Prehab is short for pre-habilitation or preventive rehabilitation. It’s the practice of proactively exercising and taking care of your health in a way that reduces the risk of injury and thus prevents you from needing rehab.
Although everyone should practice Prehab, it’s more crucial for athletes because the risk of injury in that population is much higher.
As physical therapists, we see too many athletes that need months-long rehab due to injuries that could’ve been avoided with proper form and effective physical therapy exercises. But there is a lack of knowledge about this in amateur athletes that leads to such injuries.
In this article, we’ll explore what Prehab is, what it means for athletes and non-athletes and how it can improve your performance.
Let’s get started!
What is Prehab?
Prehab includes all forms of treatments or exercises that you do proactively to optimize your body for a certain activity. This could be as a part of your training for a sports competition, for improving general fitness or as a treatment approach before elective surgeries.
Prehab might include:
- Improving the range of motion of the knee joint and the muscle strength of quads before a knee replacement surgery.
- Strengthening the gluteals, hamstrings, and quadriceps muscles to prevent ACL injuries.
- Exercises to improve balance in the elderly to reduce the risk of falls.[i]
- Aerobics for people at risk for cardiac issues.
- Exercises to improve the stamina and quality of life of cancer patients scheduled to begin chemotherapy.
What Is The Difference Between Prehab and Rehab?
Rehabilitation, or rehab for short, is what you go through after you’ve suffered an injury. It’s the restoration of the body’s normal function.
On the other hand, prehab is what you do to prevent having the injury in the first place.
It’s not always possible to avoid injuries even with a good prehab program but it significantly reduces the risk.
A lot of the exercises are the same for both these approaches although the intensity may vary.
For example resistance training, flexibility exercises, and step training are exercises that your physical therapist would prescribe as part of prehab to strengthen your knee. These same exercises are used to help a patient recover after a total knee replacement surgery.[ii]
What is Preventive Physical Therapy?
Physical therapy (PT) is mostly known as a rehabilitation program and not as something that you do proactively.
But preventive PT is a big part of what physical therapists do for their clients, especially athletes.
Healthy adults can benefit greatly from PT. That’s because physical therapists are experts in assessing and identifying weak structures in your body and fixing bad biomechanics that could lead to potential problems down the line.
Is Preventive Physical Therapy Effective?
The literature on the effects of prehab on clinical outcomes is lacking. But multiple studies show the effectiveness of prehab or preventive PT in reducing the need for rehab. We’ll discuss some of them in this section.
A systematic review of RCTs by Cabilan, C J et al. (2015) found that preventive physical therapy in hip arthroplasty for osteoarthritis patients reduces admissions to rehab programs. However, they didn’t find any improvement in pain, quality of life or function post-surgery.[iii]
Quick tips:
Systematic review: It’s a type of research that summarizes other publications on a certain topic. Each publication has to meet a criterion to be included in the review.
RCT: Randomized Controlled Trials are the gold standard of research. Here, two groups are formed – control and experiment. Participants are assigned randomly and are usually not told what group they are in. This type of research often generates excellent results.
Hip arthroplasty: This a hip replacement procedure usually to resolve pain and remove a dysfunctional or degenerated hip joint.
Similarly, a study by M.A.Castel et al (2021) showed that prehab program reduces the length of stay for heart transplant patients. They also found that prehab reduced readmissions and the total cost of hospital admission.[iv]
A randomized controlled trial by María Torres Lacomba et al (2009) showed that early preventive PT can prevent lymphedema after surgery for breast cancer for up to a year. Their prehab program included manual lymph drainage, massage of scar tissue, and progressive active and active assisted shoulder exercises and education.[v]
A study by Fiona C. Willingham et al. (2019) found that prehab for patients that were scheduled for dialysis was beneficial. Their prehab program included a 1-hour gym-based exercise circuit and an education program. The results showed an improvement in physical function, shuttle walk distance, quadriceps one REP max and patient perception of activity. [vi]
Quick tip:
1 REP Max: This is the maximum weight you can lift for repetitive of the desired movement. For example, if you can do a bicep curl with 20 pounds at a time, and not more than once. Then that’s your 1 REP max value.
Benefits of Preventive Physical Therapy or Prehab
Some of the benefits of preventive physical therapy include:
- It tends to improve post-surgical outcomes in some populations.[vii]
- Reduces secondary complications after an injury or surgery.
- Reduce the risk of primary injuries.
- Prevents postural risk factors and ergonomic issues from becoming chronic pain syndromes.[viii]
- Improve the quality of life and reduce pain due to mechanical causes.
Importance of Prehab
In Prehab, physical therapists assess your strength, range of motion, mobility and other structures to determine any area that might be susceptible to injury. Then they design a program to optimize your physical health accordingly.
In this section, we’ll cover what prehab means for athletes and non-athletes and why it’s important to get preventive PT at the right time.
Prehab for Athletes
A lot of sports-related training that athletes undergo can be classified as Prehab. But not all training is prehab.
Training can also involve learning a sports-specific skill or practicing techniques. Prehab is where you train your bodies to adapt to the load and strengthen the structures to prevent injury and build endurance.
This could mean learning the correct landing techniques after a jump or strengthening the muscles to reduce over-pronation to protect the ankle.[ix]
The most common sports injuries that prehab prevents include ACL ruptures, hamstring strains and groin strains.
Gymnasts, professional athletes and weekend warriors – all can benefit from preventive PT.
Athletes can simply not perform at the professional level without a good prehab program. The intensity of activity is much higher for them as compared to non-athletes. Hence they need to be proper physical conditioning to stay injury-free and healthy for the long term.
Prehab for Non-Athletes and Patients
After excluding the athletes, we can divide the population into two main groups; healthy people and patients either requiring surgery or suffering from an injury.
Prehab is important for the patient population to improve their condition before they undergo surgery and also to reduce the reoccurrence of the injury.
Regular healthy people who occasionally exercise can also benefit from prehab as it can identify the areas that need to be supported.
Prehab is especially useful if you’re someone who often works in unusual postures sitting at a desk all day or lifting boxes of all sizes. Some muscles in your body might be compensating for other weak structures, and that could lead to chronic problems in the future.
You should reach out to a physical therapist as soon as you notice a sudden onset of pain in any area, even if it’s mild.
Remember: You don’t need to be seriously hurt to do PT. It’s also great to prevent the onset of an injury.
Moreover, prehab is especially important for the elderly. They tend to suffer from muscle weakness, flexibility issues, mobility problems and falls to name a few. A physical therapist can improve the quality of life of the elderly by designing a safe exercise program.
Prehab and Its Importance – In Summary
Prehab is often neglected due to a lack of awareness about what preventive PT is and what it can do for people. Everyone from professional athletes and fitness enthusiasts to patients and the elderly can gain something from prehab exercise programs.
These are designed specifically for your needs. And can help you avoid physically disabling injuries and improve post-surgical outcomes.
Contact our qualified physical therapists today to get personalised information regarding your Prehab.
[i] https://www.sciencedirect.com/science/article/pii/S1836955315000120
[ii] https://www.sciencedirect.com/science/article/abs/pii/S1934148209005528
[iii] https://journals.lww.com/jbisrir/Abstract/2015/13010/The_effectiveness_of_prehabilitation_or.14.aspx
[iv] https://www.sciencedirect.com/science/article/abs/pii/S105324982100735X
[v] https://www.bmj.com/content/340/bmj.b5396.abstract
[vi] https://onlinelibrary.wiley.com/doi/abs/10.1111/jorc.12262
[vii] https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-017-0655-8
[viii] https://www.tandfonline.com/doi/abs/10.1163/156856902760189214
[ix] https://go.gale.com/ps/i.do?id=GALE%7CA218529554&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=08992517&p=AONE&sw=w&userGroupName=anon%7Ea116b085