Do you have an upcoming surgery? Your doctor may recommend pre-surgical rehabilitation before surgery to help you during and after the operation. Where physical therapy was once reserved for those who had already had a procedure done, physical therapists have recently documented the validity behind the idea of having rehab before surgery.
What is Pre-Surgical Rehabilitation?
You may not have to imagine too hard what it feels like in the part of your body where you are expecting to have surgery. Is it strong and ready for anything or is it weak, inflamed and painful? Have you exercised the area to improve blood flow and circulation or have you been favoring that part of your body, trying not to move unless it is absolutely necessary?
You are not alone. In most cases, patients who resort to surgery to solve their movement problems are not in the best of health or physical condition. Otherwise, they wouldn’t need surgery, right? But physical therapy not only strengthens the surrounding muscles and tissues in anticipation of surgery, it can help improve blood flow and circulation that are so important for wound healing and the prevention of scar tissue. Physical therapy can also help improve your overall health in preparation for the strain and stress that often goes with general anesthesia, surgery and recovery.
Does Pre-hab Really Work?
There have been numerous research studies on the validity of prescribing pre-hab before surgery. Most results point to the benefits of pre-hab when it comes to postoperative recovery. In a study published in the Journal of Bone and Joint Surgery, researchers in Ohio reviewed more than 4,000 Medicare cases where people over age 65 received a total hip or total knee replacement. What they found was that 79.7% of patients who did not participate in preoperative physical therapy needed longer hospital stays and more care once the surgery was over. That rate dropped to 54.2% for patients who just did a few physical therapy sessions before their total knee or total hip replacement.
Between 2007 and 2011, more than 2,500 patients in a different study were monitored after surgery. Those who participated in pre-hab experienced less pain, shorter hospital stays, and even had better recovery markers a year after surgery.
As a whole, studies have shown that patients who participate in some form of pre-hab do not spend as many days in the hospital after surgery, return to normal function, and have better movement long after recovery than those who do not. Many surgeons have not begun “prescribing” sessions with a physical therapist before they will consider operating on a patient, especially if that patient is over the age of 65, has previously not been in good health, or is at risk for postoperative complications. Most HMO’s and insurance companies are also recognizing pre-surgical rehabilitation as a cost-saving measure and have begun to cover the cost of these treatment plans.
What Can I Expect From Pre-surgical Rehabilitation?
For the best possible outcomes, rehab before surgery should:
- Begin around six weeks before surgery
- Progress slowly to avoid aggravating the existing problem
- Incorporate breaks in exercise to minimize discomfort
Your physical therapist will begin by conducting a thorough review of your surgeon’s recommendations, any pertinent medical records and your medical history. They will then perform several tests to see how well you move the affected area and what can be done to help maximize your postoperative recovery.
You will then receive a personalized treatment plan that may include:
- Manual therapy to help minimize pain and maximize movement in the area
- Targeted exercises to help improve your overall physical condition and prepare you for surgery
- Isometric strength training and low-impact muscle toning to strengthen supporting tendons, ligaments and muscles.
- Supportive measures to protect the area that will be operated on while you are in physical therapy
- The use of ice, heat, ultrasound and/or TENS to minimize pain
Periodically throughout the process, your physical therapist will evaluate your progress and communicate with your surgeon to determine the point where you are ready for surgery. This process will begin again once your surgery is over so you can complete your recovery and reclaim a better life.