When people hear “physical therapy” their minds generally go right to treatment after an injury or pain. And that is the majority of what currently fills our schedule.
But it’s not all we can do.
Physical therapy can also include prehabilitation. No, we promise we didn’t just make that up. Prehabilitation, or “prehab,” may be therapy to avoid injury or pain or therapy to prepare for a surgery. It can address limitations in strength, stability, range of motion, balance, and overall function—all of the same things we may address after you have an injury or surgery, but basically taking a proactive approach instead of waiting for something to happen.
So, if you work on similar things, what’s the difference? You’re likely wondering how prehab can benefit you. Why take this proactive approach?
For someone who has a surgery scheduled, there’s a common belief that physical therapy can’t help until after surgery. And if you have a surgeon with a good reputation, that may mean you’re waiting around for a while. We should probably more accurately call it a common misbelief, because the reality is that therapy before a surgery can help in a number of ways.
Studies have shown that following a prehab program before surgery can lead to shorter hospital stays (by up to 4 days!) and increased chances of going straight home after surgery, rather than to a rehab facility. It can also reduce the risk of complications from surgery and reduce overall medical costs. But while statistics are great, prehab can also help you on a more personal level by increasing your post-op safety and addressing any concerns you may have about your surgery. We tend to be foggy right after surgery, thanks to anesthesia, which seems to coincide with when the doctor tells us how everything went and what precautions we need to take—not a spectacular time to rely on memory.
During prehab, your physical therapist can teach you all of your precautions and modified ways of going through your daily routine, as well as fall prevention for any lower extremity procedures before your operation. That way they can make sure there’s no confusion about what you should or shouldn’t do right after surgery and you’ll be much more prepared. Your physical therapist can also answer any questions or ease any concerns you may have about the operation so that you can head into it more relaxed and confident.
Doing a bout of prehab before a surgery has also been shown to result in better outcomes and a more rapid return to regular life. Research shows that those who do prehab before a total hip or knee replacement show improvements in pain, function, length of hospital stay and strength, and often reach functional range of motion sooner. For athletes, similar benefits have been seen with ACL reconstructions. Pre-op quad strength can help predict functional outcomes after ACL reconstruction.
Basically, those with greater quad strength going in to surgery tend to have better function of their knee after reconstruction. Since you lose some ability to activate your quads after injury due to pain and swelling, prehab can help you gain that strength back before your surgery so that you give yourself the best chance at optimal recovery in the long run. Those who do prehab before their ACL reconstruction tend to have better functional outcomes not only weeks after surgery, but as far as 2 years later.
Following a prehab program can increase your chances of returning to your pre-injury activity level and may help you return to your sport sooner than if you wait until after surgery to start the rehab process. So while you’re waiting what can be weeks or months before your scheduled surgery date, why not put yourself in the position to get the best outcome you possibly can?
And prehab isn’t only for those with an operation on their calendar.
Working with a physical therapist can benefit many athletes. Muscle imbalances can change the way your joints are loaded and the mechanics of your movement. But when one area is limited, your body will still find a way around it to move the way you want to. It will compensate by using other joints or muscles, and compensations can lead to dysfunction over time. Following a prehab program with a physical therapist can help you strengthen the correct muscles, find mobility in the right joints, and perform your sport or activity with optimal form to reduce your chances of pain and injury later on.
Why wait for rehab if you can prehab?
