Yes. Once your surgeon and physiotherapist have cleared you, strength training after a knee or hip replacement is usually not just allowed but the point: the new joint is designed to be loaded, and loading it through a full, pain-free range is how it becomes a joint you trust rather than one you protect. The timeline is months, not weeks. The first movements back are supported squats to a set depth, step patterns, cable work and incline walking; the ones to ask your surgeon about are deep loaded flexion, high impact and anything on your precaution list. A coach's job starts where the physiotherapist's discharge sheet ends.
This page is general information, not medical advice, and nothing on it overrides your surgical team. It is about what a coached strength program looks like once you are cleared.
Why loading the new joint is usually the goal
A replaced joint has had its painful surfaces removed. What it has not had is its muscle put back. Months of pain before surgery and weeks of protection after it leave the quadriceps, glutes and hip muscles weaker than the other side, and that weakness, not the implant, is what makes stairs, chairs and hills hard at six months. Strength work rebuilds it, and rebuilding it is what protects the implant in the long run: a strong leg loads the joint evenly, a weak one loads it badly.
Range matters as much as strength. Clinicians generally want a replaced knee to bend and straighten fully and a replaced hip to move freely within its precautions, and loaded movements taken to the edge of the pain-free range and held there briefly are one of the better ways to keep that range once physiotherapy ends.
The movements that come back first
| Movement | First version | Progresses to |
|---|---|---|
| Squat | Squat to a set depth holding the rig, the depth chosen by the coach from your current range | Goblet squat, deeper as range and confidence return |
| Step pattern | Split squat with a short step, one hand on the rig | Reverse lunge with a shortened step, then a low step-up |
| Hinge | Cable pull-through | Dumbbell Romanian deadlift |
| Glute and hip | Glute bridge, then single-leg glute bridge | Loaded hip work as the physiotherapist's targets are met |
| Conditioning | Incline walk on the treadmill, handrails available | Longer and steeper walks; hill repeats much later, if ever |
| Upper body | Everything, from the day you are cleared | Unchanged by the surgery; a good place to feel strong early |
The goblet squat and the cable pull-through lead because both let the coach set the range precisely and both keep you upright and supported. The last row deserves attention too: nothing about a knee or hip replacement stops rows, presses and, once walking is confident, carries, and training the half that is fine keeps the habit alive while the leg catches up.
The ones to ask your surgeon about
- Deep loaded flexion: a full-depth squat or lunge with weight, and kneeling on a replaced knee
- High impact: running, jumping, landing, and sports with hard cutting
- Heavy twisting under load through a replaced hip
- For hips, the precautions specific to the surgical approach: some restrict deep bending or crossing the midline for a period, some do not
- Any exercise the physiotherapist flagged at discharge
Ask, get the answer in writing if you can, and bring it to the coach. Surgeons differ in what they permit and when, and a coach programs inside the answer rather than around it.
The timeline, honestly
Months, not weeks, and different for everyone. A rough shape: the first weeks belong to the surgical team and the physiotherapist; progressive strength work with a coach usually begins some months after surgery, once you are discharged; and many people describe the joint as feeling like theirs somewhere around a year. Progress inside that is measured in range, in the log and in the stairs at home, not on the calendar.
The next-day rule is the one that matters. Swelling, warmth or pain that is still there the next morning means the session asked too much, and the coach backs off. Mild stiffness that clears with movement is normal and expected.
What a coach does with the discharge sheet
Reads it before writing anything. The precautions become the no-go column; the current exercises become the warm-up and the first stations; the range numbers become the starting depth; the physiotherapist's next target becomes the block's goal. Then the coach sends progress back: a note when a milestone is hit, a question when something is unclear.
At Coresa this usually starts as 1-on-1 personal training, because the first block needs an assessment and a coach's full attention. Training after physio describes the handoff in detail, and strength training with osteoarthritis covers the years before surgery, if that is where you still are.
Common questions
Will lifting wear the replacement out faster?
Modern implants are built to be loaded, and the general clinical direction is that strength work protects a replacement by improving how the joint is loaded. The usual caution is repeated high impact, not weight in a rack. Ask your surgeon about your specific implant and the activities you have in mind.
Can I join small group training after a replacement, or does it have to be 1-on-1?
1-on-1 for the first block, almost always, then the group once your swaps are stable and the movements are automatic. Groups at Coresa never exceed eight and every load is individual, so the transition is a normal one. Ask on the consult.
Should I keep doing my physio exercises once I start with a coach?
Yes, and tell the coach exactly what they are. Most get folded into the warm-up or the first stations rather than duplicated; anything the physiotherapist wants done separately stays separate.
How do I know the joint is being loaded enough versus too much?
Enough: the log goes up over weeks and the joint feels no worse the next morning. Too much: swelling, warmth or pain still there the next day, or a range that has shrunk. Report the second kind to your physiotherapist; the coach backs off the same day.
