Training · Before surgery
Get stronger before surgery
Got an operation coming up? Use the weeks before it. Getting stronger and fitter first can make the recovery easier, and your physio and coach carry you through the other side.
For knee, hip, shoulder and back surgery, and other planned operations.
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What the research says
The weeks before surgery count
The evidence is promising, but not certain. Here is what pooled trials found.
50%
lower odds of complications after surgery with exercise prehab, in 186 pooled trials. The certainty of this was very low.1
1day
shorter hospital stay, roughly, with exercise prehab, in the same review.1
20%
or more weaker thigh before ACL surgery was linked to bigger strength gaps two years later, in one study.2
Not every operation shows the same benefit. For hip replacement, a review found no clear gain in function after surgery.3
How we train
Stronger in, faster out
In pooled trials, exercise and nutrition were the parts of prehab most likely to help every outcome.1 We cover the training; health coaching covers food.
Your surgeon first
We follow your surgeon’s advice and work around any restrictions before the operation.
Strength for the area
Strength work for the joint being operated on, as far as pain allows, and for the rest of you.
Fitness for recovery
Walking and cardio fitness. Before heart surgery, prehab improved walking distance in pooled trials.4
A plan for after
You meet your physio before surgery, so rehab starts with a plan already in place.
Your program
Before, after and beyond
One team from your first session before surgery to your last after it.
- 01
Weeks to go
Before surgery
Strength, fitness and practising the exercises you will do after the operation.
CheckStrength and fitness tested, so we know your starting point for rehab.
- 02
Physio leads
Rehab
Your physio leads your recovery after surgery, following your surgeon’s plan.
Move on whenYour physio’s tests for each stage are passed.
- 03
Coach leads
Back to training
Your coach builds you back to full strength and fitness, with physio check-ins.
RetestStrength and function compared with your targets and your own pre-surgery results.
Check with your surgeon first if
- You have a heart or lung condition
- Pain is getting worse quickly
- Your surgeon has given you restrictions
- Chest pain, dizziness or unusual breathlessness when active
Our guides cover ACL rehab, joint replacement rehab and rotator cuff tears.
Client reviews
What our clients say
Rated 5.0 from 57 Google reviews
“Great Physiotherapy. Khun Meaw helped me very professionally with my the post-op rehab of my knee after ACL and Meniscus repair. She is very kind, knowledgeable and helpful. Really recommend her and Optimize!”
ELIH HectorGoogle review “I started seeing Khun Maew last August for a knee issue and within 15 minutes she had identified a multitude of issues I’d been dealing with for more than 20 years … I have been pain free for 6 months and am now in the gym working to rebuild my mobility and strength.”
Michelle LawlorGoogle review “I honestly can’t thank Karim at Optimisefit enough … I’ve lived in five different countries and, unfortunately, had to deal with many injuries, so I’ve seen quite a few physios over the years. But no one has ever come close to the level of knowledge, care, and clarity that he brings.”
Unfiltered OpinionsGoogle review “I came to Optimize with chronic back pain and absolutely no ability to train. I was first matched with Khun Meaw, a highly skilled rehabilitation trainer who helped me eliminate my back pain completely. … After that, I continued training with Kate for a full year.”
nesterzhzhotGoogle review “I have been working with Khun Meaw on some strengthening exercises for my shoulders, hips and knees. … Her goal has been to give me the tools I need to work on my specific areas of need and not to keep me in an endless cycle of needing help……so professional and a joy to work with.”
Catlin McCrackenGoogle review “Optimise is a fantastic set up, I have been working with Khun Meaw on a physio front, and she is awesome and really gets to the root of the problem and starts from there – could not recommend highly enough. Having seen a couple of different physios on the island, Khun Meaw is certainly number 1.”
Jamie AllworkGoogle review
Questions
Prehab questions
Does prehab really help?
How long before surgery should I start?
As soon as you know the date. Your physio and coach plan around the time you have.
My joint hurts. Can I still train?
Usually yes, around the pain. We train what you can and work the rest of your body.
Should I train before ACL surgery?
Yes, if you can. Thigh weakness before surgery was linked to bigger strength gaps two years later.2 See our ACL rehab guide.
Do you do the rehab after surgery too?
Yes. Your physio leads rehab after the operation, and your coach takes over for the return to full training.
What happens at the free training consultation?
A coach goes through your goals, injury and physio history, sleep, stress and eating, and what has stopped you before. Then you agree where to begin. It’s free, with no obligation.
Physio and coaching team
Your physio and coach
Karim has a background in post-operative knee and ACL rehab, and Kate in return to sport. Meaw leads our clinical standards.
How integrated training works
Meaw
Head Physiotherapist
Karim
Physiotherapist
Kate
Senior Coach
Joonas
Coach
Also on the team Sukanya, Physiotherapist Katie, Client Experience and Junior Coach Beer, Coach
Next step
Use the weeks before surgery
Message us on WhatsApp to book your free training consultation. Tell us your operation and the date.
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In pain? Start with a free physio assessment
Questions first? WhatsApp +66 65 914 1604
Sources (4)
- McIsaac DI, Kidd G, Gillis C, et al. Relative efficacy of prehabilitation interventions and their components: systematic review with network and component network meta-analyses of randomised controlled trials. BMJ. 2025;388:e081164.
- Eitzen I, Holm I, Risberg MA. Preoperative quadriceps strength is a significant predictor of knee function two years after anterior cruciate ligament reconstruction. Br J Sports Med. 2009;43(5):371-376.
- Saueressig T, Owen PJ, Zebisch J, Herbst M, Belavy DL. Evaluation of exercise interventions and outcomes after hip arthroplasty: a systematic review and meta-analysis. JAMA Netw Open. 2021;4(2):e210254.
- Steinmetz C, Bjarnason-Wehrens B, Walther T, Schaffland TF, Walther C. Efficacy of prehabilitation before cardiac surgery: a systematic review and meta-analysis. Am J Phys Med Rehabil. 2023;102(4):323-330.
This page is general information based on the research listed here. It is not medical advice. Your coach will tailor the plan to you, and your doctor’s advice comes first. Last updated November 2026.