Let’s face it.  Surgical procedures, whether big or small, are stressful!  You want to be as prepared as possible and know what to expect before surgery, during surgery and after surgery.  However, most patients fail to ask all the necessary questions of the surgeon prior to their procedure.  How could you know all the right questions to ask of your surgeon?  It is not like you do this type of thing every day!  This is the main reason why our therapists recommend scheduling “prehab” visits with your physical, occupational or speech therapist prior to surgery.  These visits can provide time for the procedure to be explained in greater detail and give you an opportunity to discuss your rehabilitation program so that you can fully understand what will be expected of you both before and after surgery.

The Prehab Advantage

Prehab can help reduce your anxiety and focus your energy on realistic, positive outcomes heading into your surgery.  Without it, you are much more likely to become frustrated and demotivated when recovery seems to be taking a long time because you never had anyone help you understand the time-frame for recovery in the first place. In a study in the Journal of Arthritis and Rheumatism, patients who received THA (total hip replacement) and TKA (total knee replacement) were post-surgically discharged to home more often rather than to inpatient rehabilitation facilities when they received preoperative physical therapy (Rooks D, Huang J, Bierbaum B, et al, 2006). Their research also showed that exercise participation prior to total joint arthroplasty reduced odds of discharge to inpatient rehabilitation facilities by 73%.

At Therapy Specialists, our goal is to prepare you physically and mentally for your upcoming surgery, and help educate any caregivers that might be helping you in your recovery.  Here is an example of what a prehab program might include:

During your first visit we will:

• Conduct insurance verification
• Complete required paperwork

After securing a physician’s prescription, an individual evaluation will be conducted which will include:

• Testing to determine current function and areas of potential impact to improve post-operative function.
• Review of techniques for pain management post surgically
• Discuss post-surgical expectations and timelines for recovery

Subsequent visits might also involve the use of skilled therapy interventions to strengthen areas of weakness that will impact post-surgical recovery. Treatments might include:

• Deep soft-tissue massage and stretching of muscles into the end of range of movement
• Strengthening exercises while maintaining a pain-free range of movement
• Gait re-education and proprioceptive balance work
• Core stability, flexibility, and Injury prevention education
• Introduction to use of assistive devices (crutches, walker), or braces that may be prescribed after surgery

If you are near one of our three outpatient locations or live in one of the senior living communities we serve, please contact us to discuss how prehab can help you!

Depending on the impact of your surgery, our prehab program may also include an assessment from an occupational therapist.  You will be amazed at how much an occupational therapist can help you prepare for your return home after surgery.  Immediately following surgery you should expect to be on a variety of pain medications and often times listening to post-operative instructions can be very difficult.  An occupational therapy assessment typically includes a discussion of any concerns or anxieties you may have regarding your current functional abilities in relation to self-care, productivity and leisure, your occupation, or daily tasks you have to complete in your home environment.  An occupational therapist will also educate you on what to expect after surgery and help you understand how your recovery will impact your daily routine.

An occupational therapist will likely:

• Assess you and your home environment
• Demonstrate proper techniques for use of basic adaptive equipment (reacher, sock aid, elevated commode).
• Demonstrate modifications to your daily routine
• Assess for proper shower/ bath access
• Instruct joint protection techniques and safety considerations
• Include potential caregivers in pre-operative assessment/education, and post-operative intervention
• Set up post-operative occupational therapy to facilitate ease of transition home, and decrease need for higher levels of care

In summary, we know that surgery can be very intimidating!  Most patients ask questions about the surgery but forget to ask about expectations after surgery and whether there is any thing they can do prior to surgery to be better prepared.  A prehab program can be helpful in not only preparing you for your surgery, but it can also help you prepare for life after surgery and enable you to have proper expectations regarding how long it will take you to rehab and recover.