If surgery is on your calendar, what you do in the weeks before it can shape how you feel in the weeks after it. It's one of the more overlooked levers in surgical recovery — and most patients never hear about it from anyone.
What the research says
A growing body of evidence supports "prehabilitation" — building strength and function before surgery, not just after. A systematic review and meta-analysis of resistance training before total hip or knee replacement found that patients who did progressive strength training pre-op saw better post-operative functional performance, greater knee extensor strength, and improved patient-reported outcomes compared with those who didn't train beforehand.
The logic tracks with what surgeons see clinically: the stronger and more functional a patient is walking into the operating room, the more physiological reserve they have to draw on while healing. Prehabilitation is increasingly recognized as a meaningful complement to standard post-op rehab — not a replacement for it, but a head start.
The problem: you're often in pain right when you need to exercise
Here's the catch. The window when prehab would help most is often the same window when a patient is already dealing with pain, swelling, or joint dysfunction — which makes traditional heavy resistance training difficult or unsafe. Standard strength-building protocols typically call for loads around 70% of a person's one-rep max, a bar that's simply out of reach for many pre-surgical patients.
This is where blood flow restriction (BFR) training comes in. BFR uses a pressure cuff to partially restrict blood flow to a limb during low-load exercise, which allows the muscle to experience a strength-training stimulus at a fraction of the mechanical load. Reviews of the technique describe it as a way to build strength and reduce post-injury or post-surgical muscle loss without placing heavy stress on compromised joints or tissues — making it especially relevant for people who can't yet tolerate conventional resistance training.
It works after surgery, too — even when you can't bear weight
The same problem that shows up before surgery shows up after it, often worse: you're told to protect the joint, avoid loading it, or stay non-weight-bearing entirely, right at the point when disuse starts eating away at the muscle around it. Traditional strength training isn't an option during that phase, which is exactly when patients tend to lose the most ground.
This is one of the more well-documented applications of BFR. Because the training stimulus comes from restricted blood flow rather than heavy mechanical load, it can be applied to a limb well below normal weight-bearing thresholds — including in early post-op and non-weight-bearing recovery. Reviews of BFR in post-surgical rehab describe it as a way to counter the muscle loss, strength deficits, and swelling-related "muscle dump" that typically follow surgery, and clinical protocols have used it specifically in patients recovering from procedures like ankle fracture fixation and ACL reconstruction — populations where weight-bearing is restricted by definition. The result is a way to keep training the muscle through the exact window where conventional rehab has nothing to offer.
For patients, that means the strength work doesn't have to stop the day you leave the operating room. It can continue straight through the non-weight-bearing phase, so there's less ground to make up once you're cleared to load the joint again.
Suji's approach
Suji's low-load compression training is built specifically for this pre-op window: a way to build meaningful strength without loading injured joints or aggravated tissue. It's designed to meet patients where they are — even if "where they are" is a few weeks out from surgery and not able to lift heavy.
Go in stronger. Come out faster.
Sources: Cognetti DJ, Sheean AJ, Owens JG. "Blood Flow Restriction Therapy and Its Use for Rehabilitation and Return to Sport." (PMC8811521). · "Effects of Resistance Training Prior to Total Hip or Knee Replacement on Post-operative Recovery in Functional Performance: A Systematic Review and Meta-Analysis." (PMC9329591).