Four Perfectly Good Reasons to Skip Prehab

It’s Expensive

Money is tight and I have to keep my powder dry for when I’ll really need it- after the surgery.  Or I can just do what my HMO Physical Therapist gives me.

I don’t have time or attention for this

I have to get ahead on my work and make all these arrangements. I’m already in overwhelm. Search out a trainer?  Learn new practices? You’re suggesting I add ALL OF THIS on top of everything else?  Where’s my paper bag- I think I’m hyperventilating now. Thanks a lot.

I’m too sore to build strength now

I’m already limping/wincing/sore. Start an exercise program now? Are you kidding?   ¯\_()_/¯

I’m wasn’t athletic before, and don’t intend to be

The way you describe it sounds like overkill. I just want to be able to get back to doing my daily activities without being so uncomfortable and limited.

If these statements resonate, I’m sure you’re in good company. But let’s look at each of these in turn.

Expense and Time: Here’s how I think about these topics. If you’re able to get back to work (or your daily activities, if you’re in retirement) a month early, how much is that worth? Or how much is it worth to feel not impaired a month or three early? The reality is that your HMO PT’s mandate is likely to get you back to a basic level of functioning within a specified number of short visits. What I’m suggesting could be considered doing however many month’s worth of (perhaps unnecessarily gradual) exercise in half the time, and having your life back (Keep in mind: the more prehab you do, the more rapid your progress will be after surgery).

Even if you forgo the outside trainer and use your HMO-provided PT, the intensity and pace are largely in your hands. They will meet you at whatever pace you set, and they are used to people making excuses for not doing their exercises regularly.  Are you going to meet them there, or surprise them?  You could still end up spending far more money (in co-pays) and time than you need to. I’m just suggesting you front-load it, and use the self-reinforcement that comes with being able to detect your own progress on a week-by-week basis (don’t look for progress day-to-day: you won’t see it). Here’s the hard truth- if you don’t bring a certain intensity to your recovery at the outset, and maintain it as long as you can (or until you reach a plateau you’re satisfied with), all of your other commitments and priorities are going to take over and your recovery could easily stall at 60% or 70% of where you were before you became limited (let alone getting to 130%+ which is where I happily find myself). What are you aiming for, and are you taking the actions that will get you there?

Soreness: There actually IS a way around the pre-surgery soreness. First of all, you’ll have the benefit of endorphins, another set of feel-good chemicals generated by effortful exercise. In my experience, a workout is actually as restorative and discomfort-reducing as visiting a bodyworker. It turns out that much of our pain is from some muscles being overworked and others not being properly engaged at all (this is likely true for all hip replacement candidates). So retraining the body’s major and supporting muscles to all do their jobs in concert creates ease and fluidity in the system.

We can also use the most powerful painkillers available, which are produced by our own brains. Using Heart-centered meditation (like Prepare for Surgery, Heal Faster, or Hemi-Sync’s Heart Energy) or Auto-suggestion (Hemi-Sync’s De-Discomfort), we can ‘turn down the dial’ on our discomfort. There’s also a cognitive piece- we need to understand the difference between activity that is injurious and should be avoided, vs the noise created by an agitated nervous system (watch the short videos on this page).

A balanced program will also include the Melt Method (self-massage focused on connective tissues) and/or other restorative practices (restorative yoga postures, laying on a roller, standing stretches using a staff, etc), as well as informed use of cold and heat. In short, becoming a master of self-care.

If ALL of that is still not enough (you should try all of it before moving on), you might consider using NSAIDs when necessary, or getting a prescription and using a non-psychoactive cannabis tincture (like Care by Design’s 20 parts CBD to 1 part THC), which will reduce pain and (perhaps) inflammation, without making you the star of a Cheech & Chong movie.

Athleticism: If you’ve been dealing with limitation for a while, you may have developed a self-limiting idea of what kind of physical life you are capable of. If you’ve become sedentary and developed comfortable routines, you may not realize how much you would enjoy criss-crossing the farmer’s market, walking on the beach, trekking hut-to-hut in Switzerland, ballroom dancing, or whatever ways you might use your body that bring your joy and fulfillment.

For more on this topic, read “Seven Reasons to Embrace Pre-Hab


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