• David Jeremic

"Prehabilitation" - More Than Just a Fancy Buzzword

Updated: Feb 26



Rehabilitation, or "Rehab", is as common as any term today's health and fitness world, and it's likely you've come across it before. It refers to patients adhering to a doctor-supervised treatment and/or exercise program for people with impairments or disabilities due to disease, disorders, or injury to the muscles, tendons, ligaments, or bones. The aim of Rehab is to improve the person's ability to function, reduce symptoms, and improve the person's well-being. That is, to return the body to it's best functional capacity, as it was before surgery, or the best it can be given the impairments.


This Blog explores what exactly Prehab is and who it is for who it is for.


For further information on where you should do it and why you should be doing it, you can read on more deeply on the topic.


Let's begin!


Prehab vs Rehab


Prehab, on the other side, is quite a nonce term that is maturing in the health and fitness world, though is quite fashionable!


Prehab, in it's entirety, is "Preventative Rehabilitation"The idea behind this term was to prepare a person as best as functionally possible for imminent surgery, and in doing so would allow the person to undergo a smooth transition though their recovery and rehab phase following their surgery, to gain the quickest path to full recovery of injury for return to sport or otherwise.


For example, if someone has ruptured their Anterior Crucial Ligament (ACL, a ligament found in the knee, commonly ruptured in Australian Rules Football), it is highly recommended, th they undertake a thorough Prehab program under the guidance of a Physical Therapy practitioner (Chiropractor, Physiotherapist), and/or exercise physiologist/strength and conditioning coach. This program may focus on achieving full knee range of movement, good quadriceps and hamstrings activation and strength, and good biomechanics and function. Many orthopaedic surgeons will not undertake the reconstruction until the individual can achieve these things, with the main reason being to minimise the effects of surgery (as well as rest and immobilisation), such as joint stiffness, and muscle atrophy (wasting) and weakness (1, 2).


For patients awaiting spinal stenosis surgery, conduction of an active exercises rehabilitation program has been found to be both feasible and safe with the aims of decreasing leg pain intensity, increasing active lumbar ranges of motion, low back extensor muscles endurance, and walking capacities preoperatively(3).


As said before, the aim of Rehab is to facilitate the return the person back to their pre-operative functional capacity. In saying this, usually their previous level of function, and the potential predispositions to the specific injury, are what caused the injury to begin with. Therefore, adhering to a Rehab program and it's goals may not be enough in preventing these injuries from happening in the future, and potentially put the person at risk from sustaining the same or related injury. Consequently, Rehab should focus on more than just the returning the person to their pre-operative function, and in fact help the person achieve a new level in their functional capacity, allowing the greatest likelihood of avoiding injury again. This maybe achieved by altering the body's biomechanics, strength, and balance). Prehab, like this, has been trialed in Rugby Union teams, and has seen benefit(4).


Injury's happen all the time, and if you find yourself in a pre-operative situation, then you may as well do what you can do to better yourself, to reach a potentially better level post-operative. Effective Prehab is optimal for this!


Understanding Prehab and it's application to the person has only been touched on in this blog. If you're interested, continue delving more deeply in to the topic.



If you're awaiting surgery or are interested in keeping on top of your injury prevention, book online to see how we may be able to help.



David Jeremic,

Chiropractor

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1. Failla MJ, Logerstedt DS, Grindem H, et al. Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction? A Comparative Effectiveness Study Between the MOON and Delaware-Oslo ACL Cohorts [published correction appears in Am J Sports Med. 2017 Apr;45(5):NP9]. Am J Sports Med. 2016;44(10):2608–2614. doi:10.1177/0363546516652594


2. Alshewaier, S., Yeowell, G., & Fatoye, F. (2017). The effectiveness of pre-operative exercise physiotherapy rehabilitation on the outcomes of treatment following anterior cruciate ligament injury: a systematic review. Clinical Rehabilitation, 31(1), 34–44. https://doi.org/10.1177/0269215516628617


3. Marchand, A., Suitner, M., O’Shaughnessy, J. et al. Feasibility of conducting an active exercise prehabilitation program in patients awaiting spinal stenosis surgery: a randomized pilot study. Sci Rep 9, 12257 (2019). https://doi.org/10.1038/s41598-019-48736-7


4. Evans, K.L., J. Hughes, and M.D. Williams, Reduced severity of lumbo-pelvic-hip injuries in professional Rugby Union players following tailored preventative programmes. Journal of Science and Medicine in Sport, 2018. 21(3): p. 274-279.




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