Quickly Recover from Surgery + (best way to avoid)

Prehab Is Your Best Chance At Quickly Recovering From Surgery

“When my doctor gave me two choices about the pain in my right shoulder- Either live with it or have surgery, I felt hopeless.”- Sherry Chriss, client.

Facing surgery is scary and quite common for a lot of adults. Although every surgery can’t be avoided, one solution to prepare for a swift recovery and potentially avoiding surgery altogether is slow-motion strength training. We call this prehab or “prehabilitation” and it’s happening in our studios and virtual training sessions every day.

Prehab for Total Knee Replacement

One of the most common surgical procedures our clients face is a Total Knee Replacement (TKRs), and they are as popular as ever. More than 381,000 TKRs take place every year, and researchers expect that number to grow six-fold in the next 20 years [1].

The surgery can be very helpful as it enables people with severe knee osteoarthritis to decrease or eliminate their pain while improving their functional ability. However, a TKR also leads to a period of inactivity during recovery, and that inactivity has drawbacks. People lose about 60% of their quadriceps strength within the first month following surgery.

Considering that information, it’s no surprise that people with TKRs have demonstrated slower walking and stair-climbing speeds when compared to their peers.

Medical Diagram of a before and after total knee replacement

Studies Show...

Researchers at the University of Louisville conducted a study comparing people who “prehabbed” against those who did not (control group) for five months prior to surgery. Like our clients, the individuals who strength trained fared very well.

The exercise group trained three times per week prior to the surgery, including exercises such as the leg curl and leg extension. Following the surgery, both groups received the same physical therapy.

Watch one of our clients on the Leg Extension! 

Before the surgery, strength training prevented knee pain from increasing and improved the participants’ functional abilities like getting up from a chair, walking speed, and stair-climbing speed.

One month after the surgery, the control group experienced losses in quadricep strength and walking speed, whereas the exercise group did not (when compared to baseline tests). Three months later, functional ability and strength in the operated leg were greater in the exercise group. 

Overall, the study found quadriceps strength was associated with greater functional ability and less knee pain. Researchers in a study out of the University of Delaware found the same connections when monitoring quadriceps strength days before and one year after a TKR [2].

They also noticed that quadriceps strength before surgery also predicts dynamic balance a year after surgery. Dynamic balance is tested by seeing how quickly a person can stand from a chair, walk around a sharp turn, and then return to the chair.

Balance and strength are some of the most important benefits of slow-motion strength training, especially in older adults who fear falling.

How Long Do You Prehab For?

If a TKR or any other major joint surgery is in your future, you might wonder how long you should train for prior to the procedure. As mentioned, the study included five months of prehabilitation, although we have clients who have only trained for 3 months leading up to their surgery and still experienced a quick and less-painful recovery period. Obviously, the earlier you start, the more strength you will build prior to surgery.

The process of strengthening before a surgery just makes sense. The joints are healthier when their surrounding muscles are stronger. Strength training before a joint replacement surgery allows you the opportunity to build healthier joints and muscles that you will simply work to maintain after surgery, instead of having to build them for the first time.

If a surgery like TKR is in your future, or you want to do whatever you can to avoid one, slow-motion strength training is the solution.

Clients Who Have Avoided Surgery:

In addition to those who have prehabbed before surgery, we’ve helped many people prevent injuries and avoid surgery altogether.

Michael Slosek

Michael, 66, had been told by his doctor that he needed a hip replacement. He also wanted to lose weight, gain overall strength and stamina, and a 20 minute workout was very appealing to him. Michael’s strength training results speak for themselves:

  • No longer has back or hip problems
  • Has more energy and stronger muscles
  • Able to hit the golf ball 20-30 yards further at the driving range
  • Has been able to avoid hip replacement surgery


“The Perfect Workout has a great thing going. You feel like you have a workout when you come here. I’ll continue to do it.”

Mary Jane Bartee

When you have medical conditions like fibromyalgia, osteopenia, and pelvic prolapse, you’re going to be very careful about exercise. “Anything that’s fast-moving and aggressive aggravates it,” says Mary Jane (MJ) Bartee. Slow, safe movement is what first appealed to her about slow-motion strength training. MJ’s strength training results are nothing short of fantastic:

  • Her most recent bone density test showed that her osteopenia is gone
  • The pain from her other conditions is more manageable, resulting in less medication
  • Her pelvic prolapse has greatly improved, to the point where the doctors aren’t talking about surgery anymore


“It’s quick and accommodating,” says MJ. “20 minutes and I’m done. It’s something I do for myself, and as long as I’m functioning as well as I am, I’ll stick with it.”

Her Story of injury prevention

Sherry Chriss

After unsuccessful physical therapy and cortisone shots for an injured shoulder, Sherry was desperate for an alternative to surgery. She was also distraught about the effects of menopause, including loss of bone density, decreased upper body strength, and weak legs. A year after she began strength training at The Perfect Workout:

  • Sherry’s bone density scan improved, surprising even her doctor.
  • She no longer has shoulder pain, and no longer needs surgery.


“I enjoyed it right off the bat, and little did I know how fantastic it would turn out to be. My husband and I have both seen great results, so we’re committed to doing The Perfect Workout for the rest of our lives!”

Don’t wait for post-surgery to start building up strength. In fact, surgery may not be necessary if you take action now. It only takes 20 minutes, twice a week and you’ll get a lifetime workout guaranteed to get you stronger.

  1. Topp, R., Swank, A. M., Quesada, P. M., Nyland, J., & Malkani, A. (2009). The effect of prehabilitation exercise on strength and functioning after total knee arthroplasty. PM&R, 1(8), 729-735.
  1. Mizner, R. L., Petterson, S. C., Stevens, J. E., Axe, M. J., & Snyder-Mackler, L. (2005). Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. The Journal of rheumatology, 32(8), 1533-1539.

Knee Replacement “Prehabilitation”

knee replacement "prehabilitation"

Let me tell you about Lilly. Lilly is 81 years old and holds a position on the board of a large hospital. She routinely works 10-hour days, five days per week, which includes giving lectures and running board meetings. Due to all of her work, Lilly is on her feet for hours per day.

This is not only impressive when considering Lilly’s age, but also because she had a total knee replacement (TKR) six months ago. Despite the close proximity to her surgery, Lilly has no knee pain, caregiver, or gait issues. How? Lilly attributes her quick recovery to the strength she built during three months of “prehabilitation,” where she strength trained twice per week prior to her surgery.

Lilly is not a fluke. A 2009 study at

the University of Louisville demonstrated that strength training prior to a TKR led to greater improvements in strength of the operated leg, standing from a chair, and with walking up and down stairs [1]. In addition, quadriceps strength prior to surgery is associated with greater dynamic balance a year after surgery [2].

TKRs are as popular as ever. More than 381,000 TKRs take place every year, and researchers expect that number to grow six-fold in the next 20 years [1]. The surgery can be very helpful as it enables people with severe knee osteoarthritis to decrease or eliminate their pain while improving their functional ability.

However, a TKR also leads to a period of inactivity during recovery, and that inactivity has drawbacks. People lose about 60% of their quadriceps strength within the first month following surgery. Considering that information, it’s no surprise that people with TKRs have demonstrated slower walking and stair-climbing speeds when compared to their peers.

Researchers at the University of Louisville conducted a study comparing people who “prehabbed” against those who did not (control group) for the five months prior to surgery. Like Lilly, the individuals who strength trained fared very well. Before the surgery, strength training prevented knee pain from increasing and improved the participants’ functional abilities (getting up from a chair, walking speed, and stair-climbing speed).

One month after the surgery, the control group experienced losses in quadriceps strength and walking speed, whereas the exercise group did not (when compared to baseline tests). Three months later, functional ability and strength in the operated leg were greater in the exercise group.

The exercise group trained three times per week prior to the surgery, including exercises such as the leg curl and leg extension. Following the surgery, both groups received the same physical therapy.

Overall, the study found quadriceps strength was associated with greater functional ability and less knee pain. Researchers in a study out of the University of Delaware found the same connections when monitoring quadriceps strength days before and one year after a TKR [2]. They also noticed that quadriceps strength before surgery also predicts dynamic balance a year after surgery. Dynamic balance is tested by seeing how quickly a person can stand from a chair, walk around a sharp turn, and then return to the chair.

If a TKR is in your future, you might wonder how long you should train for prior to the procedure. As mentioned, the study included five months of prehabilitation, although Lilly trained for only three. Obviously, the earlier you start, the more strength you will build prior to surgery.

As a whole, the studies and Lilly’s experience make sense: joints are healthier when their surrounding muscles are stronger. Strength training before a TKR allows you the opportunity to build healthier joints and muscles that you will simply work to maintain after surgery, instead of having to build them for the first time.

  1. Topp, R., Swank, A. M., Quesada, P. M., Nyland, J., & Malkani, A. (2009). The effect of prehabilitation exercise on strength and functioning after total knee arthroplasty. PM&R, 1(8), 729-735.
  2. Mizner, R. L., Petterson, S. C., Stevens, J. E., Axe, M. J., & Snyder-Mackler, L. (2005). Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. The Journal of rheumatology, 32(8), 1533-1539.

“From my first visit, I was hooked!”

"from my first visit, i was hooked!"

margo a female client who is 60 years old

For anyone who's considering slow-motion strength training, Margo says, “You have to try it. It's something wonderful to do for yourself. The Perfect Workout is worth it to me. It's my health! I'm turning 60 in July, and this is not the time to backslide!”

Margo Smith came to The Perfect Workout in November of 2011 to rehabilitate her knee. “I had spent the previous year very restricted,” she says. “I had a torn meniscus in my left knee from attending a fitness bootcamp.

The surgery didn't go well, and I was left with only 40% cartilage in one knee, or what is known as ‘bone on bone.' After doing physical therapy for a year, I knew I wanted to get a trainer, particularly one who was aware of what to do with my knee.” She had already done her homework on The Perfect Workout after reading some articles about it. Her husband, an engineer and former triathlete, did some research, too. “He told me, ‘This makes sense.' “

When she went in for her introductory session, Margo says, “I had such a good feeling about everyone. They knew what they were doing. They were very well-educated and well-prepared. Plus, I had read the testimonials beforehand.” The one-on-one aspect was a big draw, and she and trainer Kim Van Loon got right down to business, being very careful about her knee.

“No matter which trainer I'm working with, I know I have their undivided attention every time. They're there, focused, and helping me. They're giving me 100%, and I feel I need to give them 100%.” Margo calls her current trainer, Ryan, “The Workout Whisperer” because he gets in her head and urges her on. “He gets more out of me than I think I have to give. He knows what I can do and helps me achieve the most I can on any given day.”

It's that personal touch that helped Margo get some great results fairly quickly. She lost 10 pounds, went down a size, gained muscle tone, and lost inches off her waist. More important, she says, “There was a big difference in the shape of my body.

Everything fits better and looks better. I never had upper body fat, but in that year off, my tops got tight in the arms. I have shape in my biceps and legs now! All in all, I look better.” The key is consistency. Margo never misses a workout, and she makes every workout count.

It's paying off in the studio, where she's now leg pressing 300 pounds, as well as outside. She's able to hike, walk, dance, and scuba dive – things she wasn't doing during her knee rehabilitation. Margo says, “I am so grateful to the trainers. Both for the training and that they've become friends. I appreciate them.”

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