“Prehabilitation” – Physical Therapy BEFORE Surgery

What is Prehab?

Prehabilitation is an exercise rehabilitation program that we at Total Performance Physical Therapy can help you begin BEFORE you have any type of non-urgent surgery. Prehab programs are designed to increase your overall body strength, flexibility, and endurance.

Why prehab?

Exercise, in general, is something everyone can benefit from, not just people who need surgery or have had an injury. Doing any sort of exercise, whether it is walking, biking, dancing, or weight lifting, will make everyday activities easier. For example, increasing your arm and leg strength will make picking up your children easier or allow you to garden longer. Increasing your endurance will make it easier for you to stand and wait or even run for the bus. Keeping your muscles strong will also help you prevent injuries!

With surgery, your muscles will become weak and stiff. If your muscles are strong before surgery, the impact of muscle loss will be decreased. Exercising before surgery has been proven to decrease overall recovery time, decrease time spent in the hospital following surgery, and increase quality of life after surgery. By having prehab before a knee surgery, for example, you are helping your whole body prepare for the recovery process, which can include going about your daily activities on crutches or using a walker.  In one study, where participants had prehab before a total knee replacement, the participants showed they could walk farther and go up the steps faster one month after surgery than the participants who didn’t have prehab1. Another study showed that people who had prehab before a knee replacement reported higher social functioning and emotional health2. This shows that preparing for the physical stress of recovery before the surgery can have a positive effect on your quality of life.

Who can benefit from Prehab?

Anyone! The surgery you are having, though, has to be elective, meaning that you are choosing to have it and it’s not urgent, but scheduled ahead of time. Common elective surgeries treated with prehab are:

  • Rotator cuff repair
  • ACL repair
  • Total knee replacement
  • Total hip replacement
  • Cancer/Tumor removal surgery
  • Cardiac Surgery

It is important to note that with certain operations, like a cancer surgery, you shouldn’t put it off just to start a prehab program.

What does a Prehab Program look like?

A prehab program can be anywhere from 8 to 2 weeks long depending on when your surgery is. At Total Performance PT, your physical therapist will design a prehab program that is specific to you and the type of surgery you are having.  However, all exercise programs will follow the same basic structure:

  • Warm Up – You will perform a warm-up that gets your heart pumping and warms up your muscles like walking or biking.
  • Strengthening – The focus of a prehab program is total body strengthening to decrease recovery time. So you will be performing exercises that strengthen more than one muscle at a time. You may also do exercises that are more functional in everyday life like sit-to-stands, where you repetitively sit and rise from a low chair to increase your leg and core strength. Also, if you are having any sort of leg surgery, your therapist will want you to strengthen your arms and shoulders so you can be prepared to use crutches or a walker.
  • Flexibility – Your therapist will help stretch out your muscles to try to decrease any possible stiffness that surgery might cause. They will also target your joints and make sure they can bend and straighten easily.
  • Cool Down – The cool down will include a period where you relax to slow your heart rate and ice your muscles or joints. Ice will help decrease swelling or muscle soreness.

Don’t worry – your prehab program won’t look like you are training to win a bodybuilding competition, but it will focus on getting you strong and fit enough for surgery.

Are you having a surgery in the next couple of weeks that you’d like to prepare for?

Call Total Performance Physical Therapy today to schedule your Prehab appointment!

1. Topp, Swank, et. al. The Effect of Prehabilitation Exercise on Strength and Functioning After Total Knee Arthroplasty. American Academy of Physical Medicine and Rehabilitation. 2009. 1:729-735.

2. Brown, Topp, et. al. Prehabilitation and Quality of Life Three Months After Total Knee Arthroplasty: A Pilot Study. Perceptual & Motor Skills: Physical Development & Measurement. 2012. 115, 3: 765-774.

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