You’ve heard of rehab, but have you heard of “pre-hab?”




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Prehab is preparing your mind, body and spirit for surgery.

Recently, I’ve seen many of my patients and friends heading into surgery. But often times what I hear is that their care provider did not educate them on preparing for surgery. Prehab has been shown to reduce hospital stays and reduce the post-surgical pain experience.

A study by researchers at New England Baptist Hospital, Beth Israel Deaconess Medical Center and Harvard Medical School, based in Boston, found that knee and hip replacement surgery patients who had participated in water and land-based strength training, and aerobic and flexibility exercises for six weeks prior to their surgeries reduced their odds of needing inpatient rehabilitation by 73 percent.”–

What’s involved with prehabilitation?  Exercise, to include strength, flexibility and balance.  Good nutrition. And mindfulness and breathing practices. I usually encourage them to start prepping for their surgery at least 2 week if not 6 weeks prior.

Pre-Op Exercise Tips

  • Ideal to start 6 weeks prior to surgery
  • Even if you only have 2 weeks, don’t hesitate to start
  • Have your physician clear you for exercise
  • Ideal to include Strength (resistance training and weight bearing exercise), Flexibility (yoga, stretching) and Cardiovascular (walking, biking, swimming, dancing) forms of exercise
  • Specifically for strength, ideal to target core muscles (gluteals, abdominals) and lower body muscles. But don’t forget to get upper body strength too, especially if you’re post-surgical plan involves using walking aides such as crutches, walkers or canes.

Pre-Op Nutrition Tips

  • Eliminate alcohol at least 2 weeks prior–stresses the liver and causes dehydration. You want your liver as available as possible to process all the drugs used during and after surgery. Alcohol is also inflammatory.
  • Eliminate or reduce caffeine at least 2 weeks prior–caffeine breaks down capillary walls and encourages bleeding. It also stresses the liver and can cause high blood pressure.
    • Caffeine found in: Coffee, tea, sodas, carbonated drinks, and energy drinks. Green tea has between 15-40 milligrams of caffeine. Black tea has about 50 milligrams per eight ounce cup. Chocolate contains a small amount of caffeine. May be found in some over-the-counter medications: Anacin, Excedrin, and Motrin
  • Eliminate smoking–tobacco residues promote inflammation in the body. Your healing time, pain and swelling are dependent on the amount of inflammation. Blood flow and oxygen to your healing tissues is also important. Smoking limits the amount of oxygen to your lungs and thus to your tissues.


Get your FREE Pre- and Post Surgery Nutrition Tips Handout here. I usually save this for private clients only.

Pre-Surgical Mindfulness/Relaxation Tips

  • Positive affirmations that healing is already occurring. Make them about you, in the positive and as if it had already been manifested.

    “I am open to healing on all levels.”

    “My surgeon is there for me and is guiding me through this healing process.”

    “My body is relaxed and ready to heal.”

    “My body is getting stronger and healthier every day.”

    “My surgery was a complete success. My mind and body are renewed.”

    “I am surrounded by love. I am completely safe.”

    “I let go of the things I cannot control.”

    –From Valerie Girard

  •  Meditation–in several controlled studies, meditation and guided imagery were shown to lower cortisol levels and thus control pain, as well as reduce bleeding during surgery
    • Bennett, H. L., Benson, D. R., Kuiken, D. A. Preoperative Instructions for Decreased Bleeding During Spine Surgery. Anesthesiology, (1986) Vol. 65, A245.Devine, E. C; Effects of Psychoeducational Care of Adult Surgical Patients: A meta-analysis of 191 studies. Patient Education and Counseling, (1992). Vol. 19, pp. 129-142. Dreher, H. Mind-body interventions for surgery: evidence and exigency. Advances in Mind-Body Medicine, (1998). Vol. 14, pp. 207-222.

  • Meditation before, during and after surgery has been proven to:
    • lessen pain levels
    • reduce recovery time (thus shortening your hospital stay)
    • strengthen your immune system
    • allow you to sleep more deeply
    • reduce the use (and thereby the cost) of pain medication
    • Technique 1: Meditate on the breath. Follow the sensation of the breath in through the tips of the nostrils to a count of 4. Exhale, feeling the sensation of the warmth of the air to your upper lip to a count of 8. As thoughts flood in, use them as a reminder to come back to the sensation of the breath moving in and moving out. It’s normal to have a steady flow of thoughts, but it is the awareness and coming back to the breath each time that creates your meditation practice. Try for 5-10 minutes to start. Progress to 30 minutes over time. It’s helpful to use a meditation timer. I like this one
    • Technique 2: Meditate on mantra (sound, phrase). You can use the sound, Om. Or So Hum (I am that). Or Hum Sa (That I am). Where each breath in could be So and each breath out is Hum. Or each breath in = Hum, each breath out = Sa. Silently or quietly repeated with the breath. I like to use Neti Neti, meaning “not this, not that.” As in not this body, not that thing. It sends a chill within me and a sense of letting go. Again try for 5-10 minutes and progress over time to 30 minutes.
  • Progressive Relaxation–progressively moving up or down the body, consciously relaxing parts of the body to let go of unconsciously held breath and tension. Click here for a FREE recorded progressive relaxation. 

I hope this gives you some prehab to begin if you are planning on or already have surgery scheduled. Our bodies are wonderfully complex. But as noted above, there are several ways we can personally attempt to manifest the best healing opportunity after surgery.

“There is a force in the universe, which if we permit it, will flow through us and produce miraculous results.”–Mahatma Ghandi

I welcome your feedback and if you find this information helpful, please share with your colleagues, friends and family. I would love to hear if this worked for you.  Contact Tianna if you are searching how you can create a prehab program specifically for your needs and your surgery experience.

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