Surgery Pre-Hab

 Pre-Hab 101

More than a million people a year are getting a total joint replacement with the majority of them being an artificial knee or hip.

With an aging but still active population, the number of joint replacement surgeries is expected to grow to some 4 million in the next decade.

Of these, more than half will be younger than 65.

If you or someone you know is staring at an upcoming joint replacement surgery, the information you are about to read is of upmost importance. Pretty much everyone is familiar with the practice of rehabilitation after surgery, but the thought of pre-habilitaton before was seldom considered.

Nearly twenty years ago, in my clinical exercise practice, I observed that many, actually most, of my clients that had experienced a joint replacement procedure were far ahead of those that were not actively participating in an on-going strengthening and conditioning program.

I realized this was not by accident or coincidence. The evidence was clearly there.

Think about this—fifty percent of the outcome depends on surgeon’s skills—the other fifty percent—you determine.

I soon realized the reason that the majority of those not preparing for their pending surgery was due to a lack of awareness—not knowing how much quicker and easier their return to a normal life could be.

It was then I began to formulize Pre-Hab 101.

Typically, there is a period of waiting involved prior to the surgery. This time is valuable and an excellent time to become proactive and prepare the body. When muscles, bones, and joints are in optimum condition before the procedure, the impact of the inevitable muscle loss and joint stiffness is minimized post operatively.

After all, who wouldn’t want to cut down risk and be their best going into an elective surgery?

Those patients that choose a supervised pre-hab conditioning program have taken a huge step in determining a successful surgery and subsequent recovery.

These patients are:

  • On their feet sooner
  • Require less intervention from healthcare practioners
  • Strengthen the muscles that support the joint that is being replaced
  • Reduce fatigue and muscle soreness
  • Improve circulation
  • Possibly reduce swelling and the risk of blood clots
  • Speed up the overall recovery and healing

In fact, many physicians are now encouraging pre-hab before surgery because of the positive results. Unfortunately, health insurance does not specifically cover pre-hab sessions, or they often combine them with post-rehab for a total of only so many weeks.

Also, in my experience, those patients that participate in our pre-hab program need less supervised physical therapy. This allows for out-patient, post-surgery rehab rather than at an in-patient rehab facility. This independence is uplifting and very promising for those in recovery because a positive outlook is critical for healing.

Prior to joint replacement surgery, it’s likely that you’ll be in pain with decreased mobility. For these reasons, my prehab program is designed to be low-impact with emphasis on strength, flexibility and range of motion.

Check out his article in the Green Valley News, Green Valley, Az.

Over view of Pre-Hab 101

Improving health and over fitness can go a long way towards the facilitation of post-operative recovery.

This also helps with pain relief, correct movement patterns, and minimize compensatory movements like leaning and uneven weight bearing.

It also can help in reducing inflammation and improve circulation to the surgical site.

The following are the guidelines I used to create Pre-Hab 101:

  • I began with a consultation that will involve an evaluation to determine:
  • Muscle and joint strength
  • Ability to move and perform day-to-day tasks
  • Degree and kind of assistance required from family and friends
  • Start the program at least six weeks prior to the surgery.
  • Start slowly. This is not the time to aggravate an existing issue or trigger a new one.
  • If you are physically active and fit, I consider increasing your intensity, frequency or duration as long as it doesn’t interfere with your current issue.
  • I use Pilates as an excellent method to prepare both the mind and body for surgery. The combination of exercises that establish strength, improve flexibility, and increase in range of motion is beneficial before and after surgery.
  • I will help you familiarize yourself with walking aides and other supportive devices like crutches, walkers, or canes should they be needed.
  • You will discover the importance of breathing, proper techniques and the importance of exercises after the surgery.


Over view of Pre-Hab 101… bonus!

Foods for Healing and Pain Reduction

Current studies are showing that food affects the body’s inflammation and pain levels.

  • Unhealthy fats (trans and saturated) found in processed foods are known to increase inflammation and causes pain.
  • Avoid high-sugar foods. Sodas, candy, pastries, and even some cereals fall under this category. If you find it hard to totally avoid them, please use in moderation.
  • Snack on walnuts, flax seeds, and pumpkin seeds. Eat more cold-water oily fish, such as sardines.
  • Protein builds healthy body tissue. Enjoy lean poultry, fish and seafood, nuts (skip the peanuts), legumes, and seeds.
  • Regularly eat dark green vegetables, brightly colored vegetables, and berries. Blueberries and strawberries are especially loaded with anti-inflammatory phytochemicals and antioxidants. Fiber will also help with bowel issues that commonly arise from anesthesia.

Fruits and vegetables are an essential part of a healthy diet as they provide vitamins, minerals, and antioxidants. However, vegetables from the “nightshade family”—such as potatoes, tomatoes, and eggplant—may have an adverse effect on some people.

Pre-Hab 101 provides an opportunity for you to take a pro-active approach in your surgical care, rather than just complacently waiting for the upcoming procedure. While preparing your body, your mind is kept active, therefore, relieving the stress provoked by the pending surgery.Prehab for surgery



Even Arthritis Today is talking about Prehab!



If you or someone you know is considering surgery, schedule a consultation with me. Pre-Hab is a great way to speed up rehab and I am here to help you in every step of the way.

Also, this program is a huge eye-opener as to how you should be treating your body and mind without the prospect of a pending surgery.

Best of luck to you and remember to create great memories every day!