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How Physical Therapy Can Help Before Surgery

April 12, 2023

For major orthopedic surgeries, physical therapy is one of the keys to restoring your mobility and functionality. With some procedures – rotator cuff repairs, for example – you may spend up to six months in therapy working your way back to normal.

But you can actually start physical therapy sessions before the surgery happens. With pre-rehabilitation (prehab), you get a head start with your physical therapist – optimally six to eight weeks or more before your procedure.

Even if your injury is causing pain, there’s no reason you can’t get ahead of things. Your physical therapist can design a safe treatment plan, with exercises and stretches, that works with your pain tolerance.

Prehab Benefits

If you’ve injured your knee, shoulder or some other body part, surgery can go a long way toward repairing the damage. But the surgery alone won’t make you stronger, more flexible or more mobile. Those are things you have to work on. So, any improvement you make before the surgery happens will help your chances of a successful recovery.

Prehab also gives you a chance to learn more about your rehabilitation ahead of time, helping you mentally prepare for what’s coming. Among the other benefits:

  • Being as healthy as possible before surgery
  • Increased strength and stamina
  • Better healing and muscle growth
  • Faster post-op recovery
  • Reduced swelling and stiffness
  • Greater confidence and less anxiety
  • Having realistic expectations and setting short- and long-term goals

How Prehab Works

Ideally, you would have your first physical therapy appointment six to eight weeks or more before your surgery. During that meeting with your physical therapist, you’ll go over what’s wrong and how therapy can help. What are your goals? Are you trying to get back to an active lifestyle? Or just wanting to do typical household tasks?

Among your physical therapist’s objectives is identifying potential weak spots and obstacles that could stand between you and a successful outcome. By starting your plan before your surgery, you give your body’s muscles an opportunity to learn the new routine. That makes it easier to jump back into it once the surgery is complete.

If you are active, sessions will also help you understand what you can keep doing – without risking further damage. Your physical therapist may recommend cutting back on some of your activities, or adding others to the mix. There may be strengthening and stretching exercises that can be modified so that they can be done safely ahead of surgery.

If you are more sedentary, the goal is to get you into a more active lifestyle. This could be as simple as starting a walking or exercise program to encourage movement and build endurance.

Either way, you’ll leave your session with a plan for things you can do on your own at home. As with physical therapy programs that begin after a surgery, a significant part of your success is your willingness to work on your rehab while away from your physical therapist.

Does Insurance Cover It?

One of the reasons more people don’t take advantage of prehab is that they don’t realize most insurers will cover it. Some surgeons aren’t aware of it either, making it less likely that they’ll refer their patients.

Insurers typically cover a certain number of physical therapy appointments as part of a surgical procedure. Often, they’re fine with allowing some of those visits to occur before the procedure happens.

Using even a single visit ahead of time can put you on track to be better prepared for your rehab work. You’ll leave with a progressive plan that you can do on your own. In more complicated cases, such as a total knee replacement, you might need a second prehab visit. These early appointments can be followed up and modified via phone, email or telehealth sessions.

If you are looking at an upcoming surgery, talk with your doctor to explore your prehab options.

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