At Virginian Rehabilitation and Wellness we have a proud tradition of raising up the next generation of physical, occupational, and speech therapists and therapist assistants. This Spring/Summer we have been fortunate enough to have Student Physical Therapist, Luke Stelmack serving and learning along side his clinical instructor Susan Geiger, PT, DPT and the rest of our team. As his parting gift he does a deep dive into things to consider before you have surgery. “Is “prehab” right for you?” Thank you Luke and best wishes as you head out on your new career.
Every year, more Americans are having surgery for a variety of different reasons. Many people have surgery to eliminate or mitigate pain (ie. Arthritis or ACL tear). While many others have surgery as an intervention for a potentially life-threatening condition (ie. Cancer or Heart Failure). Regardless of the reason, surgeons almost always refer their patients to physical therapists afterwards for rehabilitation. But what about BEFORE surgery?
Physical therapists (PT’s) are known in the medical community as “movement experts,” who understand how the body is supposed to move and can enable patients to get back to their daily, functional lives safely and effectively through personalized care plans. Physical therapy is a proven way to treat painful conditions of all kinds – sometimes resulting in a patient no longer requiring surgery, or opioids, to manage their pain.
As research continues to shed light on the benefits of PT for pain, and as a necessity for post-surgical rehab, it is becoming more commonplace for surgeons to prescribe PT BEFORE their patient’s major surgeries as well. Some studies have shown that this step can diminish the need for post-operative care by 30%! This process has been coined Prehabilitation or “Prehab” and the advantages are clear:
Decreased pain
Stronger body and joints before surgery
Improved surgical outcomes
Shorter hospital stays
Increased odds of being discharged straight home
Mentally prepares for post-surgical rehab
Decreased costs associated with recovery
Prehab benefits patients of all ages! From young athletes to older adults who hoping to move better. Physical therapists have the skill and knowledge set to make a positive impact well before surgery. There is high quality evidence suggesting prehab is applicable to nearly all types of major surgery from orthopedic conditions (ie. hip replacements or rotator cuff tears) to cardiac, abdominal, and cancer surgeries.
If you or a loved one is considering surgery, consider reaching out to a physical therapist. Once in touch, a Prehab plan of care can be personalized to your needs and can provide a tangible first step towards a responsible, safe recovery.
Citations
Malot, C., Durand-Bouteau, A., Barizien, N., Bizard, A., Kennel, T., Fischler, M., ... & Le Guen, M. (2021). Prehabilitation Program in Elderly Patients: A Prospective Cohort Study of Patients Followed Up Postoperatively for Up to 6 Months. Journal of Clinical Medicine, 10(19), 4500.
Hoogeboom, T. J., Dronkers, J. J., Hulzebos, E. H., & van Meeteren, N. L. (2014). Merits of exercise therapy before and after major surgery. Current opinion in anaesthesiology, 27(2), 161.
Lokapavani, Y., Krishna, S. R., & Madhavi, K. (2014). Influence of pre-operative physical therapy education and exercise on post-operative shoulder range of motion and functional activities in subjects with modified radical mastectomy. Int J Physiother, 1, 170.
Patel, B. K., & Hall, J. B. (2013). Perioperative physiotherapy. Current opinion in anaesthesiology, 26(2), 152.
Lemanu, D. P., Singh, P. P., MacCormick, A. D., Arroll, B., & Hill, A. G. (2013). Effect of preoperative exercise on cardiorespiratory function and recovery after surgery: a systematic review. World journal of surgery, 37(4), 711-720.
Snow, R., Granata, J., Ruhil, A. V., Vogel, K., McShane, M., & Wasielewski, R. (2014). Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement. JBJS, 96(19), e165.