Getting a Joint Replacement: Why PreHab and ReHab?

Although you may not feel exactly lucky to have a hip or knee replacement on the books, we want to point out one major thing you do have working in your favor: time. Unlike a lot of major surgeries you get a relatively long lead time before due day. This is a something that should be used to your full advantage as a way to break bad habits, lower your risk, and get your body and mind in check. Using the weeks leading up to surgery in order to mentally and physically prepare is something that professional athletes and world-class physical therapists and clinicians have been doing for years. It’s an idea that you may be familiar with called “PreHab”.

What Joint Replacement Surgery Should Look Like (In a PeerWell Ideal World)

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In an ideal world, the flow for major surgery would allow for active physical, mental and environmental preparation time before the operation. This is the “PreHab” portion of your surgery episode. Then, the operation would take place, followed by a recovery period after. This recovery period is where physical therapy, diet and other factors are continued, advancing you toward a faster and safer recovery. This is the “ReHab” portion.

When is the ideal time to PreHab before surgery? Ideally, 1-3 months before. Some bad habits that put you at greater risk during surgery (like smoking) must be broken 2-3 weeks before the procedure to take effect, so you want to begin making changes to your routine as early as possible. If you don’t have months of advance notice, any PreHab time is better than none.

Patients who complete a solid PreHab program before surgery, have the procedure, then immediately begin ReHab see the fruits of their labor payoff with a faster, safer recovery that’s more comfortable and less likely to encounter complications. Sounds good, doesn’t it? If you’re not yet convinced of the modern flow of elective surgery (PreHab-Surgery-ReHab) that more and more doctors, hospitals, physical therapists, athletes and everyday patients are swearing by, let’s break down the benefits.

Here’s how PreHab, when adopted in the weeks or months leading up to a knee replacement or hip replacement, works real magic.

The Real Benefits of PreHab

1. Exercise to Support Your New Joint

The most common thing people think of when they hear “PreHab” (or “ReHab” for that matter) is exercise. This is for good reason. Running through a daily list of targeted exercises that will strengthen your body and support your new artificial joint is hugely important.

Introducing pre-knee replacement exercises or pre-hip replacement exercises will not just strengthen the muscles that will support your new joint, but improve circulation, flexibility, motion and enhance your balance. These are all things that will aid in your physical recovery. The more you force yourself through these movements prior to surgery, the easier it’ll be to get back on your feet (literally).

2. Lose Extra Weight

Shedding extra pounds is one of the biggest things you can do to lower your risk on surgery day and set yourself up for an easier recovery. This is especially true for knee replacement patients as the knee is responsible for supporting a lot of body weight. In fact, medical reports suggest that each pound lost relieves 4 pounds of pressure off the knee joint. This means a 10 Lbs weight loss feels like dropping 40 Lbs for your knees!

A good PreHab program will introducing foods that will raise your metabolism and trigger weight loss, but will also show you how to safely perform low impact cardio with minimal pain. For example, aquatic therapy or pool therapy. Pool therapy is a fantastic way to burn a lot of extra calories and improve cardiovascular health without placing stress or more pain on the joint.

3. Begin Healing Your Body with Better Food

Superfood groups boost your immune system, support the building of new muscle, collagen and tissue, and can even reduce the chances you’ll need a blood transfusion after surgery. PreHab will safely show you the nutrients, food combinations and food groups you should eat to fuel a healthier you. Your body needs time to restart and become acquainted with new foods and a new way of eating to reap the rewards before surgery.

Always consult your doctor before majorly changing your diet. In the two weeks before surgery, consult your clinician again about your pre-operative diet. Some vitamins, supplements and nutrient-dense foods should be taken out of your diet as they can interfere with medications and the healing process. Here is an article that details the ins and outs of a balanced, supercharged PreHab diet.

Other Benefits to PreHab

  • Learn long-term pain management techniques. These methods are drug-free alternatives that can be used anytime throughout painful surgery prep and recovery.
  • Manage pre-op anxiety, fear of the unknown and general nervousness through guided meditation, breathing exercises and other medically-proven activities.
  • Don’t miss a beat. Tie up loose ends like arranging a ride to the hospital and setting up a safe environment for your return home is often overlooked.

How ReHab Helps You Recover (Especially After PreHab)

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Although PreHab before surgery can be seen as a relatively new concept, ReHab is thought of as an absolute must, usually enforced by your care team. Rightfully so, because in order to regain your range of motion and movement, and reduce swelling, stiffness and pain, you’ve got to play an active role in your recovery. Simply going in for surgery, attending scheduled physical therapy, and resting for the weeks that follow won’t cut it. To recover faster, better and safer, you need to run through the various factors that force speedier healing. For those who committed to PreHab before their artificial joint, they’re already strides ahead.

To sum it up, ReHab will help you:

  • Get back normal movement in your joint (and then some). In the weeks and first couple of months after surgery, lots of patients report that their range of motion is better than it’s been in years.
  • Rebuild strength in muscles surrounding your joint. If you worked through a daily checklist of targeted exercises, you’re already halfway there. However, during your surgery, tissue and muscle was cut through and damaged. ReHab will help you repair tissue and regain the muscle you lost.
  • Deal with pain. You will be given exercises to reduce swelling and inflammation, medication for pain relief, as well as be taught proper icing and elevation techniques.
  • Improve circulation to prevent issues with blood clots and prolonged bruising.

So, Why PreHab and ReHab?

If you think of the actual total or partial joint replacement surgery as a hamburger patty, think of PreHab as the bottom bun and ReHab as the top, sesame seedy layer. The bread (PreHab and ReHab) sandwiched around the meat (your hip or knee replacement) is what keeps the burger in tact and supports it. In relation to the patty, both bun pieces serve a purpose and when combined offer the complete burger experience. Now, who’s hungry?

When thinking “why PreHab and ReHab?”, think of it this way: PreHab is training for the race. It gets your body and mind where it needs to be, breaks bad habits, minimizes the effects of pre-existing conditions or diseases, and shows you how to prepare your environment. Now, surgery is the race--the main event. The more time and effort you put into prepping for the big day, the better your outcome will be and the less likely things will be to go off-track. Lastly, ReHab is more than a post-race cooldown. ReHab helps get you to next phase of your life after you’ve tackled something major--it ensures that you do more than just cross the finish line. ReHab helps you avoid complications, cut down pain, regain movement, and has a large hand in determining what your permanent new normal will look like.


Are you getting ready for a hip or knee replacement? If so, you might be the right fit for PeerWell’s PreHab app. Perhaps you’ve recently had a replacement and are interested in learning more about PeerWell’s smartphone ReHab app? Either way, sign-up and learn more.

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Hi, I'm Grace. I write all things surgery for the PeerWell blog. You may remember me from such titles as: "Diabetes & Joint Replacement 101" & "Sex After a Joint Replacement".

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