Prehab has been shown to reduce the recovery time and complications after surgery. The general conditioning that is incorporated into a prehab program can offset some of the detrimental side effects of these procedures so that the patient is better prepared and can handle them with ease.

The time that precedes a surgical procedure, at least 6-8 weeks, is a great time to prepare the body for the negative effects of the procedure. A body part that requires surgery will often experience a loss of strength, motion, and function. If the injury site is swollen, the muscles surrounding the injury site are prone to atrophy (loss of size and strength), and the joint can lose motion and flexibility. The neuromuscular activity at the injury site can also be altered leading to a decrease in muscle activation. With more severe injuries that require surgery there is a higher likelihood of the entire body becoming deconditioned as well. There are many benefits of prehab:

• Provides pain relief before surgery
• Increases endurance levels
• Increases muscular strength
• Improves range of motion of the joint
• Decreases the risk of post-operative stiffness
• Decreases recovery time
• Decreases the risk of post-operative complications
• Reduces anxiety surrounding surgical procedures

The prehab program is individually designed by your Physiotherapist and may include the use of modalities, manual techniques and exercises that will reduce the symptoms and help to restore the function of the injured area. The program focuses on reducing swelling, pain, and loss of motion and improving muscle and neuromuscular activity. In many cases, the use of a prehab program will shorten the post-operative rehabilitation process.

Post-surgery rehab with a physiotherapist often begins in hospital within 24 hours of surgery. A physiotherapist in the hospital will have patients standing up and walking as soon as possible to reduce post-surgical complications and reduce recovery time. Often patients are given basic exercises in hospital to continue at home until they see a physiotherapist in the community. It is important that once you have been discharged from the hospital that you continue physio to achieve the best possible outcome. Depending on the type of surgery patients receive, post-surgery rehab can begin within a few days or a few weeks. Most of the time your surgeon will guide you on when to start physiotherapy. The main goals of post-surgery rehab are to return to regular functioning (work, hobbies, physical activities, and sports), manage pain and prevent re-injury. Working with a physiotherapist can help reduce the post-operative pain which may lessen the need to take prescription pain medication. Post-surgery rehab involves a combination of hands-on techniques, exercises, and modalities to maximize your recovery potential and achieve your short-term and long-term goals. During the recovery period it is essential to keep moving to avoid losing general function and conditioning. Physiotherapists can guide you through the process to ensure that you stay on track and also to make sure you are not doing too much too soon.

• Benefits of post-surgery rehab include:
• Effective management of pain
• Help you return to activities of daily living, recreational activities and sports
• Strengthening weak muscles
• Stretching stiff muscles
• Mobilizing stiff joints
• Improving posture
• Improving balance/proprioception and reducing risk of falls
• Reducing anxiety so you may regain your confidence and independence

There are 4 main stages to post-surgical rehab. The first stage focuses on controlling pain and swelling through use of modalities, hands on treatment and gentle exercises. The second stage aims to improve range of motion of the joints and flexibility of the muscles through hands on techniques and exercise. The third stage focuses on Improving strength and balance (proprioception) through a progressive exercise program. The last stage takes patients through sport specific training and gradual return to full activities.

The most common surgeries that benefit from physiotherapy include:

• Hip and knee replacement surgery
• ACL surgery
• Rotator cuff repairs, labral repairs, and debridement/decompression surgeries
• Achilles tendon repair
• Lumbar and cervical surgeries for discectomies, fusions, disc replacements