Understand how surgery affects your muscle health — and what you can do to regain strength safely and effectively.

Whether you're recovering from a joint replacement, fracture, spinal procedure, or abdominal surgery, one common complication often goes unnoticed: muscle loss. It’s not just the incision site or the pain that slows you down; your muscles actually weaken during and after surgery, even if the procedure was successful.
This type of muscle loss can impact mobility, metabolism, recovery time, and long-term health. The good news? With the right approach, combining nutrition, movement, and structured rehabilitation, you can recover not just from the surgery itself, but also from the silent muscle damage it causes.

Why Does Muscle Loss Happen After Surgery?

1. Immobility and Bed Rest

Even short periods of immobility, such as a few days in the hospital, can lead to a measurable decline in muscle mass and strength¹. Prolonged bed rest further accelerates muscle atrophy, especially in weight-bearing muscles like the thighs and calves.

2. Inflammatory Stress Response

Surgery triggers a systemic inflammatory response, which affects protein synthesis and muscle regeneration². Your body goes into a catabolic state, breaking down muscle protein to mobilise energy for healing, often at the expense of strength.

3. Nutritional Gaps

Many post-operative patients experience reduced appetite, nausea, or restrictions on food intake. This can result in inadequate protein and calorie consumption, which delays muscle repair and leads to further loss³.

4. Age and Pre-Surgical Frailty

Older adults or those with pre-existing conditions like osteoarthritis, sarcopenia, or osteoporosis are more vulnerable. Their baseline muscle reserve is already low, so even small setbacks can lead to significant deconditioning⁴.

Who’s Most at Risk?

Muscle loss after surgery can affect anyone, but certain groups need extra attention:
• Elderly patients, especially post joint replacement or spine surgery
• Patients recovering from fractures, THR/TKR, or abdominal surgeries
• People with sarcopenia, osteoarthritis, rheumatoid arthritis, or osteoporosis
• Individuals with prolonged ICU stays or post-operative complications
• Athletes and active individuals, due to their high baseline muscle needs

How Much Muscle Loss Are We Talking About?

Studies suggest that up to 1 kg of lean muscle mass can be lost in the first 10 days of immobility, with strength loss exceeding mass loss⁵. For example:
• After total knee replacement (TKR), patients can lose 10–20% quadriceps strength within two weeks
• In spine surgeries, trunk and core muscle loss can delay posture recovery and increase fall risk
• ICU or trauma patients may experience rapid, whole-body atrophy if not mobilised early

The Right Way to Recover: Step-by-Step

Recovery isn’t just about wound healing; it’s also about rebuilding the muscle system. Here’s what works:

1. Start Movement Early (But Safely)

• With physiotherapist guidance, early mobilisation improves circulation and reduces muscle breakdown
• Passive stretching, ankle pumps, and isometric holds are often introduced in the first 24–48 hours
• Gradually progress to assisted walking, standing exercises, and range-of-motion drills

2. Focus on Protein and Calorie Replenishment

• After surgery, protein needs go up to support tissue repair (0.8–1.2g/kg/day recommended⁶)
• Include leucine-rich sources like lentils, eggs, dairy, or soy
• Don’t overlook micronutrients like Vitamin D, calcium, magnesium, and antioxidants for muscle recovery

3. Progressive Resistance Rehabilitation

Once cleared for full movement:
• Use resistance bands, ankle weights, or bodyweight exercises
• Focus on lower limb strength (especially after orthopaedic surgery)
• Aim for 2–3 sessions/week to rebuild strength gradually
• Incorporate gait training, balance drills, and functional mobility for everyday tasks

4. Avoid Overcompensating on One Side

Post-surgical pain can cause patients to rely on the non-operated limb or side. This leads to muscle imbalance, overuse of healthy joints, and prolonged recovery. Always follow bilateral training protocols to restore symmetry.

Tailored Recovery Plans for Different Surgery Types

Surgery Type Focus Areas for Recovery
Total Knee Replacement Quadriceps, hamstring, calf strengthening
Total Hip Replacement Glute, hip flexor, balance training
Spine Surgery Core, postural, and back extensors
Fracture Recovery Weight-bearing and proprioception rehab
Abdominal Surgery Core activation and deep abdominal strength

A Silent Risk to Your Independence

Unaddressed muscle loss post-surgery can result in:
• Rehospitalisation due to falls or fatigue
• Long-term frailty and reduced quality of life
• Increased burden on caregivers and family
• Slower return to daily activities and work

That’s why muscle care is as essential as wound care in the post-op period.
With the right physiotherapy, dietary support, and follow-ups, most patients can regain lost strength. And for elderly or orthopaedic patients, muscle rebuilding isn’t just about recovery; it’s about regaining confidence, mobility, and control over life.

Frequently Asked Questions (FAQs)

1. Why do I feel weaker even weeks after surgery?

Muscle loss doesn’t just happen during surgery. The combination of inactivity, inflammation, and poor nutrition leads to gradual strength loss, which might not be obvious until you try to resume daily activities. That’s why structured rehab and protein intake are critical even after the wound heals.

2. Can I regain all the muscle I lost post-surgery?

In most cases, yes — especially with a guided rehabilitation plan. Muscle memory, proper nutrition, and strength training can help you regain mass and functionality within weeks to months, depending on age and surgery type.

3. What should I eat to support muscle recovery?

Focus on high-quality protein sources (like lentils, paneer, tofu, fish, and eggs), complex carbs, and anti-inflammatory foods like turmeric, leafy greens, and citrus. Stay hydrated and avoid skipping meals, even if your appetite is low.

4. How long does it take to rebuild muscle after surgery?

Recovery timelines vary. Light muscle activation starts within 1–2 weeks, but significant strength may take 6–12 weeks to rebuild. Patience and consistency are key, and always follow the physiotherapist's instructions.

5. I’ve had spine surgery. Can I still strengthen my core safely?

Yes, once cleared by your doctor, core strengthening is essential for spinal recovery. Start with gentle deep core engagement like pelvic tilts and gradually progress to isometric holds and balance exercises.