When to Start Physiotherapy After Surgery — and Why Earlier Is Almost Always Better

Why Early Physiotherapy Produces Better Outcomes

Research consistently shows that patients who begin physiotherapy early after surgery achieve better functional outcomes than those who delay. The reasons are biological and mechanical:

• Preventing stiffness: Scar tissue begins forming immediately after surgery. Early gentle movement prevents excessive adhesions and preserves range of motion.
• Reducing muscle atrophy: Muscle wasting begins within 24–48 hours of immobility. Early physiotherapy minimises this loss.
• DVT prevention: Gentle movement of the legs significantly reduces the risk of deep vein thrombosis in the early post-operative period.
• Pain management: Appropriate movement and positioning actually reduces pain by reducing swelling, improving circulation and preventing protective muscle spasm.
• Psychological confidence: Early guided movement helps patients feel in control of their recovery — reducing anxiety and improving motivation.

When Can Physiotherapy Start for Common Procedures?

• Total hip replacement: Day 1–2 post-op (in hospital), continuing at home from discharge
• Total knee replacement: Day 1–2 post-op, home physiotherapy from discharge
• Spinal surgery (discectomy/fusion): Usually day 1–2 with gentle mobilisation; full programme within 1–2 weeks
• ACL reconstruction: Day 1–3 post-op for early mobility; structured programme from week 1
• Shoulder surgery: Timing varies by procedure — your physiotherapist will follow your surgeon's specific protocol

What Does Early Physiotherapy Look Like?

Early post-operative physiotherapy is gentle, progressive and entirely guided by your symptoms and healing stage. It is not about pushing through pain — it's about strategic, controlled movement that promotes healing and prevents complications.

In the first 1–2 weeks, sessions typically include:

• Safe transfers and mobility techniques
• Gentle range-of-motion exercises
• Swelling and pain management strategies
• Breathing exercises where relevant
• Walking practice with appropriate aids
• Basic strengthening to prevent muscle loss

Why Home Visits Are Ideal in the Early Post-Op Period

In the days and weeks immediately after surgery, travelling to a clinic is genuinely difficult — sometimes impossible. Home visit physiotherapy solves this completely. Your physiotherapist comes to you, starts your rehabilitation in your own environment, and ensures you're progressing safely from day one without the barrier of travel.