Eight weeks of strength before (or instead of) surgery

By the end of eight weeks you will do three strength movements with good form, twice a week, with a written record showing the weight or reps have gone up.

Why this works

Prehabilitation, getting stronger before an operation, is now recommended by many surgical teams for hip and knee replacements. The muscles around a joint do the walking and stair-climbing afterwards, and the stronger they are on the day, the sooner those come back. Trials of pre-surgery exercise have reported shorter hospital stays and quicker return to independent walking.

You do not need an operation booked for this to be worth doing. Leg and hip strength keeps you off the floor and out of the chair. Older adults who take up resistance training gain measurable strength within six to eight weeks, and beginners improve fastest.

The plan is narrow on purpose: three movements, twice a week, one small increase each week. A written log turns “I think I’m stronger” into “4 kg more than week one”, and the number keeps people turning up.

Before you start

Check with your GP first. If surgery is coming, ask the consultant or physiotherapist: “What exercise would make this go better?” Take this plan along.
Kit: a sturdy chair, a rucksack you can add tins to, a resistance band, and later a kettlebell or dumbbells (£20–£40).
Cost: one session with a physiotherapist or trainer who works with over-60s, £40–£70, is the best money in this plan. NHS physiotherapy may be available if surgery is booked. Council gyms run over-60s inductions, often free.
Where: search “strength and balance class” plus your town; Age UK and Later Life Training list instructors. (In the US, SilverSneakers classes or a physical therapist.)

The plan

The three movements: sit-to-stand (squat), hip hinge (the deadlift pattern, bag first, kettlebell later), and row (band or dumbbell).

Week	Do this	How often	Notes
1	Sit-to-stand, hands on knees, 2 sets of 5. Hinge with an empty bag, 2 × 8. Band row, 2 × 8.	2 sessions, 15 minutes	Never done any of this? Higher chair, 3 reps not 5. That counts.
2	Same, add 1 rep to each set. Book the physio or trainer for week 3.	2 sessions	Write down every set.
3	Have all three movements checked by the professional.	1 session plus 1 at home	A straight back is the whole hinge.
4	3 sets of each. Two tins in the bag. Hands off knees if you can.	2 sessions, 20 minutes	Muscle ache next day is normal. Joint pain is not; back off and ask.
5	Swap the bag for a 6–8 kg kettlebell. Row with a heavier band or 3–5 kg dumbbell.	2 sessions	At a gym: the same with a trap bar, with an instructor.
6	Add a rep or 1–2 kg to each movement. Sit-to-stand holding a weight at your chest.	2 sessions	One increase per movement per week, no more.
7	Same again. Try a lower chair or a slower descent (3 seconds down).	2 sessions	Slow lowering is where much of the strength is built.
8	Re-test the Track it table. Compare with week 1.	2 sessions	Then keep going.

If it goes wrong

Knees hurt on the sit-to-stand. Higher seat, shorter range, and ask the physio. Pain that builds is a signal to stop.
Lower back aches after the hinge. A rounded back or too much weight. Back to the empty bag; film yourself from the side.
You keep missing the second session. Same two diary slots every week, paired with something you already do.
Surgery arrives before week 8. Good; you are stronger than you were. Stop when the surgeon says, restart with their physio, then come back to week 1.

Track it

Measure	Start (week 1)	End (week 8)
Sit-to-stands in 30 seconds, no hands
Hinge weight (kg) for 8 clean reps
Row weight or band colour for 8 reps
Stairs: how they feel (one word)
Sessions completed (out of 16)

What next

Strong at 60, our 12-week plan, picks up exactly where week 8 leaves off, with the “why” behind each exercise and a progress log.
If a gym feels right, ask about a lifting-for-over-50s session. British Powerlifting runs masters age groups from 40 upwards; a local masters meet is a good afternoon out.
If a health event set you back, the 30-Day Restart is the gentle way back to this plan.

General information, not medical advice. Check with your GP before starting a new exercise programme.