Prehab before surgery, treatments or activity may help some avoid extensive rehab
Can physical therapy before joint surgery help speed up your recovery after surgery? There’s mounting evidence that it can.
The Journal of Bone and Joint Surgery published a study two years ago that followed more than 4,000 patients before and after joint replacement surgery. It found that those who had physical therapy before surgery as well as after (the standard for treatment) saw a nearly 30 percent decrease in their need for post-surgery medical services.
Prehabilitative care, commonly referred to as “prehab,” isn’t the norm yet, but the study prompted healthcare professionals to more seriously consider the benefits of prehab for a variety of people, including oncology patients and others facing a rigorous procedure or treatment regimen.
“It’s something that research hasn’t really caught up with yet, but it’s coming,” said Kimberly Steward, a physical therapist in the outpatient rehabilitation department at Banner Del E. Webb Medical Center in Sun City West/Surprise, Ariz.
Who benefits
In any given year, about 50 million Americans suffer from physician-diagnosed arthritis. If the arthritis is advanced enough in, for example, a knee, hip or shoulder, that joint may require replacement.
Prior to a joint replacement procedure, a doctor might look to a physical therapist to help a patient lose weight to increase the likelihood of a successful outcome.
Sometimes, prehab may be ordered to address other problem areas before surgery, Steward adds. For example, a knee replacement candidate may often have some lower back pain or weakness, or perhaps some limping has been occurring, too. So, there may be a need to strengthen leg muscles like the calf or quadriceps before surgery.
Additionally, prehab provides clinicians an opportunity to educate patients on what to expect after surgery. Many knee replacement patients, for example, may not know they are expected to resume walking the day of surgery, Steward noted.
“They come out of prehab better understanding what is expected of them after the procedure,” she said. “You’re not really avoiding rehab but we’re trying to make it more efficient … and it may decrease the need for an inpatient rehab center.”
Being proactive
Beyond surgery, medical experts say prehab can help prevent injury in everyday life, and it could also provide valuable support for those playing sports or exercising.
Recently, one patient approached Steward about neck pain. In talking with the patient, the physical therapist learned that the woman had returned to enjoying outdoor activities she hadn’t done in several months. Steward was then able to help the patient understand that certain muscles that hadn’t been tested as much in the past few months were now being exercised more rigorously.
“She was smart in that case, and was able to do some prehab exercises in order to continue with the fun activities and not get to where the pain is debilitating,” she said.
Any active adult, Steward said, can use prehab to prevent or address sports or exercise-related pain or injury, too.
“If you have a little back pain and are taking ibuprofen before you exercise, you’re not really addressing why you have the pain,” she added. “Physical therapists are specialists trained to look at how you move and how to make those movements more efficient and less painful.”
She gives examples of golfers performing certain prehab exercises before hitting the links to avoid elbow problems and runners who have their gait examined to better understand personal movement limitations or stretching needs before certain aches and pains surface.
“Anyone can take a pill; the hard part is changing the habit,” Steward said.
To learn more about how the Banner CORE Center for Orthopedics can help you lead an active, healthy lifestyle, visithttp://www.bannercorecenter.com.