Pre-Hab… The new REHAB

When planning for elective total hip or knee surgery, one of the most common questions I get is: What about the Phyiso and rehab after surgery?  While post-operative Physio is key in your rehabilitation after surgery, I personally believe the work done prior to surgery is far more important.A total knee or hip replacement removes the damaged arthritic surfaces of your bones, and replaces them with metal and plastic – this change happens in approximately an hour of surgery.  However, the “soft-tissue” or surrounding muscles, tendons and ligaments are not changed and their recuperation takes weeks to months.

It is important to realize that the process of rehabbing your “soft-tissue” begins with your commitment to surgery.  Once booked, the earlier you can begin strengthening your arthritic joint, the easier your recovery will be.

Muscle strength has 2 important components: Power and Endurance.  Both are important to aid in a speedy post-operative recovery.  Both have to be trained separately.

Power involves performing a set number of repitions of a focused exercise, with increasing resistance over time.  Single limb/leg exercises are important to ensure a balanced result.  Specific exercises or routines should be reviewed with a personal trainer or physiotherapist.

Endurance involves longer periods of exercise – typically some form of cardio. Swimming laps, using a stationary bike or an elliptical machine are all beneficial.  These forms of exercise offer less impact than the use of a treadmill or running.

The frequency of exercise has to be tailored to the patient.  It has to be frequent enough to stimulate the body to respond, but not so intense or painful that you can’t move for several days after a day of exercise.

Routines, exercises and guidance are best overseen if starting to condition yourself before surgery, especially if you haven’t worked out in a while.  Please remember to involve a trainer or physiotherapist while undertaking a pre-hab program.

My advice is to start with a stretching program (especially for arthritic hips), work on endurance and fitness, then more targeted muscle strengthening.

Good Luck! Hopefully this makes recovery easier.

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