Planning your recovery before surgery might feel like looking too far ahead. But having a clear picture of what physiotherapy involves, both before and after your operation, can reduce anxiety and improve how well you heal. This guide explains what pre- and post-operative rehabilitation looks like in practice, what to expect at each stage, and when to seek urgent help.
What is post-operative physiotherapy and why does it matter?
Post-operative physiotherapy is a structured rehabilitation programme that helps you recover movement, strength, and confidence after surgery. It starts early, often within days of your operation, and continues until you return to your normal activities or sport. The aim is to reduce complications, manage pain and swelling, and restore function safely.
Surgery is a controlled injury. Your body needs to heal the tissues that have been cut, repositioned, or repaired. During that process, swelling develops, muscles weaken from disuse, and movement patterns can become guarded or uneven. Physiotherapy guides you through this phase with exercises, manual techniques, and education tailored to your surgery type and baseline fitness.
Starting early matters because delays can lead to stiffness, muscle wasting, or a loss of confidence in moving. People who engage with physiotherapy soon after surgery tend to return to daily life faster and with fewer setbacks. That does not mean pushing through pain or forcing progress. It means working within a safe range, guided by someone who understands surgical healing.
What does pre-operative physiotherapy involve?
Pre-operative physiotherapy, often called prehab, prepares your body for the demands of surgery and early recovery. This is not always offered routinely on the NHS, but many people choose to arrange it privately because the benefits are well documented. Prehab typically takes place in the weeks leading up to your operation and involves baseline assessment, education, and physical preparation.
During an initial session at our Central London clinic, a physiotherapist measures your current range of motion, strength, walking pattern, and any pain or limitations. This gives a clear picture of where you are starting from and helps set realistic recovery goals. If you are having knee surgery, for example, the therapist will check how far you can bend and straighten your leg, how strong your quadriceps and hamstrings are, and whether you walk with a limp.
Education is central to prehab. You will learn what to expect in the first few days after surgery: how much pain is typical, what swelling looks like, how to use crutches or a walking frame if needed, and how to manage stairs safely. Some people also practise exercises they will need to do immediately after the operation, such as ankle pumps to reduce the risk of blood clots or breathing exercises if they are having abdominal or chest surgery. Knowing what is coming reduces the shock of waking up with limited mobility or discomfort.
There is also practical planning. A physiotherapist might suggest small changes at home, such as moving items to waist height if you are having shoulder surgery, or arranging a bedroom downstairs if you live in a house with steep stairs and are having hip or knee replacement. These adjustments sound minor but can make early recovery much smoother.
Who benefits most from prehab?
Prehab is particularly valuable if you have existing joint stiffness, muscle weakness, or conditions like arthritis that already limit your movement. It can also help if you feel anxious about surgery or uncertain about what recovery will involve. Younger, fitter people sometimes assume they do not need prehab, but baseline strength and movement quality still matter. Even if you are active, surgery will disrupt your routine, and having a clear plan helps you return to sport or exercise more confidently later.
When should you start physiotherapy after surgery?
Physiotherapy often begins within the first few days after surgery, sometimes while you are still in hospital. The exact timing depends on the type of operation, your surgeon’s protocol, and how you are feeling. For major orthopaedic procedures like hip or knee replacement, a hospital physiotherapist will usually visit you on the ward to help you sit up, stand, and take your first steps with a walking aid.
Once you are home, the focus shifts to continuing that early mobility work and gradually increasing what you can do. Some people are referred to NHS outpatient physiotherapy, while others choose private post operative physiotherapy in London to access more frequent sessions or avoid waiting lists. The sooner you start structured rehab, the less likely you are to develop stiffness or lose muscle strength unnecessarily.
After less invasive surgery, such as arthroscopic shoulder or knee procedures, you might not need physiotherapy immediately. Your surgeon may advise rest for a few days before starting gentle movement. In these cases, your first physiotherapy session could be one to two weeks post-op. What matters is following your surgical team’s guidance and not assuming that resting completely is always the safest option. Prolonged immobility can cause its own problems.
What happens in the first few weeks after surgery?
The early phase of recovery is about protecting healing tissues while preventing complications. Swelling and pain are expected, but they should gradually reduce. Your physiotherapist will teach you how to manage both using ice, elevation, gentle movement, and pacing. You are not trying to do as much as possible. You are trying to do the right amount.
In the first week or two, exercises are usually simple: ankle pumps, gentle knee bends, isometric muscle contractions (where you tighten a muscle without moving the joint), and short walks around the house. These keep blood flowing, prevent stiffness, and maintain some muscle activity. If you have had abdominal surgery, you might focus on breathing exercises and gentle core activation rather than leg or arm movements. The principle is the same: move what you can, protect what needs time.
Walking re-education is a key part of this phase. Many people develop a limp or altered gait after surgery because of pain, swelling, or fear of putting weight through the affected area. A physiotherapist will observe how you walk and give you cues to improve your pattern, such as taking equal-length steps or putting more weight through your operated leg. This might feel awkward at first, but walking well early on reduces the risk of developing compensatory pain elsewhere, such as in your lower back or opposite hip.
Pain levels vary widely. Some people feel surprisingly comfortable after surgery, while others find the first two weeks quite difficult. Both experiences are normal. What is not normal is pain that worsens dramatically or does not respond to prescribed medication. If you are unsure whether your pain is within the expected range, contact your surgical team or GP rather than waiting for it to resolve on its own.
When to seek urgent medical help
Contact your surgical team, GP, or seek urgent care if you notice:
- Sudden, severe calf pain or significant swelling in one leg (possible blood clot)
- Sudden breathlessness or chest pain (seek emergency help immediately)
- Increasing redness, heat, or swelling around the surgical site
- Fever or feeling generally unwell with flu-like symptoms
- Wound discharge that smells unpleasant, or the wound opening up
- New numbness, tingling, or weakness that was not present before
- Pain that worsens significantly despite taking prescribed medication
These symptoms can indicate infection, blood clots, or other complications that need prompt assessment. Do not wait to see if they improve on their own.
How long does post-operative rehabilitation take?
Recovery timelines depend on the type of surgery, your age, fitness level, and how consistently you engage with rehab. There is no single answer, but some general patterns can help set expectations.
For knee or hip replacement, most people regain basic mobility within six to eight weeks. You might be walking without aids, managing stairs, and doing light household tasks by this point. Full recovery, meaning a return to more demanding activities like hiking, cycling, or gardening for extended periods, often takes three to six months. Some people continue to see improvements up to a year post-surgery as strength and confidence build.
Shoulder surgery, particularly rotator cuff repair, tends to follow a slower timeline because the shoulder is a complex joint and healing can be gradual. Early movement is restricted to protect the repair, then range of motion is slowly increased over weeks and months. Strengthening begins later, often around the three-month mark. Returning to overhead sports or heavy lifting might take six to nine months, sometimes longer.
Abdominal surgery, such as hernia repair or gynaecological procedures, varies widely. Some people feel ready to return to normal activity within a few weeks, while others need several months before they can lift, run, or do core-based exercises comfortably. Women’s health physiotherapy can be particularly helpful after pelvic or abdominal operations, as it addresses pelvic floor function, scar tissue, and core rehabilitation in a specialist way.
These are typical ranges, not guarantees. Some people recover faster, others more slowly, and both can be entirely normal depending on individual circumstances. Factors that influence recovery include pre-surgery fitness, whether there were any complications during or after the operation, how well you sleep, your pain levels, and whether you follow your rehab programme consistently.
Can you do too much too soon after surgery?
Yes, but it is also possible to do too little. Finding the balance is one of the main reasons people benefit from working with a physiotherapist rather than following generic advice alone. Doing too much too soon can increase swelling, irritate healing tissues, or cause a flare-up of pain that sets you back. Doing too little can lead to stiffness, muscle wasting, and a longer recovery overall.
Sharp pain during or after an exercise is a signal to ease off. Discomfort, mild aching, or a pulling sensation is more common and often acceptable, especially in the early weeks. If an exercise causes a sharp, intense pain that makes you stop immediately, that is your body telling you it is not ready for that movement yet. Dull soreness that settles within a few hours is different and usually indicates you are working within a safe range.
Some people feel pressure to push through pain because they believe that recovery has to hurt to be effective. This is not true. Progress comes from gradually increasing load and movement over time, not from forcing your body into painful positions. A physiotherapist helps you judge what is appropriate at each stage and adjusts your programme as you improve.
There is also a psychological side to this. Fear of movement, sometimes called kinesiophobia, can develop after surgery. You might feel anxious about bending your knee fully, putting weight on your leg, or lifting your arm above your head. This is understandable, particularly if you have been told to protect the area in the early weeks. A good physiotherapist recognises this and helps you rebuild confidence gradually, showing you what is safe and what your body can handle as healing progresses.
What about online rehab videos and apps?
YouTube, apps, and generic post-surgery exercise sheets can be useful, particularly if you are doing well and just need some guidance on basic movements. But they cannot assess your specific situation, watch how you move, or adjust your programme when something does not feel right. If you are recovering well and your surgery was straightforward, simple online guidance might be enough. If you have complications, unusual pain, or you are not progressing as expected, a proper assessment is worthwhile.
What are the stages of post-operative rehabilitation?
Rehabilitation is not a straight line. It happens in overlapping phases that vary in length depending on your surgery and individual recovery.
Phase 1: Protection and early movement (weeks 1-3)
The priority here is managing swelling and pain, protecting healing tissues, and maintaining basic mobility. Exercises are low-load and gentle. You might walk short distances, do ankle pumps, practise basic muscle contractions, and move the joint carefully within a pain-free range. This phase is about preventing complications like stiffness or blood clots, not about building strength yet.
Phase 2: Restoring range of motion and building control (weeks 3-8)
As pain and swelling reduce, the focus shifts to regaining full or near-full movement and improving muscle control. You will gradually increase the range of exercises, add resistance with bands or light weights, and work on balance and coordination. Walking distances increase, and you might start practising stairs, getting in and out of a car more easily, or doing tasks like putting on shoes without discomfort. Functional goals become more specific here: can you walk to the shops, cook a meal standing up, or sit comfortably at a desk for a few hours?
Phase 3: Strengthening and return to function (weeks 8-16)
Strength-building becomes the main focus. You will work on exercises that challenge your muscles more significantly, such as squats, lunges, step-ups, or resistance band work. If you are recovering from shoulder surgery, you might start with light overhead movements and progress to weighted exercises. The goal is not just to move the joint but to load it progressively so that it can handle real-life demands. This phase also includes more dynamic activities like walking longer distances, cycling, or swimming if appropriate.
Phase 4: Sport-specific or advanced rehab (3-6 months and beyond)
If you want to return to running, gym training, tennis, or other sports, this phase prepares you for those demands. It involves higher-load exercises, sport-specific drills, agility work, and gradual reintroduction of impact or explosive movements. Not everyone needs this phase. If your goal is to walk comfortably, do the gardening, and manage daily life without pain, you might finish rehab earlier. Sports injury physiotherapy expertise becomes particularly relevant here for anyone with athletic goals.
People often ask when they can drive, return to work, or travel after surgery. These timelines are individual and depend on your surgery type, pain levels, and mobility. Your surgeon or physiotherapist can give specific guidance, but general principles apply: you should be able to perform an emergency stop comfortably before driving, you should not be taking strong painkillers that impair your concentration, and you should be able to sit or move in the way your job requires before returning to work.
Does location matter when choosing a physiotherapy clinic?
Convenience matters more than people sometimes realise. Attending regular physiotherapy sessions in the weeks and months after surgery is easier if the clinic is accessible. PhysioReform is located in Bloomsbury, just a short walk from Tottenham Court Road station, which makes it straightforward to reach by tube, bus, or on foot if you live or work in Central London.
In the early weeks after surgery, travelling long distances can feel exhausting. Choosing a private physiotherapy clinic in London that is easy to reach means you are more likely to attend sessions consistently, which directly affects how well you recover. For people who cannot travel easily in the first few weeks, some clinics offer telehealth consultations as a temporary option, though hands-on assessment and treatment are usually preferable once you are able to attend in person.
Book a post-operative physiotherapy assessment in Central London
If you are preparing for surgery or have recently had an operation and want expert guidance on your recovery, our team at PhysioReform can help. We offer tailored pre- and post-operative rehabilitation in a calm, accessible clinic near Tottenham Court Road.
Book an appointment online or contact our team to discuss your needs.
Recovery after surgery is rarely linear. Some weeks you will feel stronger and more capable, other weeks you might feel frustrated or tired. Both are part of the process. Working with a physiotherapist who understands surgical rehabilitation gives you a clear plan, realistic expectations, and someone to adjust your programme when things do not go as expected. Whether you are recovering from a knee replacement, shoulder repair, or abdominal procedure, structured post-surgery physiotherapy in London can make a significant difference to how quickly and confidently you return to the life you want to live.