Exercises Before Hip & Knee Replacement

Most people think of recovery as something that starts after surgery — but some of the most valuable work happens before it. Going into a hip or knee replacement stronger and more mobile — what's often called “prehab” — tends to make the whole recovery smoother and faster. This guide explains why preparation matters and what to focus on. As with the recovery side, it covers the concepts; your specific program comes from your surgeon and physical therapist (and the downloadable guide below).

Why prepare with exercise

Starting a gentle conditioning program before surgery is genuinely one of the best ways to set up a quick, complete recovery. The reasons are straightforward:

In short: the fitter and more mobile you are on the day of surgery, the more you have to draw on afterward. It's the natural front half of the same effort described in our companion guide, exercises after hip & knee replacement.

How to approach it safely

Preparing well isn't about pushing hard — it's about consistency and good sense. A few guiding principles:

• Warm up first — a few minutes of easy walking or a stationary bike before you start.
• Favor low-impact activity — walking, cycling, and pool work are easy on an arthritic joint.
• Sore is okay, sharp pain is not — work within your comfort and ease off anything that genuinely hurts.
• Consistency over intensity — gentle and regular beats hard and occasional, every time.

Foundational conditioning (both joints)

Some preparation helps no matter which joint you're having replaced. The shared foundation covers a few categories:

• Low-impact aerobic fitness — walking, cycling, or pool work to support your overall conditioning.
• Gentle strengthening of the major muscles in the leg, so they're ready to support the new joint.
• Range-of-motion and circulation — easy movements that keep the joint supple and the blood flowing.

From there, where you put a little extra focus depends on whether it's your hip or your knee.

Hip vs. knee: where to put your focus

Just as recovery differs between the two joints, so does the most useful preparation.

Preparing for a knee replacement

Because knee recovery is largely about regaining range of motion, preparation that builds good bending and straightening habits pays off. Getting comfortable with gentle motion work — and strengthening the thigh muscles (the quadriceps) that control the knee — gives you a real head start on the range-of-motion focus that defines the early weeks after surgery. You can see why that matters in the knee recovery timeline.

Preparing for a hip replacement

Hip preparation leans toward mobility and strengthening the muscles around the hip — especially the stabilizing muscles on the side that keep you level when you walk. Maintaining hip motion and building that surrounding strength supports smoother walking mechanics afterward. It complements the muscle-sparing direct anterior approach Dr. Harb often uses, which is designed to get you moving comfortably quickly.

Getting ready for your walker (upper body)

Here's a piece of preparation people rarely think of: your arms and upper body. In the first stretch after surgery you'll lean on a walker or cane, and that takes upper-body strength. Spending a little time before surgery on gentle arm and shoulder strengthening — and practicing rising from a sturdy chair — makes those first days noticeably easier. It's a small thing that pays off immediately.

What patients commonly tell me

When the subject of preparing comes up, I hear a familiar handful of reactions:

The “my joint hurts too much to exercise” concern is a fair one — and the answer is to work gently within your comfort, leaning on low-impact options, rather than to do nothing at all.

Your program

This page explains the concepts behind preparing well. The specific exercises for you come from your surgeon and physical therapist, tailored to you and your joint.

Preparation is one piece of getting ready; for the full checklist of what to do beforehand, see how to prepare for joint replacement surgery. And if you're still weighing whether it's time, the signs you may need a hip replacement or knee replacement are a good place to start.

From Dr. Harb

I'd rather a patient arrive on surgery day having done a little steady preparation than a lot of last-minute worrying. The work doesn't have to be hard — it has to be consistent. Gentle, regular conditioning in the weeks beforehand is one of the few parts of this whole process that's entirely in your hands.

The bottom line: a strong, mobile start sets up a strong recovery. A little steady preparation now is one of the best gifts you can give the version of you waking up from surgery.