Physical Therapy for Joint Replacements

Joint replacement is a type of orthopedic surgery in which an arthritic or dysfunctional joint surface is replaced with prosthesis. Joint replacement is considered when severe joint pain or dysfunction is not helped by less invasive therapies.

Joint replacement surgery is quite common. Nearly three-quarters of a million Americans have a hip or knee replaced each year. Other frequent replacements include shoulders and ankles.

Pre-operative consultations


Physical therapy before joint replacement can significantly help recovery after surgery. A therapist can design exercise programs to build muscles, reduce pain, increase range of motion and speed recovery after surgery.

Research has found that pre-operative therapy provides a head start on rehabilitation by stretching and strengthening the muscles around the joint to be replaced. Many times such interventions reduce the time a patient is hospitalized or has to remain in an in-patient rehabilitation center.

In addition, physical therapists will offer instruction on precautions patients should follow after the surgery. The physical therapist will also review exercises that will be required postoperatively.

Post-operative rehabilitation


Physical therapy is the most important tool to help patients recover function after joint-replacement surgery. A careful, well-planned rehabilitation program is critical to success. Patients should start gentle physical therapy as soon as possible after the operation. With the proper therapy program, patients can regain full use of their new joints, with complete range of motion.

It’s important to start therapy as quickly as possible following surgery. Therapy may begin as soon as the day of or shortly after the operation. Initially a patient may have one or two therapy sessions per day. The goal is to strengthen muscles and make sure patients are safe as they continue their recovery.

A graded exercise program is needed initially, as the patient’s muscles take time to heal after surgery. Exercises for range of motion of the joints and ambulation initially should not be strenuous. Later when the muscles have healed, the aim of exercise expands to include strengthening and recovery of function.

In addition, an occupational therapist may help patients find ways to safely perform activities of daily living in the days or weeks following surgery. The therapist may discuss how to safely bathe, dress, prepare food and function independently at home.

Finally, physical therapists also work with patients who might have specific needs, such as an equestrian who wants to ride again after surgery, or a swimmer who wants to resume an exercise routine. Along with targeted and specific exercises, therapists give patients extra motivation as they continue their road to recovery.