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.

Kelly and Richard Got Toned and Strong!

kelly and richard got toned and strong!

Strength training helped Kelly get toned, and Richard estimates that he got 50% stronger, improved his posture, and lost about 75% of the aches and pains that he had in his back and shoulders.

Kelly Alessandro doesn’t know how much time she has left. Not at The Perfect Workout, but in life. Two years ago she was diagnosed with sarcoma, a very rare form of cancer, and doctors initially didn’t give her a very good chance of survival. She’s gone through surgeries, chemotherapy, and radiation treatments. Through it all, she has stayed mentally and physically strong. Kelly attributes making it this far in part to the fact that she’s in such good shape, thanks to The Perfect Workout. “I was able to recover so much better from all those surgeries because I had a strong core, because I was so strong,” she says.

The story begins before Kelly got cancer. About two and a half years ago, she saw an ad for The Perfect Workout and decided to investigate slow-motion strength training. “I had no idea it was going to be as good as it was. Most people don’t get it. They think you have to spend an hour.” Kelly didn’t need to lose weight, she just wanted to “tone it up” and get stronger. Within a couple weeks she started seeing results, and she was hooked. Six months into her workouts, she got the bad news. She had surgery, then took five weeks off to recover. When she started her workouts up again, she was actually receiving chemotherapy at the same time, and feels like the workouts helped.

It was around this time that she finally got Richard to start working out with her. “Kelly kept nagging me,” he jokes. “I didn’t want to listen to her tell me I had to work out. She kind of shamed me. She just had major surgery, she was going through chemo, and she was still doing it.” Richard approached it with gusto the same way Kelly had, and made good progress.

Richard and Kelly agree that having a trainer keeps it safe and makes it fun. “The whole staff at Laguna Niguel has been great!” Richard is serious when he says, “I hate going! But the hate only lasts for 20 minutes. I just jump right in. I try to have fun with it. When I’m done, I’m done, and I go home and have my protein shake. The Perfect Workout is 1/335 of my week. For 1/335, I can do anything!” With everything they’ve been through together, Richard and Kelly have a remarkable sense of gratitude, and with some sarcoma experts they’ve just found, they also have a new sense of hope. Their trainers at the Laguna Niguel studio say, “Kelly’s spirit is always upbeat and positive. We’ve been honored to work with her and her husband, Richard, and their courage and determination has touched all of our lives.”

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.

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