February 27, 2023
“Prehabilitation” Before Orthopedic Surgery?
When it comes to recovery after orthopedic injury or surgery, most people are familiar with the term “rehabilitation.” Rehabilitation usually refers to the time and activity where a patient actively engages (typically with a physical therapist) in retraining and restoring the body to properly functioning after an injury, immobility, or inactivity. Yet newer research in orthopedics has given rise to a fascinating concept of helping restore patients to active living as soon as possible after surgery. It is called prehabilitation.
The premise of prehabilitation or “prehab” is underscored by helping patients improve their functional capabilities after orthopedic injury and before orthopedic surgery. Simply put, it is a key strategy for a patient’s care team to help the patient reach the best and most functional place physically before an operation. For some, this effort may seem counterintuitive. If a part of me is broken, doesn’t it need to be fixed before I can improve? The answers to that question are yes, and no. Significant amounts of research indicate that the more physically fit and active a person is before they head into surgery, the better, and often faster, their recovery will be.
To illustrate the concept of prehab, let’s use the example of a common orthopedic injury involving a ruptured anterior cruciate ligament, or ACL. The overall goal of prehab for an ACL injury is simple: to strengthen the muscle groups in the affected leg, thereby elevating the opportunity for a better functional outcome post-ACL surgery. Whether or not an individual undergoes physical therapy before ACL surgery, physical therapy for approximately 12 weeks is always necessary after surgery to help restore function and stability to the knee. Prehab and post-surgical physical therapy emphasize flexibility, range of motion, and strength. Once success is achieved in those critical foundational phases, therapy usually moves on to assessments like single-leg hop tests and exercises specific to an individual’s sport.
Other factors essential to prehabilitation include those associated with nutrition and lifestyle. What a patient puts into their body in the weeks leading up to surgery can significantly impact health and wellness in the recovery period – so too can lifestyle modifications. If a patient is overweight, a focus on weight loss, even small amounts, in the perioperative period can benefit recovery.
It is crucial to note that prehab might not be possible in all orthopedic injury cases, especially those characterized by a significant amount of joint instability or disability. However, for many others, research shows that engaging in this highly effective rehabilitative strategy can deliver many advantages, especially for athletes and active people who want to return rapidly and safely to playing sports and living the lives they love after surgery.
Prehabilitation is an intelligent component of treatment for many orthopedic injuries and should not be overlooked or underappreciated. Especially for athletes, this strategy is absolutely crucial to achieving an optimal clinical outcome. It can make a significant difference in the quality of recovery and the time it takes to recover from the injury and the surgery to repair it.
Always remember as a patient and athlete, if you trust the process, embrace the grind, and remain focused on your goal, you will find yourself back on the field or court faster and performing at a higher level than you ever thought possible.