Integrating PreHabilitation into your practice

September 23, 2008 · 1 Comment

It’s been some time since my last blog. I had the unfortunate task of undergoing meniscal surgery and trying to get back on my feet. It’s amusing how we doctors are the worst patients out there. I can’t remember the number of times being yelled at for not resting enough by my surgeon, chiropractor and therapist! However, there were some positives that came out of it, and that was right before my surgery. A few months ago, I had reinjured my knee and ended up with a very swollen knee with limited range of motion. That’s why I had decided to go for the procedure. At the time of surgery, my surgeon was amazed that I recovered full range of motion and my strength was still there. That’s one reason why I was able to get back on my feet quicker than most. This was all due to doing an effective prehabilitation program. Whenever I talk to other doctors, I start to realise that prehabilitation is not something that everyone does, although the results for your patients will be that much better.

Prehabilitation is not only defined as exercises to develop areas of the body to prevent future injuries, but also ability to maximize strength, flexibility and mobility in people prior to surgery in order to increase functional outcomes after surgery. This is starting to become more and more important in this time and age. People that are showing up at surgery are more sedentary, obese, and have a constellation of health conditions that increases the risk of morbidity and delays recovery following surgery. This is a major reason to begin getting your patients into as best of shape as possible prior to the surgery. The importance of this can’t be underestimated. Research is already showing that prehabilitation leads to better outcomes after surgery.

Prehabilitation is not as difficult to do as one may think. Setting up a small room for various exercise equipment is a good start if you don’t have any. Start off with something simple as bands and a gym ball and work your way to more equipment as interest grows. Marketing prehabilitation to your patients and the public is also important to increase awareness. Since it’s not a service most people know of, education is a key component of making this successful. Another angle to take with prehabilitation is preventing injuries from occurring in the first place. This is popular among sports trainers to prevent injuries in their athletes. But why stop at athletes? Talking about the benefits of prehabilitation is also important for workplace injuries. Back schools have been around for awhile, but there’s also the ability to address other conditions, such as carpal tunnel, knee pain, headaches, etc. By promoting a preventative practice, there will be an increased awareness of your practice in the community. So next time your patient goes for surgery, take advantage of the situation. I’m certainly glad I did.

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