Pre-hab makes a difference!

The importance of pre-hab to get a faster and less painful recovery after joint surgery.

You may have heard the term rehabilitation or “rehab” where you are given exercises to help recover after surgery to a joint, but you may not be aware of the term “pre-hab”. This is where you exercise the muscles around the joint BEFORE surgery.  This exercise program can be for months or weeks prior to surgery.

Image on left before, image on right with replacement prosthetic

Image on left before, image on right with replacement prosthetic

One surgery that has come a long way in the last 30 years are total hip replacements, where the old hip joint is removed and a new prosthetic hip is inserted. The new hip is most commonly used to replace a hip joint severely affected by osteoarthritis, an incredibly painful and debilitating condition.

Even though the actual surgery makes a huge improvement in pain and movement, exercise before the surgery leads to a faster recovery.  Exercise after is also extremely important to support the new hip.

If the muscles around the hip are strong and flexible, as possible, the function returns much more quickly.  It may also mean the surgery can be delayed for as long as possible. This part is important as the actual prosthetic is not as strong as the human hip and lasts for approximately 20 years.  A second hip replacement tends not to be as successful as the first.

Strong muscles around the joint, especially muscles around the back of the hip, support the joint.  When people have arthritis of the hip, the tendency can be to sit and avoid exercise.  Unfortunately this often makes the hip worse, as the muscles become weaker and tighter, leading to more pain.  A weak muscle is often a tight feeling muscle.  It is a balance though, incredibly important that you do the correct exercises, at the correct intensity.  

Unfortunately with osteoarthritis the joint can be very painful, but contrary to popular belief exercise will not wear down the joint.  In fact a number of studies have shown that in fact exercise is beneficial to a joint with arthritis, helping to control weight, improving function and reducing inflammation, it will not necessarily make the joint more painful particularly if you do low to moderate intensity exercise.  Doing NO exercise can make the joint more painful.

These pre-hab exercises are also useful for other forms of joint surgery such knee replacement, shoulder, ankle and foot surgery.  Of course any exercise program must be cleared by your treating practitioner, such as osteopath, physio, chiropractor or myotherapist.   

One of my clients recently had a total hip replacement, and in conjunction with his Osteopath Patrick Kuhn at Emerald Osteopathy, we worked out exercise program prior to surgery

 From his Facebook post (with permission)  “Good morning everyone, just a quick update on my Hip Replacement recovery. I had my 2 week follow up meeting with the surgeon yesterday and he is very happy with my progress. He stated that at two weeks, I'm at about the same stage of recovery that most people are at 6 to 7 weeks! I want to take this opportunity to thank Rosemary at Ranges Pilates, and Patrick Kuhn from Emerald Osteopathy for all of the great pre-op work that they have done with me to prepare for the operation. I'm sure that without this work, I would not be so advanced with my recovery......... Hiking & mountain Bike riding, here I Come!!..