April 17, 2017
Having Knee Surgery? Do Some Prehab

By Dr. Ryan Geringer

So you’ve had an injury, or maybe you’ve suffered from arthritis for years.  In either case, it has gotten to the point where your doctor says you should have surgery.  There’s nothing you can do until that happens, right?  Turns out, you can significantly improve the outcomes of your surgery with a little “pre-hab.”  Preoperative physical therapy, or “pre-hab” has been shown in research to both cut down on the costs of your recovery and improve your results.

Prehab Works

One recent study in the US analyzed the costs associated with hip and knee replacement surgeries.  What they learned was that people who had at least one pre-hab session ended up using less post-acute care services such as inpatient facilities or home health care services [1].  These pre-hab sessions were more focused on how to handle daily life after surgery rather than on any particular physical movements.  Topics included training on using postoperative assistive walking devices, planning for recovery, and managing post-surgery expectations.  Such sessions are especially useful for older patients and for patients with severe injuries or arthritis.  All in all, the study found that having just one pre-hab session lowered the cost of surgery and recovery by $871!  Not bad for an hour or two of your time.

Better Pre-Operative Function Better Post-Operative Results

Another recent study focused on more intensive preoperative physical therapy.  Knee TherapyResearchers and practitioners in Norway believe that optimal preoperative knee function will lead to better postoperative knee function [2].  To that end, persons scheduled for knee surgery first go through five weeks of progressive physical training in an effort to achieve 90% muscle strength in the affected leg.  This training includes heavy resistance strength training, plyometrics (jumping exercises) and neuromuscular exercises. 

 Recover quicker and better

Therapists and clients get to work as soon as swelling goes down and patients regain their full range of motion.  In this study, the group that went through this type of preoperative physical therapy scored significantly higher than the control group on quality of life measurements and the ability to do the activities of daily living.  The pre-hab group also reported less post-operative pain and had a much better ability to return to sports after surgery.

Use the time you have

So regardless if you opt for one or two sessions, or dive into five weeks of strength training, pre-habbing is a good idea.  It’s your first step in the right direction and the best way to recover quicker.  And while you’re waiting on that surgery, you may want to take a look at our knee care kits.  With the cooling compression of the Freeze Sleeve, the pain relieving spray Fast Freeze and a supportive brace, these kits will help you both before and after surgery!

 

 

 

[1] Snow, R., Granata, J., Ruhil, A.V., Vogel, K., McShane, M.s, & Wasielewski, R. (2014). Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement. J Bone Joint Surg Am, 96(19),165.

[2] Grindem, H., Granan, L.P., Risberg, M.A., Engebretsen, L., Snyder-Mackler, L., & Eitzen, I. (2015). How does a combined preoperative and postoperative rehabilitation programme influence the outcome of ACL reconstruction 2 years after surgery? A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian National Knee Ligament Registry. Br J Sports Med, 49(6), 385-9.

Joe McClung

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