(231) 944-6541
West: 
I'm going to tell you something that most people scheduled for hip replacement surgery have never been told.
What you do in the weeks before your surgery is just as important as what you do in the weeks after it.
Maybe more.
I know that sounds counterintuitive. Most patients, once surgery is scheduled, go into a kind of waiting mode. Rest. Conserve energy. Get through the weeks before the procedure without making things worse.
I understand the instinct. But the research tells a different story. Study after study on pre-operative physical therapy — what we call prehab — shows the same thing: patients who complete a structured PT program before hip replacement recover faster, experience less post-operative pain, return to independence sooner, and in some studies spend less time in the hospital. The benefit is not marginal. It's clinically significant.
And yet the majority of patients scheduled for hip replacement never do any prehab. Not because they don't want to. Because nobody told them to.
The strength bank account
Here's the analogy I use with every pre-surgical patient I see.
Think of your strength as a bank account. The surgery — and the early weeks that follow — is a significant withdrawal. You're going to lose muscle mass. You're going to have post-operative pain that limits what you can do. You're going to be less active than you are right now, and inactivity has a cost.
The question is: what's your balance going into surgery?
Every session of pre-operative physical therapy is a deposit. The stronger your glutes, your hip stabilizers, and your core are going into surgery, the faster they come back online coming out of it. Three to four weeks of prehab — even just two sessions per week — makes a measurable difference. Six to eight weeks makes a dramatic one.
Why patients skip it
There are usually three reasons.
Nobody told them to. The surgeon is focused on the procedure. The scheduling team is focused on logistics. Pre-operative PT falls through the cracks because there's no one in the system whose job it is to make sure it happens.
They assume they should be resting. "I'll save my energy for recovery." Understandable, but backwards. Rest does not bank strength. Exercise does.
They're in pain and figure PT will make it worse. That's sometimes true for high-intensity training. It is absolutely not true for the kind of targeted, careful prehab a good physical therapist designs. We work around arthritic hip pain every day.
What prehab looks like when it's done right
When a patient comes to us for pre-operative hip preparation, we start with a comprehensive evaluation — not just of the hip, but of the entire chain. Foot and ankle mobility. Knee function. Core strength. Spine mobility. The opposite hip. We're looking for the restrictions and weaknesses that will matter most in your recovery, so we can address them before surgery rather than discovering them three weeks post-op.
Then we build a targeted strengthening program around the muscles that matter most — the glutes, hip abductors, and core stabilizers. And we train them the way your body actually uses them: standing, weight-bearing, through the motions of walking and stair climbing — not lying on a mat. Your hip doesn't work lying down, and you don't live lying down.
There's one more benefit that doesn't get nearly enough attention: your nervous system learns movement. When you practice an exercise before surgery, that pattern gets stored. After surgery, when the same exercise shows up in your rehab program, your brain has a reference point. Patients who did prehab consistently perform their early post-op exercises with better quality than those who didn't. They're not starting from zero.
"I feel ready for my surgery"
Christine came to us a few months before her hip replacement was scheduled. She couldn't get her right sock or shoe on. She figured she would just get through it.
She worked with one of our Doctors of Physical Therapy for several weeks before her procedure. At the end of her prehab program, she said something I think about often: "I feel ready for my surgery."
Not resigned to it. Not hoping for the best. Ready.
The truth: pre-operative physical therapy isn't optional preparation — it's the first phase of your recovery. Every week of prehab is a deposit in the strength account you'll need after surgery. The more you deposit, the faster and more completely you recover.
Your next step
If your surgery is on the calendar, the prehab clock is already running — even three weeks makes a measurable difference. Call (231) 944-6541 and schedule a free 20-minute Hip Assessment with a Doctor of Physical Therapy at Superior Physical Therapy in Traverse City. We'll tell you exactly what to do with the time you have.
And if you want the complete plan — before, during, and after surgery — my book, The Complete Guide to Your Hip Replacement, walks you through all of it. You can get a copy free here.
