Undergoing a total knee replacement (TKR) or total hip replacement (THR) is a major surgical procedure often recommended to alleviate pain, restore mobility, and improve quality of life. While much attention is given to post-operative rehabilitation, pre-operative rehabilitation (often called “prehab”) plays a vital role in enhancing surgical outcomes. Engaging in a structured rehabilitation program before surgery can significantly impact recovery time, reduce post-surgical complications, and improve long-term joint function.
Pre-Surgery Rehabilitation for Better Outcomes
While pre-surgery rehabilitation is beneficial for anyone preparing for joint replacement surgery, certain signs and symptoms may indicate a stronger need for it. These include:
- Severe pain or stiffness in the knee or hip that limits daily activities like walking, standing, or climbing stairs.
- Muscle weakness around the affected joint, which can make it difficult to maintain balance or stability.
- Reduced range of motion in the hip or knee, making it challenging to fully bend or straighten the joint.
- Loss of functional independence, requiring assistance with personal care or mobility.
- Swelling and inflammation of the affected joint, sometimes accompanied by warmth or tenderness.
- Poor Balance and Proprioception: Pain and joint dysfunction can impair the body’s ability to sense joint position, increasing the risk of falls.
- Obesity or Excess Weight: Carrying extra weight increases the load on joints, as well as inflammation, and can also make surgical recovery more challenging.
We can build a personalised comprehensive pre-operative rehabilitation program based on your current function and personal needs to address these factors, ensuring you are in optimal physical condition before surgery.
Research shows that patients who engage in pre-operative rehabilitation before TKR or THR have better surgical outcomes than those who do not. Specific benefits include:
- Faster Recovery Times: Patients return to normal activities and work sooner.
- Reduced Pain After Surgery: Stronger muscles and better range of motion reduce post-operative pain levels.
- Lower Risk of Complications: Reduced hospital stays and fewer post-surgical complications (e.g., infections or blood clots) have been observed.
- Improved Long-Term Function: Patients achieve greater mobility and strength over the long term.
Treatment: Key Components of Prehabilitation
While physiotherapy forms the core of a pre-surgery rehabilitation program, other elements like education and lifestyle changes play an essential role. Our physiotherapists will design a personalised exercise program to target specific muscles, joints, and movements needed for post-surgical success. These key components include:
1. Physiotherapy Exercises
- Strength Training:
- For TKR: Focus on quadriceps, hamstrings, and calf muscles.
- For THR: Emphasis on gluteal, hip flexor, and core muscles.
- Resistance exercises may involve bodyweight movements, resistance bands, or light weights.
- Flexibility and Range of Motion:
- Stretching exercises are essential for maintaining joint mobility.
- Examples include hamstring stretches, hip flexor stretches, calf stretches, and quadriceps stretches.
- Balance and Proprioception Training:
- These exercises improve joint stability and reduce the risk of falls.
- Activities like Feet together balancing, tandem balancing, single-leg balancing may be prescribed.
- Aerobic Fitness:
- Low-impact activities like swimming, cycling, or walking improve cardiovascular health.
- Aerobic fitness supports overall health and post-surgical recovery.
2. Education and Goal Setting
Patients who understand the surgery and recovery process have better outcomes. Pre-operative education will cover:
- What to expect before, during, and after surgery.
- Setting realistic goals for mobility and pain management.
- Strategies for managing pain and using assistive devices like crutches or walkers.
3. Pain and Swelling Management
Pain and swelling are common prior to surgery. Prehab may include:
- Manual therapy: To help reduce joint stiffness and improve range of motion.
- Ice or Heat Therapy: Applied to relieve joint pain or muscle soreness after exercise.
If you have any questions, please give us a call for an appointment. We look forward to help you along your prehab/rehab journey.