Why You Should Get Prehab Before Surgery

Woman receiving prehab treatment.

Rehabilitation after surgeries performed on joints, muscles or ligaments is a known component of the recovery process, but prehab – getting physical therapy before surgery – is rising in popularity as more doctors acknowledge that it can actually enhance and shorten the healing process.

So what, exactly, is prehab, and why is it such a good idea? Great questions!

Prehab, which is also being used for other types of serious surgeries like colorectal cancer and heart bypass procedures, involves preparing your body so that you are in the best shape that you can manage before going into the operating room. NPR recently reported on a study in the medical journal Anesthesiology that showed that patients who had undergone prehabilitation and rehabilitation were able to walk far further in a six-minute timed walking test than patients who'd only gone through rehabilitation. That study was a follow-up to a previous research trial that showed that people who'd gone through aerobic and strength-training workouts pre-surgery fared better than people who'd only gone through basic walking or breathing exercises beforehand.

The Arthritis Foundation is a big believer as well. Various doctors interviewed for a recent article referred to prehab as making "a huge difference" and stating that the road to optimal recovery is one "starting with prehab." The great results prehab can lead to begin right when surgery ends, with many patients experiencing shorter hospital stays and being eligible for outpatient versus inpatient rehabilitation after complicated procedures like joint replacements.

So how does prehab work, and how might it help you?

The concept of prehab was initially developed to enable athletes to avoid sports-related injuries. After achieving success in that realm, therapists realized that the same concept could apply in surgical situations – enabling more physically fit patients to recover more quickly and completely.

Similar to how rehabilitation practices are designed, prehab is molded to fit the specific needs of individual patients. It acknowledges that pre-surgical patients come to prehab in different physical conditions, so therapy before surgery is not a one-size-fits-all solution. While some patients may be able to delay or even avoid surgery due to the success of prehab, it isn't intended as a replacement solution. Rather, prehab seeks to progressively enhance a person's fitness through targeted exercises and complementary therapies.

In addition to shaving time off hospital stays and speeding up recovery, prehab has additional benefits. First, it's never a bad thing for a person to become more physically healthy. Patients who are scheduled for surgery in one area but suffer other types of health conditions as well may notice health improvements due to strength gains and potentially, weight loss. Additionally, because many conditions that warrant surgery are terribly painful, patients may be able to lower their pain levels or their reliance on pain medications. That's a true win-win situation!

While patients can certainly perform prehab-style exercises at home or a local gym, one of the best benefits of prehabilitation is working one-on-one with a highly-trained physical therapist. Through careful evaluation, therapists can design a plan with clear-cut goals and achievable milestones. Even patients who may be starting with poor initial physical health can improve the impact of surgery through a core strengthening program.

That leaves only one question: why aren't more doctors prescribing physical therapy regimens to be completed prior to surgery?

The answer is two-fold – first, the doctor may not be thoroughly versed on the benefits of prehab and may only really be looking at recovery through the dual prongs of surgery and after-surgical rehab. Second, some insurance companies may not be familiar with prehab, either, despite the fact that it may, in fact, lead to lower patient costs overall through better results and shorter timeframes for recovery.

That means that the ball is in your court, as a patient, to advocate with both your doctor and insurance carrier so that you can take advantage of the benefits prehab physical therapy work provides. Begin by having a candid conversation with your physician, including asking about his experience with prehab and any strength or physical fitness issues you feel could and should be addressed prior to surgery. Many physicians in the New York City metro area already refer their patients to Cynergy Physical Therapy and have trust in their physical rehabilitation practices.

Once you've gained your doctor's agreement to begin prehab, ensure that all appropriate paperwork is filled out, so that your insurance company is presented with as much information as possible in order to preapprove therapy claims. Then, you'll be able to begin what may be one of the most important physical fitness challenges of your life.

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