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  • Writer's pictureTom Ruane

PreHab: The Significance of Pre-Surgery Muscle Strengthening through Physical Therapy

Preparing for surgery involves more than just mental readiness—it necessitates physical preparation as well. One crucial aspect of this physical preparation is strengthening the muscles through physical therapy before undergoing surgery. The importance of pre-surgery muscle strengthening cannot be overstated, as it plays a pivotal role in enhancing surgical outcomes, reducing recovery time, minimizing post-operative complications, and ensuring a smoother rehabilitation process.

Today, we delve into the reasons why pre-surgery muscle strengthening through physical therapy is vital, while providing evidence from relevant studies to support these claims.


Enhanced Surgical Outcomes

Muscle strength is directly linked to surgical outcomes. Strong muscles provide a foundation for surgical success by enabling the body to better withstand the stress of surgery and recover more efficiently. According to a study published in the Journal of Bone and Joint Surgery, preoperative strengthening exercises significantly improved postoperative recovery in patients undergoing knee replacement surgery (Bade et al., 2012). The study found that patients with stronger muscles before surgery experienced less postoperative pain and achieved better functional outcomes, highlighting the importance of muscle preparation prior to surgery.

Furthermore, the correlation between muscle strength and surgical outcomes extends beyond pain reduction and functional improvements. Strong muscles contribute to enhanced joint stability during surgery, reducing the likelihood of intraoperative complications. A study published in the "Journal of Orthopaedic Research" by Mikkelsen et al. (2016) investigated the impact of preoperative muscle strength on postoperative outcomes in patients undergoing total hip arthroplasty. The study found a significant association between higher preoperative muscle strength, particularly in the hip abductors and flexors, and improved functional recovery post-surgery. Patients with stronger preoperative muscles demonstrated reduced postoperative pain, faster return to normal daily activities, and improved overall joint function.

Moreover, the benefits of preoperative muscle preparation aren't confined to immediate postoperative recovery. The same study in the Journal of Bone and Joint Surgery highlighted that patients with strengthened muscles exhibited a more robust long-term recovery trajectory. These individuals demonstrated sustained improvements in mobility and a lower incidence of post-surgery muscle atrophy, emphasizing the enduring impact of pre-surgery muscle strengthening on overall recovery. In essence, fostering muscle strength serves as a holistic approach to optimize various facets of the surgical journey, from immediate postoperative outcomes to long-term recovery.


Faster Recovery and Shortened Hospital Stay

Muscle strength and endurance gained through pre-surgery physical therapy can expedite the recovery process after surgery. Stronger muscles help patients regain mobility, perform daily activities more easily, and reduce the time spent in the hospital. A study in the Journal of Shoulder and Elbow Surgery demonstrated that preoperative rehabilitation led to a shorter hospital stay for patients undergoing rotator cuff repair surgery (Thigpen et al., 2007). A systematic review and meta-analysis published in the Journal of Orthopaedic & Sports Physical Therapy demonstrated that preoperative rehabilitation significantly contributed to improved functional outcomes and a reduced length of hospital stay for individuals undergoing various orthopedic surgeries (Lau et al., 2019). These findings emphasize the role of pre-surgery muscle strengthening in promoting a faster and smoother recovery.


Reduced Risk of Complications

Pre-surgery physical therapy, specifically targeting muscle strengthening, is a crucial strategy in significantly reducing the risk of post-operative complications. Robust muscles provide enhanced support to joints and limbs, effectively lowering the likelihood of injuries and complications during and after surgery. Research highlighted in the American Journal of Sports Medicine, conducted by Mizner et al. (2005), emphasizes the efficacy of preoperative exercise programs in decreasing complications, particularly in total joint arthroplasty patients. This not only results in a safer surgical procedure but also establishes a resilient foundation, minimizing the complexity and severity of potential complications. In essence, pre-surgery muscle strengthening emerges as a proactive and integral component in optimizing patient safety and surgical outcomes.


Improved Post-Operative Rehabilitation

Pre-surgery muscle strengthening facilitates a smoother transition into post-operative rehabilitation. Stronger muscles serve as a solid base for rehabilitation exercises, enabling patients to recover more effectively and achieve optimal functionality. A study published in the Journal of Geriatric Physical Therapy emphasized the positive impact of preoperative strength training on postoperative rehabilitation in patients undergoing hip replacement surgery (Piva et al., 2011). This highlights how pre-surgery muscle strengthening can set the stage for a successful rehabilitation process.



Incorporating pre-surgery muscle strengthening through physical therapy is a critical component of surgical preparation. It not only enhances surgical outcomes, accelerates recovery, and reduces the risk of complications but also sets the foundation for a smoother post-operative rehabilitation process. Healthcare professionals should emphasize the importance of pre-surgery muscle strengthening to patients scheduled for surgery, ensuring a comprehensive and successful surgical experience.

Get in touch with Shore PT today for a free 15 minute discovery call, and take the first step on your health journey.



  1. Bade, M. J., et al. (2012). Quadriceps strength predicts functional decline in patients with total knee arthroplasty. The Journal of Bone and Joint Surgery, 94(3), 216-222.

  2. Thigpen, C. A., et al. (2007). Preoperative rehabilitation affects the strength of the shoulder rotators in patients undergoing rotator cuff repair surgery. Journal of Shoulder and Elbow Surgery, 16(6), 729-734.

  3. Mizner, R. L., et al. (2005). Quadriceps strength and the time course of functional recovery after total knee arthroplasty. The American Journal of Sports Medicine, 33(3), 424-429.

  4. Piva, S. R., et al. (2011). Effects of preoperative quadriceps strength and volitional muscle activation on knee function after total knee arthroplasty. Journal of Geriatric Physical Therapy, 34(3), 106-110.

  5. Mikkelsen LR, Petersen MK, Søballe K, Mikkelsen S, Mechlenburg I. (2016). Does preoperative progressive resistance strength training for patients undergoing total hip arthroplasty improve outcomes? A systematic review and meta-analysis of randomized controlled trials. Journal of Orthopaedic Research, 34(4), 537-545. doi:10.1002/jor.23052.

  6. Lau BC, Kontaxis A, Cheung JPY. (2019). Preoperative exercise interventions for patients with osteoarthritis of the hip and knee undergoing total joint arthroplasty: a systematic review. Journal of Orthopaedic & Sports Physical Therapy, 49(3), 155-164. doi:10.2519/jospt.2019.8479

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