The appointment is made. The surgeon has confirmed it — the joint is bad enough, the replacement is the right call. Now comes the waiting: six months, nine months, sometimes longer through the public system in Queensland. The instruction that usually accompanies this news is some version of be careful, don’t overdo it, take it easy on the joint.
What that instruction tends to leave out is what to do with all that time.
Prehabilitation — exercise designed specifically to prepare the body for surgery — has become one of the more quietly significant developments in orthopaedic care over the last decade. The evidence started consolidating around 2015, when a systematic review published in PLOS ONE found that patients who completed pre-surgical exercise programmes had meaningfully better outcomes after total knee replacement than those who did not. Since then, the findings have grown more consistent: patients who go into surgery stronger tend to come out of it faster, with fewer complications, and with shorter hospital stays.
For the many Australians currently sitting on an elective surgery waiting list, this reframes the wait itself. The months between diagnosis and operating day are not time to endure passively. They are training time.
Why muscle matters before surgery, not just after
Surgery — even routine, well-executed surgery — causes rapid and predictable muscle loss. Research in the orthopaedic literature indicates that patients can lose 20 to 30 percent of quadriceps strength in the weeks immediately following hip or knee replacement. For an older adult who arrived at surgery with limited strength reserves to begin with, that starting point matters enormously.
Muscle built in the months before surgery does not disappear when you go under anaesthetic. It becomes your baseline. The higher that baseline, the shorter the distance between where you wake up and where you need to be to walk steadily, climb stairs, and return to independent daily life.
The quadriceps muscle — the large muscle at the front of the thigh — is the single strongest predictor of how well someone recovers from knee replacement. For hip replacement, the glutes, hip flexors, and hip abductors are equally critical. None of these muscles require the actual joint to be functioning well in order to be trained. You can strengthen the muscles that will carry you through recovery even when the joint itself is not in good shape. That is the key insight prehabilitation is built on.
What the waiting list makes possible
Queensland’s public orthopaedic waiting times for elective procedures regularly stretch beyond 12 months. For many people, this feels like a frustrating delay with no clear productive use. Looked at differently, it is a long training window.
Eight to 16 weeks of two-to-three-times-per-week supervised exercise is enough to produce meaningful strength gains, even in older adults who have not exercised regularly for some time. Twelve months is close to six full cycles of that. A person who starts a structured exercise programme at the point their surgery is confirmed has a genuine opportunity to arrive at the operating table in significantly better physical condition than the day the joint was first flagged as needing replacement.
Andrea and Jessica Curtis, the sisters who run Easy Exercising, see this pattern regularly at their Capalaba and Morayfield studios. Someone comes in shortly after receiving their surgery date, cautious about whether exercising is even safe given how much the joint already hurts. After a few months of supervised, low-impact sessions, the difference is typically noticeable — not just in measured strength, but in confidence and in the ease of day-to-day movement. The joint still needs the surgery. But the person going into that surgery is better prepared for what comes after.
What prehabilitation actually involves
The words “exercise programme” can call up images of resistance machines, heavy weights, and gritted teeth. Prehabilitation for hip and knee replacement candidates looks quite different.
The joint is already damaged — often significantly. The goal is not to load it further or push through pain. The goal is to build strength in the surrounding muscle groups while keeping pressure off the compromised joint itself.
Power-assisted exercise equipment is well-suited to this. The machines assist the movement, reducing the joint force involved. A person with a bone-on-bone knee who cannot do a conventional leg press without significant pain can often work the same muscle groups with far less discomfort on pneumatic resistance equipment. The load is gentler, the movement is controlled, and the muscle stimulus is still enough to produce real strength gains over time.
Easy Exercising’s studios at Capalaba and Morayfield are built specifically around this equipment, which is part of why the space attracts so many people who are managing existing joint pain rather than training through it. Sessions are supervised — someone is in the room, adjusting machine settings, watching technique, and modifying the exercise if something is not right for that person on that particular day. Over months of prehabilitation, that ongoing supervision matters. It is not just about safety. It is about having someone track progress, adjust the programme as strength builds, and keep the sessions genuinely purposeful.
What to expect when you start
A concern that comes up often for people starting exercise before surgery: that they will push too hard, aggravate the joint, and arrive at their operation in worse shape than if they had simply rested. That concern is understandable, and the Easy Exercising team takes it seriously.
At Easy Exercising, the first session begins with an assessment. For someone on a surgical waiting list, the team is working from the outset with full knowledge that this joint is under stress, that the aim is preparation not performance, and that the exercise needs to feel manageable — something that can be returned to twice or three times a week without dread.
What many pre-surgical clients describe is that their sessions become one of the more comfortable parts of their week. Movement that has been painful in daily life — walking, standing from a chair, getting up from the floor — can feel different on properly calibrated, weight-assisted equipment. That is not a cure for the joint problem. But it can make a long waiting period less passive, and considerably less demoralising.
For participants using My Aged Care or NDIS funding, prehabilitation sessions are often fundable through existing plans. Supervised exercise and exercise physiology services fall within the kinds of supports both programmes typically cover. If the funding situation is unclear, the team at Easy Exercising can help work through what is available before the first visit.
What the research consistently shows
The orthopaedic research on prehabilitation has been building since the early 2010s, and by 2019 was substantial enough to shape clinical recommendations in several countries. Across multiple trials, patients who completed structured pre-surgical exercise programmes showed better functional outcomes at 30 days post-operation, shorter hospital stays, and lower rates of post-surgical complications than those who did not. The effects are more pronounced in older adults, where recovery trajectories tend to be less predictable and any setback — a fall, a period of immobility, a secondary complication — carries more consequence.
The strongest predictor of these outcomes is not which specific exercises were performed, but whether pre-surgical exercise happened at all, and whether it was consistent. Two or three supervised sessions per week over two to four months appears to be the threshold where outcomes start to diverge clearly from those who did not exercise.
For anyone planning both the pre-surgical preparation phase and the recovery period that follows, the exercise after knee replacement guide covers what supervised, low-impact rehabilitation looks like after surgery — the equipment used, what progress typically looks like in the first weeks, and what full recovery involves.
Before surgery is not too early to start
A free trial session is available at both the Capalaba and Morayfield studios. A pre-surgical first visit looks like any initial appointment at Easy Exercising — a conversation about the joint situation, a short assessment, and a first session on the equipment.
Surgery will happen when it happens. What sits between now and that date is months that can either pass in cautious inactivity, or be used to build the muscle that will determine how quickly life returns to normal on the other side.
Contact us to arrange your free trial session at Easy Exercising – you’ll love it!
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