How Exercise Can Prepare You for Surgery

Surgeries are no fun; I have gone through two already and, personally, would rather not go through a third one. Unfortunately sometimes, circumstances force us to have surgery and there is nothing we can do about it. But all is not lost; there are things we can do to help us get back on our feet quicker. One thing you can do to help prepare for your surgery is exercise; this is known as Prehabilitation.

In this article, I will be talking about the effects of exercising before a surgery, as a way to increase your chances of better results after the surgery. The benefits of prehabiliton can be similar among various types of surgeries[1].

Research results have been growing in the area of prehabilitation over the years; in the past, it was believed that we needed to conserve our bodies in order to prevent injury (especially if we were to going to have surgery) and exercise was rarely offered or recommended to patients[2]. It was believed that exercising would cause more damage, rather than benefit the patient. However, now there is more and more evidence that exercising before a surgery can actually improve your chances of a faster and better recovery[3].

There are several benefits for exercising before a major surgery, these include: strengthening your muscles, teaching your body how to move properly and setting good habits. These can all occur while participating in a pre-surgery exercise program. All of these benefits will come in handy post-surgery as you will be able to reap the rewards for a significant amount of time afterwards[4].

1. Strengthening Your Muscles

Often, because of pain and discomfort, a patient may stop or limit the use of their injured side (e.g. their left side as a result of their injured left knee) as a way to cope. They may not even realise they are doing so; their own bodies make adjustments so that they experience less discomfort as they perform their day to day activities. Unfortunately, this means that their injured side may not be getting enough exercise and may get weaker over time[5].

For those who are going to have surgery to “correct” their problem (e.g. knee or hip replacement surgery), they may think that exercising before surgery would not be of any use since they will be receiving a replacement anyway. However, since you would not be able to start exercising immediately after your surgery, your muscles on both sides of your body would become even weaker as you are recovering from surgery. If you exercise before the surgery, your muscles will become stronger and you will be in a better state of health when you start participating in post surgery physical therapy and exercise programming[6].

In the chart below, I show the potential benefits of prehabilitation for someone undergoing knee replacement surgery. Keep in mind these numbers are hypothetical, as each person may have variations in their exercise programs and the rate in which they would lose muscle after their surgeries:

 Strength With PrehabilitationStrength Without Prehabilitation
Starting Point20 lbs of strength20 lbs of strength
After Exercise Program40 lbs of strength20 lbs of strength
After Recovering from Surgery30 lbs of strength10 lbs of strength
Total Difference in Strength Compared to Starting Point+10 lbs of strength-10 lbs of strength

Based on this example, the person who participated in prehabilitation showed a 20 lb difference from the person who did not participate. While 20 lbs may not sound like much, it can make a big difference in our bodies’ ability to walk and stay balanced. Also, the person in prehabilitation would also have received the other countless benefits of exercising, such as improved heart health and immune system[7].

In a real world example, a study on the effects of prehabilition was completed by having colorectal surgery patients undergo 4 weeks of exercising pre-surgery[8]. When compared to those who only participated in exercise after their surgery, 53% of prehabilition patients improved in their walking speed (compared to 15% of rehabilitation patients). The average difference between the two groups was 45.4m. Again, this improvements may not seem like a big deal, but it can really help to get patients back into their normal lives.

2. Teaching your body how to move

Not only do your muscles benefit from exercising, but your nerves and brain also benefit; exercising on a regular basis can help to teach your body how to move well and prevent future injuries. For example, some patients may have a knee replacement because their knees had been worn down due to improper movements, which would not be ultimately fixed by an operation. While the operation can help to relieve the discomfort, the other knee may also start to become worn down. In fact, many people who undergo a knee replacement return to the operating table to have the other knee replaced because of overuse[9]. Exercising to restore your body’s movements can help to prevent further health problems.

3. Setting good habits

We often set goals for ourselves, and tend to have difficulty turning that goal into a habit; starting an exercise routine can be especially tough. While we often think we will keep the promises we make to ourselves about exercising, it can be very difficult to start exercising after a major surgery. This is why it is beneficial to start those habits early on. It can take several months before a new activity becomes a habit, but can be achieved with persistence.

For those who will be undergoing surgery, it is best to set these habits when we are still able to perform the exercises with relative comfort. Setting time aside every day, or every other day, can be challenging at first, but becomes easier after weeks of practice.

After the surgery, it can be very difficult to build up the motivation to exercise. By setting these habits early, you are able to exercise without as much difficulty. While you will still be dealing with the discomfort of the surgery, you have prepared yourself for the exercise routine that you had been practicing previously.

Finding the Right Health Professional

As you begin your prehabilitation journey, be sure to find a qualified health and/ or exercise professional to help you along the way. DO NOT engage in exercise before your surgery without consulting with your health professional first! They can help prevent injuries, increase your chances of a successful surgery and a better quality of life afterwards. 

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For Your Reference

  1. Li, C., Carli, F., Lee, L., Charlebois, P., Stein, B., Liberman, A. S., … & Kim, D. J. (2013). Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study. Surgical endoscopy, 27(4), 1072-1082.
  2. Cheema, F. N., Abraham, N. S., Berger, D. H., Albo, D., Taffet, G. E., & Naik, A. D. (2011). Novel approaches to perioperative assessment and intervention may improve long-term outcomes after colorectal cancer resection in older adults. Annals of surgery, 253(5), 867-874.
  3. Silver, J. K., & Baima, J. (2013). Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes. American journal of physical medicine & rehabilitation, 92(8), 715-727.
  4. Jones, L. W., Peddle, C. J., Eves, N. D., Haykowsky, M. J., Courneya, K. S., Mackey, J. R., … & Reiman, T. (2007). Effects of presurgical exercise training on cardiorespiratory fitness among patients undergoing thoracic surgery for malignant lung lesions. Cancer: Interdisciplinary International Journal of the American Cancer Society, 110(3), 590-598.
  5. Lawrence, V. A., Hazuda, H. P., Cornell, J. E., Pederson, T., Bradshaw, P. T., Mulrow, C. D., & Page, C. P. (2004). Functional independence after major abdominal surgery in the elderly. Journal of the American College of Surgeons, 199(5), 762-772.
  6. Mayo, N. E., Feldman, L., Scott, S., Zavorsky, G., Kim, D. J., Charlebois, P., … & Carli, F. (2011). Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery. Surgery, 150(3), 505-514.
  7. Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: the evidence. Cmaj, 174(6), 801-809.
  8. Gillis, C., Li, C., Lee, L., Awasthi, R., Augustin, B., Gamsa, A., … & Carli, F. (2014). Prehabilitation versus Rehabilitation: A randomized control trial in patients undergoing colorectal resection for cancer. The Journal of the American Society of Anesthesiologists, 121(5), 937-947.
  9. Higuera, C. A., Elsharkawy, K., Klika, A. K., Brocone, M., & Barsoum, W. K. (2011). 2010 Mid-America Orthopaedic Association Physician in Training Award: Predictors of early adverse outcomes after knee and hip arthroplasty in geriatric patients. Clinical Orthopaedics and Related Research, 469(5), 1391-1400.