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From The Desk Of Clarence Bass

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I wrote earlier about visiting the very impressive Michael Johnson High Performance Athletic Training Center, which adjoins the new Cooper Clinic at Craig Ranch http://cbass.com/CooperClinic20-yearanniversay.htm .  Iíve recently learned that we have a comparable facility in Albuquerque: Southwest Sports Institute (SWSI).  Scott Revels, a physical therapist and long time friend, told me about SWSI and offered to show me around. He operates out of the same complex as ďSports Driven Rehabilitation and Training.Ē The Sports Institute and Scottís physical therapy clinic, working together, provide a much needed and valuable service to performance-minded individuals in our area.  You can learn more about both by visiting their respective websites, http://www.swsinm.com/ and http://www.besportsdriven.com/about/ .

While touring the spacious and well equipped facility with Scott, I told him about the new anterior approach hip replacement and how I successfully prehabbed myself prior to having the procedure http://cbass.com/Hiprep.htm . We discussed training to improve athletic performance, prehab, rehab, and many other things. Scott has a warm and caring personality and knows his stuff. I asked him to write a short article on prehab for our visitors. I believe youíll agree that he has done a good job outlining what prehab is about and why itís important for anyone, athlete and non-athlete, contemplating orthopedic surgery. He tells me that he will be writing a series of articles addressing the importance of strength and conditioning prior to surgery for his website. He plans to discuss prehab for different surgeries, such as ACL reconstruction, hip replacement, shoulder replacement, etc. This article will be first in the series.

Prehabilitation, a/k/a Prehab

What it is and why you want it

By Scott Revels PT, MS, ATC/L, CSCS
Sports Driven Rehabilitation and Training

Prehabilitation, prehab for short, is conditioning the body and mind for surgery--before the surgery. Studies have shown that patients who participate in moderate exercise before surgery experience an accelerated recovery. This occurs because prehab creates an optimal environment for recovery by helping prepare the individual for surgery mentally, emotionally and physically. Prehab training programs incorporate a warm-up, cardiovascular activity, strength training, flexibility training, and functional skills. Preventing unnecessary atrophy is a central part of helping the individual meet their post-surgical challenge. After surgery, patients display higher levels of functioning and less pain compared to those who did not participate in prehab.

Mental Preparation

Knowing what to expect following surgery is very important. It is well documented that individuals do much better after surgery if they know in advance whatís going to happen, including pain management, time in hospital, how soon to start movement, length of rehab, and possible complications.  Knowledge and planning improve outcome. This is especially true for operations that involve complex rehabilitation protocols, such as knee ligament reconstruction.

Emotional Preparation

Emotional preparation specifically addresses the patientís fear of surgery. Fear can be more debilitating than the initial injury or the surgery. Brief periods of depression are common. Knowledge of rehabilitation procedures and typical outcomes enables the patient to prepare emotionally and develop coping strategies. A positive attitude significantly improves the chances of a good outcome.

Physical Preparation

Prehab probably won't decrease the time needed for tissue healing, but it does accelerate muscle recovery, improve function, and reduce deconditioning and down time after surgery.

By improving muscle strength and endurance, prehab reduces the chance of injury once conditioning programs are resumed. This preparation helps to accelerate the transition back into full function. Good muscle condition prior to surgery translates into improved muscle function after surgery.

The primary objective of prehab is to shorten the recovery time after surgery and aid in preventing future injury. It gives the patient/athlete a jump on formal rehabilitation. Prehab also provides time to address other areas of weakness that may have contributed to the initial injury or may result from the injury.

Prehab can be decisive in overall outcome and should be pursued whenever possible. It should take place in a safe, controlled yet challenging environment.  

Ask your health care provider about prehab before your next planned surgery. Youíll be glad you did.

Source list:

Ditmyer, M. M., R. Topp, et al. (2002). "Prehabilitation in preparation for orthopaedic surgery." Orthop Nurs 21(5): 43-51; quiz 52-4.

Jaggers, J. R., C. D. Simpson, et al. (2007). "Prehabilitation before knee arthroplasty increases post-surgical function: a case study." J Strength Cond Res 21(2): 632-4.

Spain, J. (1985). "Prehabilitation." Clin Sports Med 4(3): 575-85.

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Ripped Enterprises, P.O. Box 51236, Albuquerque, New Mexico 87181-1236 or street address: 528 Chama, N.E., Albuquerque, New Mexico 87108, Phone (505) 266-5858, e-mail:  cncbass@aol.com, FAX:  (505) 266-9123.  Office hours:  Monday-Friday, 8-5, Mountain time.  FAX for international orders: Please check with your local phone book and add the following: 001-505 266-9123

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