Preparing for Orthopedic Surgery Blog

Short answer: To prepare for orthopedic surgery, use the weeks before your date to get your body, home and routine ready. Stay active with low-impact exercise, stop smoking, keep blood sugar steady and ask about your vitamin D level. Raise your daily protein about 1 week before. Follow your fasting rules exactly the night before. Afterward, protein plus physical therapy carries you.

Facing orthopedic surgery, whether after a sports injury or years of wear on a joint, usually brings one big question: "How long until I am back to normal?" For athletes it is "How soon can I play again?" The answer depends on the operation and on you. You cannot rush tissue repair, but you can walk into surgery stronger, better fed and better organized, which removes many of the things that slow people down. This guide walks you through it week by week. Your surgical team's instructions come first, so use it as a checklist to talk through with them.

Your orthopedic surgery countdown at a glance

1. What shapes your recovery: age, health, weight and bone

Your age, overall health and fitness all play a part in how quickly you recover. In general, younger and more active people bounce back sooner than people who are sedentary or carry extra weight. Some of this you cannot change. Some of it you can.

• Weight and joint load: Extra weight adds load to your hips and knees with every step. In a study of 142 older adults with knee arthritis who were overweight, each pound of weight lost was linked with about 4 pounds less load on the knee per step [1]. So 20 pounds lost works out to about 20 x 4 = 80 pounds less load on the knee with each step. That said, the last few weeks before surgery are not the time for a crash diet: your body needs protein and energy to heal. Ask your surgeon what goal is realistic for you.
• Age and tissue quality: Younger patients usually have healthier tissue and better bone quality, which helps healing. Older patients, or people with conditions like osteoporosis, may need longer because of lower bone density or thinner tissue.
• Bone health: Strong bones give a repair something solid to hold on to. Post-menopausal women, who are at higher risk of low bone density, should focus on calcium and vitamin D in their diet along with strength training. Low vitamin D is common before orthopedic surgery: 43% of patients in one large hospital study had low levels [2]. It is worth asking your surgeon whether to check yours.

2. Prehab: condition your body before surgery

Whether you are an athlete or not, the shape you are in before surgery affects the work you face after it. "Prehab" means exercising before surgery to prepare for the physical demands of the operation and rehab. It has real research behind it. A review of 35 trials with 2,956 people having hip or knee replacement found that exercise and education before surgery led to small to moderate gains in function afterward, stronger thigh muscles after knee replacement, and shorter hospital stays after both operations [3].

• Stay active: US guidelines recommend at least 150 minutes a week of moderate activity for adults, plus muscle-strengthening work at least 2 days a week [4]. That can be 30 minutes, 5 days a week. Swimming, cycling, rowing and the elliptical keep you fit without pounding your joints. High-impact exercise like running can aggravate a painful joint.
• Mix it up: Rotating between activities works different muscle groups, lowers the risk of overuse injuries and keeps you interested. For example, swim one day, bike the next and use the elliptical later in the week.
• Get the right exercises for your joint: Some movements are off limits with a torn ligament or a damaged rotator cuff. Ask your surgeon or a physical therapist for a prehab plan that fits your injury.

3. Stop smoking and steady your blood sugar

This is the advice people least want to hear, and one of the best supported. A review of 140 studies with 479,150 patients found that smokers had about twice the odds of delayed wound healing and about 2.4 times the odds of a bone or fistula not healing, compared with nonsmokers [5]. In 4 randomized trials in the same review, programs that helped people quit around surgery cut surgical site infections (odds ratio 0.43). If you smoke or vape nicotine, ask your team for quit support as early as you can.

Blood sugar matters too. In a study of 40,836 adults having surgery in 53 hospitals, people without diabetes whose blood sugar ran high around surgery had more complications: odds of 1.3 for levels of 125 to 180 mg/dL and 1.6 for 180 mg/dL or higher [6]. That study shows a link, not proof that lowering blood sugar prevents problems. If you have diabetes, work with your doctor on control in the weeks before surgery and ask how to handle your medicines on the day.

4. Eat for surgery: protein first

Good nutrition is a key part of getting ready. A diet built on whole foods, fiber and modest amounts of sugar and fat helps you keep a steady weight and gives your tissues what they need. Protein deserves the most attention, because surgery and time in bed both pull on your muscle stores.

How much protein do you need?

European clinical nutrition experts (ESPEN) estimate that surgical patients need about 1.5 g of protein per kg of ideal body weight per day [7]. Here is the arithmetic:

• 70 kg (154 lb) ideal body weight: 70 x 1.5 = 105 g of protein a day
• 90 kg (198 lb) ideal body weight: 90 x 1.5 = 135 g of protein a day

For adults over 65 who are recovering from illness, an international expert group suggests 1.2 to 1.5 g per kg a day [8]. The same group notes that people with severe kidney disease may need to limit protein, so ask your doctor first if that applies to you.

Spread it out, and do not forget leucine

A small lab study found that eating about 30 g of protein at each of three meals switched on muscle building about 25% more over a day than eating most of it at dinner [9]. It was a study in healthy adults, not surgery patients, but a protein-rich breakfast is an easy habit to start now.

Leucine is an amino acid that acts as a signal for muscle building. Lean meat, fish, eggs, dairy and legumes are good sources. Leucine on its own has not been shown to build muscle in healthy older men [10], so think of it as part of getting enough total protein, not a shortcut. Our pre-surgery nutrition guide has a week-by-week food plan, and our hub on what to eat after surgery picks up where it leaves off.

5. Medicines and supplements: give your team the full list

Some medicines and supplements need to be paused before surgery, and only your team can tell you which. Write down everything you take, including vitamins, herbal products and over-the-counter pain relievers, and bring the list to your pre-op visit.

• Blood thinners: follow your surgeon's instructions on when to stop and restart. Never stop a prescribed blood thinner on your own.
• Diabetes and weight-loss medicines: tell your team about these, including injectable ones, because some change how your fasting and anesthesia are planned.
• Fish oil and turmeric: hospital stop lists often include them. In a trial of 1,516 heart surgery patients, fish oil taken before and after surgery did not increase major bleeding [11]. If you use OptiFuel, which contains small amounts of both, Thrive's guidance is that there is no need to stop it before surgery. Your surgeon's instructions still come first, so show them the label.

6. Get your home and your helpers ready

After knee, hip or shoulder surgery you may be on crutches, a walker or in a sling, and simple tasks get harder. Do the setup now: move things you use daily to waist height, clear loose rugs and cords, set up a spot to sleep and rest near a bathroom, and line up someone to help with meals and driving for the first week. Freeze a few protein-rich meals and keep easy options like Greek yogurt, eggs and cottage cheese in the fridge. Our checklist on how to prepare your home for orthopedic surgery recovery goes room by room.

7. Get your mind ready: set realistic expectations

Getting ready is not only physical. A clear picture of what lies ahead makes the slow weeks easier to handle.

• Know your timeline: Recovery time depends on the operation and on you. Some procedures let you return to daily life quickly, while others, such as ACL reconstruction or rotator cuff repair, are measured in months. Ask your surgeon for the milestones to expect, so you can set goals you can actually reach.
• Be ready to commit: People who have weighed the risks and benefits and know why they chose surgery tend to find it easier to stick with the daily exercises, meals and sleep that recovery asks for.
• Athletes have extra work: For athletes, recovery is not just healing. It means regaining strength, fixing movement patterns and getting back to pre-injury performance, which takes a focused, tailored rehab plan.

8. The night before and the morning of surgery

Fasting rules exist to keep your stomach empty during anesthesia, so they are not optional. For healthy adults having elective procedures, the American Society of Anesthesiologists allows clear liquids up to 2 hours before, a light meal up to 6 hours before, and suggests 8 or more hours after fried or fatty food or meat [12]. Your hospital may set stricter rules, such as nothing after midnight. If it does, follow your hospital.

• Dinner: keep it light and lower in fat, and finish by the cut-off your team gives you.
• Carbohydrate drink: US anesthesia guidelines support carbohydrate clear liquids up to 2 hours before elective procedures in healthy adults [13]. In a trial of 252 adults, people who had a carbohydrate drink the evening before and the morning of surgery felt less hungry and less anxious while they waited than people who fasted overnight [14]. If you have insulin-dependent or poorly controlled diabetes, check with your care team before using any carbohydrate drink [7]. Our carb loading drink guide covers choosing one and timing it.
• Morning of: only what your team allows. A protein shake counts as food, not a clear liquid.

9. What happens after surgery: a realistic timeline

Your commitment to recovery starts the moment you leave the operating room. A good recovery plan combines physical therapy, nutrition and steady rehab. Every operation is different and your surgeon's timeline wins, but here is what the first weeks usually look like and what research has and has not shown.

Day 1 to week 1

Appetite is often low, sleep is broken and moving takes effort. Getting some protein in each day is the realistic goal, not perfect meals. Small, frequent meals and a shake between them are often easier to finish than a full plate. Opioid pain medicines commonly cause constipation; MedlinePlus advises drinking more fluids, moving more, eating more fiber and using stool softeners [15]. Get up and move as soon as your team allows. In older men with one leg in a cast for 5 days, extra protein on its own did not reduce the muscle and strength they lost [16]. Protein supports muscle best when you are also using it.

Weeks 2 to 6

Physical therapy ramps up, and this is where steady protein earns its place.

• In a small knee replacement trial, people who took essential amino acids twice a day from a week before to 2 weeks after surgery lost less thigh muscle by 6 weeks than the placebo group (about 6% vs 18%) [17].
• A follow-up trial also found less thigh muscle loss at 6 weeks, but strength and walking tests ended up about the same in both groups [18].
• In a 60-person knee replacement trial, a daily amino acid supplement from a week before to 2 weeks after surgery was linked to keeping more front-thigh muscle over the first month and getting back to everyday tasks sooner [19].
• In a small hip fracture study, people who drank about 32 g of whey protein around their rehab sessions gained more leg strength over two weeks than people who did rehab alone [20].

These studies used amino acid blends or whey at their own doses, not any Thrive product. And a 2025 review of 10 orthopedic surgery trials found that amino acid supplements helped protect muscle in some studies but not all [21]. The honest takeaway: enough protein, paired with movement, helps you hold on to muscle while you heal. No study promises you will heal a set number of days sooner.

Physical therapy is not optional. It limits stiffness and brings back strength and flexibility. Follow the plan your orthopedic specialist prescribes, even after your insurance-covered sessions end, and keep doing your home exercises between visits. Look for a licensed physical or occupational therapist who specializes in orthopedic rehab.

After 6 weeks

Strength work builds. In healthy adults whose leg had been in a cast, creatine combined with strength training helped thigh muscle size and power come back faster during rehab [22]. In a trial of creatine around knee replacement, though, it did not improve strength or function in the first month [23], so your therapy plan drives early progress. Once you are eating normally and hitting your protein target from food, you may not need a supplement at all.

For procedure-specific detail, see our guides to supplements after knee replacement, supplements after hip replacement and supplements after rotator cuff surgery.

If you use the Surgical Protocol Kit: what a day looks like

If hitting your protein target from food alone feels unrealistic, a daily shake can close part of the gap. Thrive Protocol's Surgical Protocol Kit is built for the weeks around a planned operation. It contains daily OptiFuel packets, 2 OptiCharge packets and a shaker.

• OptiFuel (one packet a day): 25 g of whey protein with 3 g of leucine, plus glutamine, collagen, omega-3s, curcumin, vitamin C, vitamin D and other vitamins. It is made in the USA, Informed Sport tested and thin enough to drink through a straw. One packet covers about a quarter of the 105 g example above (25 / 105 = 0.24), so food still does most of the work.
• OptiCharge (night before only): a complex carbohydrate and electrolyte drink with 46 g of carbohydrate per packet.

How the routine runs: start OptiFuel about 1 week before surgery. Mix one packet with 12 to 16 oz of water, milk or non-dairy milk and drink it between breakfast and lunch. On the night before surgery, and only if your team approves, mix each OptiCharge packet with 12 to 16 oz of water and drink both at bedtime, within your fasting rules. Restart OptiFuel when you are eating again after surgery and keep going through rehab.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Check with your doctor first if this applies to you

• Kidney disease: you may need to limit protein [8]. Ask before adding protein shakes or creatine.
• Diabetes: for most people with diabetes the pre-op drink is safe, but if you are insulin dependent or your diabetes is poorly controlled, check with your physician before using OptiCharge.
• Blood thinners: tell your team about every supplement you take, including the small amounts of fish oil and turmeric in OptiFuel.
• Milk allergy: OptiFuel is whey-based and contains milk.
• Special diets: if you are on a bariatric or bowel-prep diet, follow the stages your team gives you.

Frequently asked questions

How far ahead should I start preparing for orthopedic surgery?

Start as soon as you have a date. Exercise, quitting smoking and blood sugar control take the longest to change. Prehab programs before hip and knee replacement have been linked with better function and shorter hospital stays [3]. Raise your daily protein about 1 week before surgery, and set up your home about 2 weeks out.

What should I eat before orthopedic surgery?

In the weeks before, focus on regular meals with protein at each one, aiming for about 1.5 g of protein per kg of ideal body weight a day (105 g at 70 kg) [7]. The night before, eat a light, lower-fat dinner and stop by the time your team gives you.

Should I lose weight before knee or hip surgery?

If you carry extra weight, losing some can ease the load on your joints: each pound lost was linked with about 4 pounds less knee load per step in one study [1]. Avoid crash diets close to surgery, since your body needs protein and energy to heal. Ask your surgeon what target makes sense.

Do I need to stop fish oil or turmeric before surgery?

Ask your surgeon, because rules differ between hospitals and blood thinners change the picture. Fish oil did not increase major bleeding in a 1,516-patient heart surgery trial [11]. If you use OptiFuel, Thrive's guidance is that there is no need to stop it before surgery, but your surgeon's instructions come first.

Can I exercise before orthopedic surgery?

Usually yes, and it helps. Low-impact options like swimming, cycling and the elliptical keep you fit without stressing the joint. Ask your surgeon or physical therapist which movements are safe for your specific injury.

How long does it take to recover from orthopedic surgery?

It depends on the operation. Some people are back to daily life within weeks, while ligament and tendon repairs take months of rehab. Ask your surgeon for the milestones that apply to you, and keep up physical therapy and steady protein through that whole stretch.

The bottom line

Preparing for orthopedic surgery means getting your body, mind, home and nutrition ready before the big day. Stay active, stop smoking, keep blood sugar steady, eat enough protein, follow your fasting rules and commit to physical therapy afterward. None of it guarantees a set recovery time, but together these steps give your body the best conditions to heal and help you get back to the activities you love as safely as possible.

References

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3. Moyer R et al. The value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis. JBJS Rev. 2017;5(12):e2. PubMed 29232265
4. US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition: top 10 things to know. odphp.health.gov
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13. Joshi GP et al. 2023 American Society of Anesthesiologists practice guidelines for preoperative fasting: carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration. Anesthesiology. 2023;138(2):132-151. PubMed 36629465
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15. MedlinePlus Medical Encyclopedia. Pain medications: narcotics. US National Library of Medicine. medlineplus.gov
16. Dirks ML et al. Skeletal muscle disuse atrophy is not attenuated by dietary protein supplementation in healthy older men. J Nutr. 2014;144(8):1196-203. PubMed 24919692
17. Dreyer HC et al. Essential amino acid supplementation in patients following total knee arthroplasty. J Clin Invest. 2013;123(11):4654-66. PubMed 24135139
18. Dreyer HC et al. Essential amino acid supplementation mitigates muscle atrophy after total knee arthroplasty: a randomized, double-blind, placebo-controlled trial. JB JS Open Access. 2018;3(2):e0006. PubMed 30280129
19. Ueyama H et al. Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty. Bone Joint J. 2020;102-B(6 Supple A):10-18. PubMed 32475274
20. Niitsu M et al. Effects of combination of whey protein intake and rehabilitation on muscle strength and daily movements in patients with hip fracture in the early postoperative period. Clin Nutr. 2016;35(4):943-9. PubMed 26216195
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23. Roy BD et al. Creatine monohydrate supplementation does not improve functional recovery after total knee arthroplasty. Arch Phys Med Rehabil. 2005;86(7):1293-8. PubMed 16003653

This article is for education and does not replace advice from your surgeon or care team.