Physical Therapy BEFORE Surgery

How important is physical therapy BEFORE having surgery?

We are frequently asked by clients if it is important to have physical therapy before surgery. Many people feel that if they are going to have therapy AFTER surgery, why have therapy before? This may sound like a clear cut answer, but there are a lot of factors to consider.

Pre-habilitation

Pre-hahabilitation is preconditioning for patients scheduled to undergo surgical procedures such as:

  • Joint replacements
  • ACL repair
  • RTC repair
  • Cancer surgery and chemotherapy

Having therapy PRIOR to surgery can be very useful for the following reasons:

  • Education of surgical procedure, what to expect after surgery, and train on proper use of assistive devices such as a crutch, cane or walker.
  • To improve bed mobility and ambulation after surgery
  • Increase mobility and strength for improved outcomes
  • Mentally prepare patient for what’s to come
  • Stress the importance of compliance with therapy following surgery
  • It is not just for orthopedic surgeries, it can be used for pre-chemo treatment, cardiac procedures, etc.

There are many benefits of having therapy before surgery such as saving money, faster recovery and quicker return to the activities you love to do.

  • Using Pre-op Physical Therapy for total joint replacement was associated with 29% decrease in use of post-acute care services (i.e. SNF, inpatient rehab, home health rehab) (avg of $1,215 cost reduction)
  • Patients are in better physical condition when they come out of surgery – better starting point when patients start post-op rehab which means you will be able to do more…FASTER
  • Athletes return to sport quicker

Are there any reasons to not do physical therapy before having surgery?

  • Could be possible resistance from insurance coverage
  • It is Not meant to replace post-op rehab, but help get the most out of rehabilitation and recovery process

Can you give and Example of a Pre-Habilitative (Physical Therapy before Surgery) Program?

  • The duration may be 4-6 weeks long
  • Pre-habilitative Physical Therapy may include: cardiovascular conditioning, strengthening of key muscle groups, balance/posture assessment and training, and education.

The Goals of the program include: increased muscle strength for affected joint and surrounding area; improved body mechanics; decreased pain after surgery; greater confidence and motivation to recover

Available research results show increased post-op rehab results when patients undergo pre-op rehab, when compared to post-op outcomes without pre-op rehab.

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References:
http://www.news-medical.net/news/20150903/Appropriate-pre-surgical-physical-therapy-can-help-joint-replacement-patients-recover-faster.aspx

https://www.researchgate.net/profile/Jaroslav_Majernik/publication/236034609_Contribution_to_investigation_of_pre-surgical_rehabilitation_effectiveness_for_total_hip_endoprostheses_patients/links/00b7d5229b62c10ee2000000.pdf

 

Chris Taylor is the Founding Physical Therapist at PHYSIO Physical Therapy and Wellness Asheville. He has been voted Best Physical Therapist in Western North Carolina every year by the Mountain XPress Reader Poll. His experience includes being a patient himself which deepens his understanding of each aspect of the rehab process. He has lived and worked in 11 states which contributes to the treatment style he has developed which breaks the mold. Become a better You today! #KeepAshevilleActive