If you are scheduled to have surgery, your physician might recommend that you do physical therapy (PT) in the weeks leading up to it. While PT is typically thought of as something people do after surgery – or when surgery isn’t required – in some cases, it’s also recommended for patients willing to make the effort beforehand.

The idea of exercising or stretching might be confusing and even a little scary if you’ve suffered a painful injury. But there are many potential benefits to PT if done properly before joint replacements, ACL operations, and other common surgeries. Working with a physical therapist can:

• Minimize pain
• Reduce muscle atrophy
• Lessen the chance of complications following surgery
• Restore range of motion

Under the right circumstances, following a PT routine before surgery can give you a head start on your recuperation and provide an idea of what will be needed afterward to get you back to the activities you love.

Prehabilitation Shows Advantages for Some Patients

It takes just a couple of weeks to lose muscle strength and fitness after an injury. Therefore, PT before an operation often will deliver substantial advantages to patients preparing for surgery. If you’re an athlete concerned about getting back to training, your doctor may recommend it as part of your “prehabilitation.” Generally, the goal is to strengthen the muscle groups in the affected area to improve your chances of a better outcome after your surgery.

Pre-Surgery PT May Shorten Hospitalization Time

Not only may orthopaedic PT increase your motion, dexterity, and strength, but it has been shown to shorten hospital stays by reducing atrophy, which can delay a patient's return home. Furthermore, if you’re able to improve your balance before surgery, it may help minimize the likelihood of a fall afterward.

The Mayo Clinic took a closer look at the way PT can be beneficial for a patient facing surgery to repair a torn ACL. One study compared patients with a torn ACL who did PT exercises before reconstructive surgery with a similar group who didn’t. The group that had the therapy:

1. Experienced major improvements in functional outcomes three months after surgery
2. Outperformed the group that hadn’t done PT in a single-leg hop test – a common evaluation tool for knee injuries
3. Returned to their sports after 34.2 weeks, compared with 42.5 weeks for the group that didn’t do PT before surgery

PT May Help You Avoid Surgery

When patients suffer common conditions like chronic back pain, surgery is viewed as a last resort. The vast majority of herniated disc patients won’t need surgery and instead use PT to rehabilitate the injured area. PT may be one of several alternative treatments recommended by a doctor, such as corticosteroids and Platelet Rich Plasma (PRP) therapy.

Therefore, PT is sometimes attempted before a surgery the patient wasn’t planning to have or was hoping to avoid. When people have PT before back surgery, it may be because the therapy didn’t improve their condition enough for them to return to work and other normal life activities.

PT Might Be Recommended but Not Required

Orthopaedic specialists often recommend a month or more of PT to rebuild your strength and flexibility following a non-operative sports injury. So why not do the same before an operation? Even when therapy is recommended, it’s still the patient’s choice whether or not to pursue it. If your doctor doesn’t suggest it, there might be a good reason to avoid it. Perhaps there is insufficient time due to scheduling or your condition is so precarious that any attempt at PT could exacerbate the injury.

Discuss PT with Orthopaedic Physician

Every patient is unique, and recommendations will vary according to your circumstances. Some doctors will encourage you to exercise as much as possible before surgery, as long as the level is tolerable for you. Following guidelines and working with an experienced orthopaedic therapist will help ensure you don’t pull a muscle or overdo it before surgery.

Some patients are told to begin their prehabilitation at least six weeks before their surgery. But if you’re on a tighter schedule, even two weeks of PT may provide benefits. Talk to your physician so you understand what is best for you and, if you plan to do PT, look for an orthopaedic physical therapist who has special training for your condition.

Preparing for any type of surgery can be a stressful process. At MidAmerica Orthopaedics, your care before, during, and after surgery is crucial to us. We offer orthopaedic physical therapy at both our Palos Hills and Mokena offices. If you have questions about either your PT or surgery, reach out to us today.