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Surgery day gets circled on the calendar months in advance. The knee replacement, the ACL reconstruction, the shoulder repair, the spinal fusion — whatever it is, most people spend their energy preparing for the operation itself and very little preparing for the months afterwards. Then the surgery happens, the anaesthetic wears off, and the real work starts: getting the joint moving again, getting the muscles firing again, and getting back to actually using the body the way you did before. That work is physiotherapy, and it starts earlier and matters more than most people expect.
At Pre and Post-Operative Physiotherapy sessions in Truganina and Tarneit, we see the full range — people in their sixties and seventies recovering from hip and knee replacements, younger patients back on their feet after ACL or rotator cuff surgery, and people at various stages of recovery from spinal, foot and ankle, or other orthopaedic procedures. The questions are almost always the same: when can I start moving, how long will this take, and am I doing this right? This article walks through what pre- and post-op physio actually involves, what a realistic recovery timeline looks like, and what to expect if you're booking in with us before or after an operation.
The term covers two distinct phases of care that are easy to confuse. Pre-operative physiotherapy, sometimes called "prehab," happens in the weeks before your surgery. Post-operative physiotherapy is everything that happens afterwards, from the first gentle movements in hospital or at home through to the final stages of getting back to sport, work, or simply gardening without thinking about your knee.
Not everyone gets both. Plenty of people only see a physio after their operation, and that's completely fine — post-op rehab on its own still gets excellent results for most people. But if you know surgery is coming and there's time to prepare, prehab is worth taking seriously. It isn't a formality your surgeon mentions in passing. It changes how the first few weeks after surgery actually feel.
Both phases share the same underlying goal: restoring the joint or area to as close to full function as possible, in a way that respects what the surgeon has actually done inside your body. A physio working with post-surgical patients isn't just prescribing generic exercises. They're working from your surgical report, your surgeon's specific protocol (many orthopaedic surgeons in Melbourne have their own preferred rehab timelines and precautions), and what your body is actually showing them at each visit.
If you're waiting on a knee or hip replacement, the instinct is often to rest and protect the joint until surgery day. That instinct is usually wrong. Research into "prehabilitation" for joint replacement consistently shows that patients who go into surgery stronger, with better range of motion and a clearer understanding of what recovery will involve, tend to have smoother post-operative courses. One often-cited finding is that structured pre-operative physiotherapy is linked to a meaningfully lower need for post-acute care such as inpatient rehab facilities after the operation — in other words, more people get to recover at home rather than in a rehab ward, simply because they went in better prepared.
Prehab for a knee or hip replacement generally focuses on a few things. Strengthening the muscles around the joint — quadriceps, hamstrings, glutes, and calves for the lower limb — so there's a stronger base to rebuild from after surgery. Working on balance and general conditioning, since a fall in the weeks before or after surgery can seriously complicate things. Some general cardiovascular work, often on a stationary bike or in a pool, to keep fitness up despite a painful joint. And, just as importantly, education: understanding what the first two weeks will actually feel like, what movements to avoid early on, and what "normal" post-surgical pain and swelling looks like versus something that needs a phone call.
For people booked in for ACL reconstruction, shoulder surgery, or spinal procedures, prehab looks a bit different but the principle holds. Going in with better strength, better movement control, and a realistic mental picture of the recovery process tends to produce a better outcome than going in cold. If your surgery date is still a few weeks or months away, it's worth asking your physio whether a short prehab block makes sense for your situation.
Orthopaedic surgery covers a lot of ground, and the rehab looks different depending on what's actually been operated on. The most common categories we see through the clinic:
Each of these has its own typical timeline and its own set of precautions, which is why the first post-op session usually starts with a good look at exactly what the surgeon did and what restrictions are in place, rather than jumping straight into a standard exercise sheet.
Knee and hip replacements, while both classed as joint replacements, actually rehab quite differently. Knee replacement recovery tends to be more painful in the first few weeks and puts more emphasis on regaining bend and straightening the joint fully, because a knee that heals stiff is hard to fix later without further intervention. Hip replacement recovery is often less painful day to day but comes with specific movement precautions in the early weeks — depending on the surgical approach used, you might be asked to avoid certain combinations of hip flexion, rotation, and crossing your legs, and a physio familiar with your surgeon's approach will build the program around those specific limits rather than a generic hip protocol.
ACL reconstruction sits at the other end of the spectrum in terms of who we typically see for it. It's usually younger patients, often footballers, netballers, or other field and court sport athletes in their teens, twenties, or thirties, and the goal isn't just "walking normally again" but a full return to cutting, pivoting, and landing under load. That longer horizon means ACL rehab programs are usually the most structured and criteria-based of anything we run, with specific strength and hop-test benchmarks that need to be met before progressing to the next stage, rather than a program based purely on how many weeks have passed.
This is the phase most people dread and, honestly, it's usually not as bad as feared — but it does need to be handled properly. In the first one to two weeks after most joint or ligament surgeries, the focus is on a fairly narrow set of goals: managing pain and swelling, protecting the surgical site, restoring gentle range of motion within whatever limits the surgeon has set, and getting you safely mobile, whether that's walking with crutches, a frame, or just carefully around the house.
Swelling management matters more than people expect. Elevation, ice, gentle ankle pumps if it's a lower limb surgery, and light compression all help keep swelling from becoming the thing that limits your movement. A physio will usually check your wound is healing as expected (without getting involved in wound care itself, which stays with your surgical team or GP), check your gait if you're using crutches or a frame, and start you on a small number of very specific exercises — often things like heel slides, quad sets, or pendulum shoulder exercises, done little and often rather than in one long session.
This is also where the education from prehab, if you had it, tends to pay off. Knowing in advance that some swelling, some pain with movement, and some frustration at how slow things feel is completely normal takes a lot of the anxiety out of this stage. What's not normal — and what we'd want to know about straight away — is covered further down.
By the three-to-six-week mark, most patients are past the sharpest pain and starting to see the shape of their recovery. For a knee replacement, this is usually where the focus shifts to regaining functional range of motion — enough knee bend to get in and out of a car, sit comfortably, and manage stairs — alongside progressive strengthening of the muscles around the joint. For a hip replacement, it's often about normalising your walking pattern, since most people compensate around a sore hip in ways that become habits if they're not addressed early.
For ACL reconstructions, this period is where quad and hamstring strength work really ramps up, along with balance and proprioception drills, because the graft is still maturing and needs protecting even as movement improves. Shoulder surgery patients are usually moving from passive range of motion (where the physio or the patient's other arm does the moving) into active-assisted and then active movement, still respecting whatever precautions the surgeon has set around rotation and loading.
This is also the stage where people tend to either progress well or start plateauing, and it's a good example of why physio-guided rehab tends to outperform a generic exercise sheet from the hospital. Progressing too fast risks setting recovery back with swelling or pain flares; being too cautious leaves stiffness and weakness to deal with later, which is often harder to shift. A physio who's seeing you regularly can adjust the program in both directions as your body responds.
Somewhere around the two-to-three-month mark, most patients are walking without aids, managing daily tasks without much thought, and starting to ask the question that's usually been on their mind the whole time: when can I get back to golf, gardening, netball, or just carrying the shopping without worrying about it?
This later stage of rehab is about closing the gap between "functional" and "fully recovered." It typically includes more demanding strengthening work, movement patterns specific to whatever you actually want to get back to, and honest conversations about realistic timeframes. Full recovery from a knee or hip replacement, in terms of strength and confidence rather than just healing, commonly takes six to twelve months, and ACL reconstruction rehab protocols in Australia typically don't clear a return to pivoting sport until nine months at the earliest, often closer to twelve. That's not a failure of the surgery or the rehab — it's simply how long tissue takes to remodel and how long it takes to rebuild the strength and confidence to trust the joint under real load again.
If you've never done structured post-surgical rehab before, it helps to know roughly what to expect walking in. The first session after surgery is the longest and most detailed. We'll go through your surgical report or discharge summary if you have one, ask about your surgeon's specific protocol and any precautions, check your current range of motion and strength against what's expected for your stage of recovery, and look at how you're moving generally — your gait, how you're using aids like crutches or a frame, and where you're compensating.
From there we build a program specific to your surgery, your goals, and where you actually are, not a generic template. That might include hands-on manual therapy to help with stiffness and swelling, guided exercise progressions done in the clinic and then continued at home, and for some patients, adjunct treatments like clinical pilates once they're far enough along, which is particularly useful for rebuilding core and hip control after lower limb or spinal surgery in a controlled, low-impact environment.
Sessions become less frequent as recovery progresses — often weekly in the early stages, then fortnightly, then more spaced out as you move into independent exercise with occasional check-ins. How long the whole process takes varies enormously depending on the surgery, your starting fitness, and how your body responds, so we'd rather give you an honest, individual estimate at your first visit than a generic number that doesn't apply to your situation.
We run this service from both of our clinics in Melbourne's west, with locations at Physio Truganina and Physio Tarneit. Plenty of patients coming through for post-op rehab live locally in Truganina, Tarneit, Point Cook, Werribee, and the surrounding Wyndham suburbs, and with the area's population still growing quickly, we've seen steady demand for this kind of structured, surgeon-informed rehab rather than a one-size-fits-all exercise sheet.
Post-surgical rehab isn't just "do these exercises." Depending on the stage of recovery and what's actually going on with your tissue, a physio might draw on a few different approaches. Manual therapy — joint mobilisations, soft tissue work, and stretching — helps with stiffness, particularly around scar tissue and areas that have been immobilised. Progressive exercise, moving from isometric holds through to loaded functional movement, is the backbone of most programs and is what actually rebuilds strength and control over time.
Gait retraining is a big part of lower limb rehab specifically, since months of protecting a sore joint before surgery often leaves people with compensatory walking patterns that don't just disappear once the joint itself is fixed. Balance and proprioception work matters for almost every lower limb surgery, both for fall prevention in older patients and for confidence in returning to sport in younger ones. And for patients managing significant swelling or pain, particularly in the early weeks, some physios use adjuncts like ice, compression, or electrotherapy modalities alongside the exercise-based program, though the exercise itself remains the main driver of recovery in almost all the current evidence.
The exercises you do at home matter more than the ones you do in the clinic, simply because of the numbers — you might see your physio once a week, but you're living in your body every day. A realistic home program is usually short, specific, and done multiple times a day rather than one long session that's easy to skip.
Consistency beats intensity here. Doing your prescribed exercises properly for five or ten minutes, two or three times a day, generally produces better results than one heroic 45-minute session followed by three days of nothing. It's also worth tracking how you're going — noting your knee bend, how far you can walk, or how much weight you can put through the joint — so that changes, good or bad, get picked up early rather than three weeks down the track.
If something in your home program consistently causes sharp pain rather than the expected discomfort of stretching a stiff joint or working a fatigued muscle, that's worth raising at your next session rather than pushing through it or quietly stopping altogether. Both extremes tend to slow recovery down.
Having worked with a lot of post-surgical patients, a handful of patterns come up again and again, and most of them are avoidable once you know to watch for them.
The first is doing too much too soon on a good day. Recovery isn't linear — you'll have days where the joint feels great and you're tempted to go for a longer walk, do extra reps, or skip the ice and elevation because you feel like you don't need it anymore. Often the next day brings a flare of swelling and pain that sets you back further than if you'd paced yourself. Progress in early post-op rehab tends to reward steady, boring consistency over enthusiastic bursts.
The second is the opposite problem: becoming overly protective of the joint out of fear, and avoiding movement that's actually safe and necessary. This is common after a painful early recovery, and it can lead to ongoing stiffness or a limp that outlasts the actual healing process by months. Part of a physio's job in the middle stages of recovery is reassurance — helping you understand which movements are safe to push into, based on where you actually are in the healing timeline, not just how nervous the joint still feels.
The third is stopping physio, or drifting away from the home program, once the sharp pain has settled but before strength and control are actually restored. A knee or hip can feel "fine" for daily activities well before it's strong enough for its full previous demands, whether that's sport, physical work, or just confidently managing uneven ground. Finishing the strengthening phase of rehab, not just the pain-relief phase, is what tends to prevent problems reappearing six or twelve months down the track.
Turning up prepared makes the first session more useful. If you have one, bring your surgeon's discharge summary or operation report — it tells us exactly what was done, which matters more than you'd think, since two patients with the same diagnosis can end up with quite different surgical techniques. Bring a list of any specific precautions or instructions your surgeon has given you, particularly around weight-bearing status, range of motion limits, or movements to avoid.
It's also worth bringing whatever mobility aids you're currently using — crutches, a walking frame, or a brace — so we can check they're fitted and being used correctly, which is more often an issue than people expect. Comfortable, loose clothing that allows access to the surgical area helps, as does a list of your current pain medication, since that can affect how much you're able to move comfortably during the session and how we interpret what you're reporting.
If you haven't had surgery yet and you're booking a prehab session, bringing your surgery date and any information from your surgeon about the planned procedure helps us tailor the program to what's actually ahead, rather than generic pre-surgery advice.
Most of what you'll feel after surgery — swelling, stiffness, aching, some sharp twinges with certain movements — is a normal part of the healing process. A smaller set of symptoms is not normal and is worth contacting your surgeon, GP, or physio about promptly rather than waiting for your next scheduled appointment:
None of this is meant to cause alarm — the large majority of post-surgical recoveries go smoothly. It's just worth knowing the difference between "this is uncomfortable and that's expected" and "this needs a phone call," because catching a genuine complication early makes a real difference to how it's managed.
How soon after surgery should I start physiotherapy?
It depends heavily on the procedure, but for most joint replacements and many other orthopaedic surgeries, gentle movement starts within a day or two, often while you're still in hospital. Formal outpatient physiotherapy typically begins within the first one to two weeks once you're home, though your surgeon's specific instructions always take priority over any general timeline.
Do I really need pre-surgery physio if I'm already reasonably fit?
Even reasonably fit, active people tend to benefit from a short prehab block, mainly because the specific muscles around a surgical joint are often weaker or more inhibited than general fitness would suggest, particularly if you've been favouring that side due to pain. It's not compulsory, but for anyone with a few weeks up their sleeve before surgery, it's worth a conversation with a physio about whether it's likely to help in your specific case.
How many physio sessions will I need after surgery?
There's no fixed number, and be wary of anyone who gives you one before assessing you. Frequency and total duration depend on the surgery, your goals, and how your body responds. Many patients move from weekly to fortnightly to monthly sessions over a period of a few months, but a straightforward knee arthroscopy recovery looks very different from a spinal fusion recovery, and the plan should reflect that.
Can physiotherapy after surgery be done as a home visit?
For some patients, particularly those with limited mobility in the first couple of weeks after surgery, or NDIS participants managing more complex needs, a home-based approach can make early rehab far more manageable. If getting to a clinic in the first fortnight isn't realistic, it's worth asking about options rather than assuming clinic visits are the only path.
Will physiotherapy be painful?
Some discomfort is a normal part of restoring range of motion and rebuilding strength in tissue that's been through surgery, but a good rehab program shouldn't be consistently sharply painful. There's a real difference between the expected discomfort of working a stiff joint and pain that suggests something's being pushed too hard, and a physio should be adjusting your program based on that difference rather than a fixed script.
What if my recovery seems slower than what I've read online?
Recovery timelines you find online, including the general ones in this article, are averages across a lot of different people, surgeries, and starting points. Age, general health, the specific surgical technique used, and how much muscle wasting had already occurred before surgery all affect the pace of recovery. A slower-than-average timeline isn't automatically a problem — it's worth discussing with your physio, who can compare your actual progress against expected milestones for your specific situation rather than a generic online timeline.
Do I need a referral to start physiotherapy after surgery?
Many patients are referred directly by their surgeon, particularly for structured post-op programs, but you don't strictly need a referral to book in privately. If you have a referral or a surgical report, bringing it to your first appointment helps us build a program that fits your surgeon's specific protocol from day one.
Is post-surgical physiotherapy covered by Medicare or private health insurance?
Coverage depends on your individual circumstances. Private health extras cover often contributes towards physiotherapy costs, and the level of rebate varies by fund and policy, so it's worth checking with your insurer before your first visit. Medicare rebates for physiotherapy are generally limited to specific circumstances, such as an Enhanced Primary Care (EPC) plan from your GP for patients with a chronic condition, or care linked to certain compensation schemes like WorkCover or TAC. If your surgery relates to a workplace or transport accident claim, let us know, as the funding pathway is usually quite different from a standard private appointment.
What's the difference between seeing a physiotherapist and an exercise physiologist after surgery?
There's overlap, but the general distinction is that physiotherapists are trained to assess and treat in the earlier, more clinical stages of recovery — managing pain, swelling, wound-adjacent issues, and movement restrictions directly related to the surgery — while exercise physiologists tend to come in later, focused on longer-term strength and conditioning once the acute recovery phase has settled. Many patients see a physiotherapist through the bulk of their post-surgical rehab and don't need to see anyone else, but for some longer-term or chronic conditions, a handover to exercise physiology further down the track can make sense.
Surgery is the headline event, but the months either side of it are where a lot of the actual outcome gets decided. Going in stronger, understanding what to expect, and having a clear, individually adjusted plan for the weeks and months afterwards all make a measurable difference to how recovery feels and how quickly you get back to doing what you actually want to do, whether that's playing sport, keeping up with grandkids, or just walking without thinking about it.
If you've got surgery coming up, or you're already a few weeks into recovery and want a program built around your specific situation rather than a generic sheet, our Pre and Post-Operative Physiotherapy service at both our Truganina and Tarneit clinics is built for exactly this. Bring whatever information you have from your surgeon, and we'll take it from there.
