recovery after surgery the prehab guys

How To Optimize Recovery After Surgery

Let’s face it, being told you have to have surgery after an acute or long-standing injury is a tough pill to swallow. The thought of being confined to a sling, immobilizer, or cast is a scary one. There are thousands of questions that are immediately racing through your head… How much pain am I going to have? How long does it take to get back to my 100%? When can I start walking? How long do I have to wear this ridiculous brace? Firstly, if you are going to have surgery or have recently had surgery, we are here to provide reassurance, confidence, and a positive mindset! You are not only going to persevere but also come out on the other side of this large obstacle in life a better person mentally as well as physically. In this article, we are going to teach you how to optimize your recovery after surgery!


The First Step Is…Get Educated!

Once you know that you are going to have surgery, the first step to take is to educate yourself! Each individual involved in your care is there for you to answer your questions, from the orthopedic surgeon, physical therapist, nurses, and disposition team.

Here are examples of common questions that you can ask:

  • Can you walk me through the specifics of the surgery?


  • How long (on average) is the recovery process?


  • Is there anything I can do before the surgery that can help improve my outcomes after the surgery?


  • Will I have any restrictions in regards to activity after my surgery? (examples including lifting restrictions, certain motions, etc.)


  • What trends have you seen in former patients that have had successful outcomes? (nutrition, recovery, rehab approach, etc.)


  • What will my rehabilitation program look like? How long should I expect to have rehab after surgery?


Think of having surgery as having a newborn. Before you are expecting a child, you want to prepare yourself in every way possible for someone who is going to be a big part of your life. You ask your parents, friends, or other individuals who have had a child for advice. You read baby books so you know what to do when a baby is crying in the middle of the night. The same applies to when you are going to have surgery!

The more educated you are, the more prepared you will be, and the faster you will recover. 


Step 2: Prehab!

Not to toot our own horn, but…[P]Rehab is the next step to take in order to optimize recovery after surgery. Numerous studies have supported that the more active and healthy an individual is prior to surgery, the better the postoperative results are. Garrison et. al performed a retrospective study in 2019 of 1,043 adult patients who underwent a total knee replacement. The individuals involved were split into two groups: those who received rehab before surgery, and those who did not receive rehab before surgery. Results demonstrated a significant decrease in length of hospital stay, with 37% of preoperative PT patients leaving inpatient care on day 1 compared to 27% of the no preoperative group. Also, 41% of the individuals who performed PT before surgery were discharged home and to outpatient physical therapy, compared to only 23% in the other group.

There have been many other studies showing similar results to the aforementioned one above. If you can get yourself in a habit of regular exercise prior to surgery, it is going to strengthen the tissues that are being addressed surgically, thus making them more resilient. In addition, improving your cardiovascular exercise capacity will allow you to perform more exercise at a higher level, which promotes a healthy environment for healing as well as a faster recovery. The same way that athletes have preseason before the regular season, the same applies to you before a surgery. Interested in learning what the ‘true meaning’ of [P]Rehab is? Read this!

Watch This To Learn Exercises You Can Do Before Surgery


Have You Just Had Surgery And Are Looking For Guidance?

prehab programs recovery after surgery the prehab guys

Our [P]Rehab Programs have been designed by Doctors of Physical Therapy, with a combination of clinical expertise and evidence-based care. Whether you have sustained an injury resulting in surgery for your shoulder, neck, knee, ankle, or back, we have the program for you! Click HERE to gain access to our various programs!


Step 3: Familiarize Yourself With Recovery

In addition to educating yourself on what surgery you are going to have as well as performing exercises before your operation, you also need to educate yourself on what factors play a role in recovery. Besides being active in your own care with exercise and rehabilitation, the processes that are occurring in the body outside of activity and exercise are just as important. This includes getting quality sleep, eating well with a balanced diet, relaxation techniques, and proper hydration, just to name a few factors. Remaining adherent with your home exercises and staying on top of your care is great, but if you neglect rest and recovery, your body is eventually going to talk back to you.

Recovery Pyramid

recovery after surgery pyramid the prehab guys


This recovery pyramid can help you strategize what to pay more attention to both before and after your surgery. In addition, read this article below to become more familiar with enhancing your recovery.


how to improve recovery after surgery the prehab guys


Step 4: Don’t Let A Cast, Boot, Or Immobilizer Confine You From Staying Active!

Being stuck in a boot or cast after an injury or surgery is no excuse to not move. It is actually quite the opposite, now is the time to take extra care of your body! While it is imperative to protect the integrity of the injury/surgical site and allow for proper tissue healing, you can and should continue to maintain the strength, range of motion, and health of muscles and joints above and below the area.

There is research to support the notion that you can lose up to 350g of muscle tissue (~10%) and a reduction of 30% of muscle protein synthesis for every 2 weeks you’re immobilized after surgery!

Below is an example of how you can still exercise the hip and core muscles even when you are wearing a boot!

Exercises To Keep You Strong After Surgery


Step 5: Be An Active Part Of Your Care

Whether or not you would like to, rehab is inevitably going to be a part of your recovery after surgery. Your body is an amazing machine; however, you can’t expect to make a full recovery by sitting on the couch and doing nothing! Once you start your rehab process with your physical therapist, learn as much as you can about the importance of particular exercises as well as activity modification. More importantly, all the work you put in outside of your treatment sessions as part of your home program is JUST AS IMPORTANT as your treatments themselves! 

Realistically, with the way most insurances work, you will be going to physical therapy 2x/week, maybe 3x/week if you have a lot of coverage. That means you have 4-5 days/week that you are not at your physical therapy treatments. To get even more specific, that is only 2-3 hours out of the 168 hours in the week, which is a very small percentage of your time!

From your very first initial evaluation after surgery and each week, your physical therapist will be updating your program with the following information:

  • How often you should be performing each exercise


  • How many times a day you should be performing each exercise


  • Instructions for how to perform an exercise, with written and visual demonstrations


  • Understanding the differences between muscle soreness and post-operative pain


  • Any movements or activities you should be avoiding for a period of time after your surgery


Are You Looking For A Better Way To Provide Programming For Patients?

exercise library the prehab guys recovery after surgery

Looking to save time and improve outcomes? Our exercise library has thousands of videos and counting, with an easy to use interface, videos, and written instructions. Gain your access HERE!


Step 5 Continued: Initial Phase Of Exercise

During the first phase after surgery, you want to introduce early movement which will help improve tissue healing. This includes exercises such as passive range of motion, active assist range of motion, and isometrics. Below are some examples. You will want to listen to your body when performing these exercises. Some of the exercises will reproduce some pain, which is not abnormal! However, it is imperative you understand your limitations, how much pain you should expect, and when you may be pushing it too much. This blog article below will give you an excellent understanding of this concept.


no pain no gain the prehab guys


Regaining Range of Motion

Below in this video is an example of exercises that you may perform after knee surgery to help improve your range of motion.


The Benefits of Isometrics

Each of our [P]Rehab Programs are packed with education similar to this video that will help guide you during your recovery after surgery! 


4 Way Ankle Isometrics

Sample Foot and Ankle Rehab Program


Step 6: Make Exercise A Part Of Your Daily Activity

Your home exercise program is not meant to be rigorous or time-consuming, especially after surgery. What is even more important is that you can incorporate movements into activities that you do each day several times! Let’s take an example. You have just had knee surgery. Think about how many times you go up and down the stairs, get out of a chair, walk to the kitchen, etc. Each time you work on any of those activities, make it intentional! Practice even weight distribution through both legs, improving your gait each time you walk throughout the house and placing more weight through the knee with stairs.


Staggered Sit To Stand

Sample Knee Rehab Program

This shows an example of how you can exercise the leg you had surgery on by placing it slightly behind the non-injured leg, so it will have to work harder each time you stand up and sit down throughout the day! 


How To Work On Improving Knee Function From Home


Other Great Resources For Education

After reading this article, take some time to read and listen to some of Prehab’s other content in relation to recovering after surgery, which is listed here below:

  • Understand How Different Tissues Heal: A bone fracture will heal differently than a hamstring strain. It is great to familiarize yourself with the basics of how different tissues heal, which gives you perspective when recovering after surgery.

rates of tissue healing timelines



  • POLICE Principle After Surgery: The POLICE principle has become the better approach to rehabbing after surgery, with a focus on early, appropriate movement to facilitate a healthy healing response.


  • Blood Flow Restriction: Personalized blood flow restriction training is an exercise modality that involves using a cuff to occlude venous blood flow out of a limb while restricting arterial blood flow into a limb. A growing body of evidence now supports the use of blood flow restriction at rest, combined with aerobic training, or combined with low-load resistance training to mitigate disuse muscle atrophy and enhance hypertrophic and strength responses in skeletal muscles.



Closing Thoughts

Patience is key following an injury….and yes, MUCH easier said than done! Overall, the more you know and the more active you are in your own care, the better your results will be. Recovery after surgery is a team effort, with equal effort needed from both parties. That is why we at [P]Rehab are advocates of you taking ownership of your own health! If you are unable to continue treatment after surgery either due to lack of insurance coverage, accessibility, or resources, visit our [P]Rehab Programs page, and we can help you get back to your 100%!


About The Author

Sherif Elnaggar, PT, DPT, OCS 

[P]Rehab Head of Content

sherif the prehab guysSherif graduated from Temple University with a Bachelor’s of Science Degree and a concentration in Kinesiology. He then received his Doctorate of Physical Therapy Degree from DeSales University, graduating with honors of the professional excellence award and research excellence award. After his graduate studies, he served as Chief Resident of the St. Luke’s Orthopedic Physical Therapy Residency Program. Sherif is a Board Certified Orthopedic Clinical Specialist. Sherif focuses on understanding how movement impairments are affecting function while also promoting lifestyle changes in order to prevent recurrences of injury. His early treatment interests include running related injuries, adolescent sports rehab, and ACL rehab in lower extremity athletes. He also has been involved in performance training for youth soccer players. Outside of working as a physical therapist, he enjoys traveling, running and cycling, following Philadelphia sports teams, and spending time with his family.


Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

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