Seven Reasons to Embrace PreHab

Prehab is just what is sounds like: it’s rehabilitation before surgery.

The stronger you are going into surgery, the easier and faster your rehab will be.

Your doctor or surgeon will readily confirm this (all of mine were emphatic about this). “Fat lot of good that does me”, you may be thinking. “I’m in too much pain to do strength training. Plus I’m crazy busy and stressed out and one more thing will put me in overwhelm”. But hear me out. I have five compelling reasons to do it anyway.

Prehab will reduce your current pain level

Done correctly, with a gradual ramp-up, targeted strength and stability training will reduce your pain, soreness and limitation, wherever you’re at. If you want to understand the WHY, I’d suggest buying Adrian Louw’s excellent little book “Why do I hurt” (first, watch this video). Pain is produced in the mind and we can address it with our mind (with Hemi-Sync’s De-Discomfort MP3, for instance) but we can also calm down our nervous system so everyday movements don’t set off the alarms so frequently. My own experience during the months before a double hip replacement, when I was basically bone-on-bone, were that my strength training was allowing me to function well in spite of the degenerated joint. Doubtless, part of it was that exercise was encouraging my mind to produce pain medicine more effectively than it was before.

Prehab familiarizes you with the exercises you’ll be doing later.

I had never had a daily stretching or strengthening habit. In fact, I had never lifted weights.. So there was a lot to learn in terms of technique. Since we develop as we train, incorrect form will lead to less-than-ideal results later. For example, if I am doing a leg extension exercise and don’t fully extend the leg (without extending SO completely that the knee ‘locks’), then the muscle will not be strengthened along its full length and we will be educating that muscle to not extend fully. A good physical trainer or PT will observe you closely and non-judgmentally correct your form. If you are learning the form of every exercise while in a weakened condition post-surgery, you won’t have much time to do the exercises.

As we train, so we develop.

Prehab includes delicious restorative exercises

A good Prehab program will include strength training (major muscle groups with appropriate weights), stability exercises (for the small muscles involved with balance and stability). But it should also include some restorative activities, like laying on a foam roller, stretches, and other gentle movements that dissipate tension, build your proprioceptive awareness, and just plain feel good when you are experiencing a lot of discomfort in your day. This is why I say that your hospital/insurance-provided PT may not be enough (your PT will not have enough knowledge or time to provide this), and I advise you to supplement with a personal trainer or PT at a Rehab facility, whose gym you can (typically) use, if you don’t have the space or resources to assemble a home gym of your own. If your eyes are getting very big, recall that I’m speaking now to folks who are preparing for major surgery like joint replacement or back surgery, where the whole body is going to be impacted, and a whole-body approach to recovery is warranted.

Prehab will set you up for early and rapid progress

During the first few months after surgery, you’ll be able to advance through the exercises you’re given, and if you have a repertoire of restorative and other exercises that you know well, then you can show them to your PT and get cleared to add those. I’m saying that you won’t have to wait for the PT to suggest new exercises. You’ll be using them more efficiently, to help you determine which parts of your established routine you can resume.

Prehab prepares your tissues for surgery

Which muscles do you think will respond better to being stretched, manipulated, bruised or partially cut?  Muscles that have been chronically tight, limited by old injuries or insults, or ennervated and atrophied?  Or muscles which are long and supple and well-oxygenated?

Prehab familiarizes you with the rhythm and ups and downs of strength and stability training

It’s important to get familiar with how your body feels after a workout, so you can distinguish a natural mild soreness from something actually being amiss with your body. Strength training is an inherently disruptive activity, and the strengthening actually occurs in the following days, when you are resting, as the muscle rebuilds stronger. I learned when to take extra rest days, for instance, and how to fit workouts into my day and week.

A Prehab Exercise Program Will Support a Sense of Agency

Last but not at all least, you will be taking an active role in your own body’s well-being. There is a certain amount of surrendering involved in surgery. We are putting ourselves into another’s hands. But at every step of the process, I want you to experience, as I did, that it’s actually our own body that does the healing, and we can allocate our time and resources to support that.

That’s all well and good, but I don’t have enough time before surgery to start a Pre-hab program.

Do what you can. Identify your outside trainer and do their intake. Get started with Melt Method. Learn restorative exercises you can do every day. Equip your home gym or locate where you’ll be doing your regular exercise program.

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