Being asked to prepare for surgery can make the weeks beforehand feel like a waiting period. They do not have to be. A tailored pre surgery exercise program can help you arrive with more confidence in your movement, clearer expectations and a practical routine to return to when your surgical team says it is safe.
This preparation is often called prehabilitation, or prehab. It is not about pushing through pain, losing a certain amount of weight or trying to become exceptionally fit before an operation. The aim is more straightforward: maintain or improve the strength, mobility, balance and general activity that will help you manage the demands of recovery.
Why exercise before surgery can help
Surgery places a temporary demand on the body. Afterwards, you may need to get in and out of bed differently, use crutches or a walking aid, climb stairs, complete breathing exercises, or spend a period moving less than usual. Building capacity beforehand may make these changes easier to manage.
For many people, the most useful gains are practical. Stronger leg muscles can support standing from a chair and walking after hip, knee, abdominal or spinal surgery. Better upper-body strength may help if you will use crutches. Gentle cardiovascular activity can support endurance for everyday tasks. Mobility work can help you understand which movements feel restricted before surgery, rather than discovering this during recovery.
The research around prehab is encouraging, particularly for people having orthopaedic surgery, but results vary. The type of operation, your starting fitness, pain levels, other health conditions and the length of time before surgery all matter. Exercise cannot remove every risk or guarantee a faster recovery. It can, however, give you useful physical and psychological preparation for a significant health event.
Start with the surgical plan, not a generic routine
The safest program begins with your surgeon’s advice. Ask what movement is encouraged, what must be avoided and whether there are specific precautions for your procedure. This is particularly important if you have a fracture, severe joint instability, a heart or lung condition, uncontrolled blood pressure, neurological symptoms, cancer treatment, or a recent change in medication.
Your anaesthetist, GP and surgical team should also know about all medicines, supplements and herbal products you use. Some products can affect bleeding, blood pressure or interactions with anaesthesia. Do not assume that because something is natural, it is automatically suitable before an operation.
An allied-health assessment can then turn broad advice into an individual plan. At Central Sydney Osteopathy, this may involve looking at your usual activity, pain pattern, range of movement, strength, balance, work demands and home set-up. Your practitioner can also work alongside the recommendations of your surgeon and other treating professionals. The goal is not to replace surgical advice, but to help you prepare for the real activities that recovery will require.
What a pre surgery exercise program may include
There is no single correct program. Someone preparing for a knee replacement needs a different focus from someone awaiting abdominal surgery, shoulder repair or pelvic surgery. Still, most plans draw from a few core areas.
Walking or other comfortable aerobic exercise
If approved by your treating team, regular walking is often a simple place to begin. It can be broken into manageable bouts, such as 10 minutes once or twice a day, rather than one long walk that flares symptoms. A stationary bike, pool exercise or gentle rowing may suit some people, depending on the operation and the body area involved.
Use the talk test as a basic guide. During moderate activity, you should be able to speak in short sentences, though not sing comfortably. If you become markedly breathless, dizzy, develop chest pain or feel unwell, stop and seek medical advice.
Functional strength
Strength exercises work best when they relate to tasks you will need to do. A sit-to-stand from a stable chair, for example, can build thigh and hip strength for standing and transferring. Supported calf raises can help ankle strength and balance. Wall push-ups or light band exercises may be useful before surgery that will require a walking aid, provided they do not aggravate a shoulder, neck or wrist problem.
Technique matters more than load. Start with a level that feels controlled and repeatable, leaving a little in reserve rather than exercising to exhaustion. Two or three sessions each week is often enough to create a useful routine, with rest days between strength sessions. Your practitioner can adjust this if pain, fatigue or medical treatment limits what is appropriate.
Mobility and movement confidence
Gentle mobility work may include comfortable knee bends, hip movements, ankle pumps, shoulder range exercises or thoracic rotation. These are not meant to force a stiff joint further than it can safely go. A mild stretch or effort is generally acceptable; sharp pain, catching, increasing swelling or symptoms that last well beyond the session are signs to reduce or stop the exercise and seek guidance.
If your surgery is for a painful joint, it is understandable to guard that area. Yet completely avoiding movement can lead to further stiffness and loss of confidence. Small, regular movements within your agreed limits are often more helpful than occasional intense stretching.
Balance, breathing and everyday practice
Balance work can be valuable for older adults and anyone worried about falls after surgery. Simple options might include standing near a kitchen bench with feet closer together, practising controlled weight shifts, or walking heel-to-toe with support nearby. Safety comes first: do not practise challenging balance exercises alone or in an area where a fall could cause harm.
Breathing strategies may also be prescribed, especially before chest or abdominal procedures. Your hospital team may provide a device or specific instructions. Follow those rather than choosing breathing exercises from social media. It can also help to rehearse practical tasks: using the stairs safely, getting in and out of a car, or arranging frequently used items at bench height before you leave for hospital.
How hard should you work?
A good program should feel purposeful, not punishing. For many people, pain during exercise should remain mild and settle back to their usual level within 24 hours. This guideline does not apply to every condition, so defer to the advice you have been given for your specific surgery.
Consistency is more useful than a last-minute burst of activity. If surgery is only two weeks away, a modest routine of walking, gentle strength and mobility can still be worthwhile. If you have several months, progression can be slower and more structured. Increase one element at a time, such as a few extra repetitions, a slightly longer walk or an additional session each week.
Recovery preparation also includes enough sleep, regular meals with adequate protein where appropriate, hydration and reducing smoking or vaping with clinical support. These are not substitutes for medical care, but they can support your body’s ability to cope with surgery and rehabilitation.
When to pause and ask for help
Do not exercise through warning signs simply because surgery is approaching. Contact your GP, surgeon or treating practitioner promptly if you have new chest pain, fainting, severe shortness of breath, a rapidly swollen or hot joint, calf pain with swelling, fever, a new loss of strength, or numbness and tingling that is worsening.
It is also worth checking in if your current pain is escalating or your program leaves you substantially worse the next day. A plan that is too difficult is not a test of commitment. It is information that the exercise choice, dose or technique needs changing.
Plan for the first weeks after surgery
Before the operation, ask what rehabilitation will look like afterwards. Find out when you can restart formal exercise, whether you will need a referral, what equipment is required and who to contact if pain or swelling changes. Having these answers written down can reduce uncertainty when you are tired or managing medication after surgery.
Your prehab exercises may not be your post-operative exercises. Early recovery has its own precautions, wound-care requirements and healing timelines. Think of pre-surgery activity as building a foundation, not as permission to skip the staged rehabilitation your surgical team recommends.
The most helpful program is the one that respects your body, your operation and your life outside the clinic. A few well-chosen movements done regularly can leave you better prepared to take each stage of recovery as it comes.
