgical process
Planning for equipment or supports needed after the procedure
Pain and swelling management
Safe movement guidance
Gentle range-of-motion exercises
Protection of surgical repairs
Progressive strengthening
Mobility restoration
Gait retraining
Functional movement
Advanced strengthening
Plyometrics (if appropriate)
Sport-specific drills
Injury prevention strategies
Working with a qualified physiotherapist ensures:Evidence-based treatment
Personalised rehabilitation plans
Regular progress monitoring
Safe progression through recovery phases
Collaboration with surgeons and GP
Reduced risk of complications or re-injury
Every surgical journey is unique. Your rehabilitation should be too.
1. When should I start pre-operative physiotherapy?
Ideally 4–8 weeks before surgery, but even a few sessions can make a difference.
2. How soon after surgery can I begin physiotherapy?
Often within days, sometimes even the following day depending on the procedure and surgeon’s protocol. Discuss this with your surgeon for further detail.
3. Do I need a referral for physiotherapy?
No referral is needed. However, we collaborate with GPs and surgeons if required.
4. Can physiotherapy reduce the need for surgery?
Yes. For many knee and shoulder conditions, physiotherapy has been shown to achieve outcomes comparable to surgery.
5. How long will post-operative rehab take?
It varies by procedure. Some recoveries take 8–12 weeks; others (like ACL reconstruction) may take 9–12 months.
6. Is prehab really worth it?
Yes. research shows moderate improvements in strength, mobility, recovery speed and post-operative pain in several major surgeries.
