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WHAT IS [P]REHAB?

WHAT IS PREHABILITATION?

I feel like it will be helpful if before we define [p]rehab, we make sure we understand what rehab is! Rehabilitation is the process of restoring someone to health, or in the case of an athlete restoring them to the same level of skill they were at, after an injury or illness. [P]rehabilitation is the process of preparing the body and mind ahead of time, in an effort to prevent illness or injury before it happens, or to possibly shorten the recovery time post-surgery. Prehab is not meant to replace rehab, but to work with it to maintain the best health and the quickest recovery possible!




PREHABILITATION FOR SURGERY

Marcia Ditmyer, PhD, describes that “By improving an individual’s functional capacity through increased physical activity before an anticipated orthopaedic procedure, it seems reasonable to assume that the individual will maintain a higher level of functional ability and rebound more rapidly in the rehabilitation process.” Again, prehab is not at all meant to replace rehab, but to aid in the recovery process, and hopefully shorten the amount of time spent doing rehab. Think of prehab—when dealing with surgery—as kind of kicking physical activity into a higher gear in order to prepare the body to be able to better deal with the inactivity that will ensue post-surgery. Prehab can include several different aspects! Prehab programs can include cardiovascular components, resistance training, flexibility training, and even training of certain functional tasks that may be crucial to the rehab program, but maybe not performed often otherwise. While more research is needed on the topic, some studies have shown that patients who are involved in prehab programs before surgery have shorter rehabilitation requirements and shorter hospital stays (both of which can lead to a reduced financial burden), and therefore are able to return to their lives/jobs/sports faster! (Image: Topp, et al., 2009)


PREHABILITATION FOR EXERCISE/TRAINING


While most of the time, when you hear someone talk about prehab, it is with regards to surgery, the principle of prehab can also be applied to exercise. The term ‘warm-up’ is more commonly used, but it’s not so common. Unfortunately—with the exception of athletes on sports teams that have programs in place or coaches to guide them—the vast majority of people who exercise/train do not adequately prepare their bodies for physical activity prior. Properly warming up (prehab) before physical activity has been shown to increase the speed and force of muscle contractions, increase blood flow to muscles (and therefore more oxygen delivered to muscles), increase the speed of nerve transmission, and ultimately aid in injury prevention! So, what exactly is the optimal way of prehabing before physical activity? That is a topic for another post coming soon!


TAKEAWAYS:

-Rehabilitation is for recovery after an injury or surgery

-Prehabilitation is for preparing someone for injury-prevention or a shortened recovery post-surgery, before the injury or surgery occurs

-Warm-ups (prehab before exercising) can have many beneficial effects, including aiding in injury-prevention



References:

Andrews, James R. Physical Rehabilitation of the Injured Athlete. ElsevierSaunders, 2012.

Ditmyer, Marcia M., et al. “Prehabilitation in Preparation for Orthopaedic Surgery.” Orthopaedic Nursing, vol. 21, no. 5, 2002, pp. 43–54.

Gometz A, Maislen D, Youtz C, et al. (May 23, 2018) The Effectiveness of Prehabilitation (Prehab) in Both Functional and Economic Outcomes Following Spinal Surgery: A Systematic Review. Cureus 10(5): e2675.

Liebenson, C. Rehabilitation of the Spine: A Practitioner's Manual. Lippincott Williams & Wilkins, 2007.

Topp, Robert, et al. “The Effect of Prehabilitation Exercise on Strength and Functioning After Total Knee Arthroplasty.” Pm&r, vol. 1, no. 8, 2009, pp. 729–735.

Woods, Krista, et al. “Warm-Up and Stretching in the Prevention of Muscular Injury.” Sports Medicine, vol. 37, no. 12, 2007, pp. 1089–1099.

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