Moving through Joint Replacement: Why Prehab and Rehab Matter

Your joints quietly do a lot of the heavy lifting of life. Joint replacements — particularly of the hips and knees — are increasingly common, especially among women navigating postmenopausal changes.

Joint replacements usually happen when someone reaches end-stage osteoarthritis. That doesn’t just mean “wear and tear” — it’s a more complex picture of joint inflammation, structural change, and pain that’s become challenging to manage. While we can’t always prevent it, certain factors can make joint breakdown more likely: changes in muscle strength and joint mechanics, previous injuries or falls, hormonal shifts (especially after menopause), and carrying excess load through the joints over time. It’s rarely just one thing — but the good news is that movement, done thoughtfully and consistently, can support the joint, reduce inflammation, and help us feel less like a passenger in the joint replacement process.

Moving through a joint replacement is not just rehab (those physio sessions you receive individually straight after surgery and then perhaps in a group setting). It’s also prehab — a way to prepare your body (and mind) for surgery, so that you recover more smoothly, rebuild strength more confidently, and feel more at home in your body throughout the process.

Whilst the surgery itself is often seen as the “fix,” what happens before and after the operation plays a powerful role in how well someone recovers.

Movement as Preparation, Not Just Prescription

Prehab refers to a targeted, intentional approach to movement in the weeks and months leading up to surgery. This isn’t about pushing through pain — it’s about gently waking up the muscles that will support your recovery, improving circulation, and establishing a rhythm of movement that helps you feel less like a passive patient and more like an active participant in your own healing.

And it matters. Research consistently shows that people who engage in prehab have faster recoveries, fewer complications, and are better able to return to the daily activities that matter to them. You can get back to what moves you.

What moves YOU? What activities might you do if you could move freely and without pain?

Why Muscle Strength Matters for Joints

Muscles don’t just move our joints — they protect and feed them.

In the case of knees and hips, the surrounding muscles act like supportive scaffolding. The stronger and more coordinated your quads, glutes, hamstrings, and core are before surgery, the more stability your joint will have during the vulnerable early stages of healing. Research shows that strengthening exercises in particular can have not only a physical impact but also a positive psychological impact on surgery and recovery.

And the good news? This strength doesn’t require hours in a gym. Gentle, consistent movement at home — even seated or supine (lying down) — can keep your muscles engaged and your confidence up.

After Surgery: Movement as Medicine

Once your surgery is complete, rehab takes centre stage — but it builds directly on the foundation laid by prehab.

Muscles that were gently strengthened beforehand tend to “remember” how to fire more easily after surgery. You’ll also be more familiar with movement patterns and breathing techniques that help manage pain and reduce compensation habits.

And beyond the physical, movement is a way to reconnect with your body. Many people experience a sense of disconnection post-surgery — from the trauma, the medications, or even just the shock of the experience. Thoughtful, guided movement (even a simple breath and ankle circle) can help you come back into your body with gentleness.

Takeaway: You Are Not a Passenger

Surgery is a big life-event, but movement gives you a way to take part in the process — not just wait for it to happen to you.

Prehab is not about pushing harder or doing “more.” It’s about preparing to recover — building strength, creating awareness, and nurturing trust in your body, so that when the time comes, you are ready.

Whether on a mat, in a chair, or on a reformer, every small move you make now feeds the joint you're preparing to heal.

Within my online Membership, you’ll find exercises for strengthening both the hips and knees, along with guided breath, mobility, and awareness practices to help you feel more connected to your body from the inside out. Why not join me for movement that supports both your physical and mental health — done in your own time and space, at a pace that feels right for you?

http://www.positivepilatessolihull.co.uk/online-pilates

Movement. Mindset. Meaning.