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A look at the annual surgery stats in the U.S. will tell you that approximately fifty million individuals undergo surgery every year. But can you guess the factors upon which the success of surgery depends? We can fill you in.

In addition to the skill of the surgeon being a major factor, surgical success also depends heavily on the physical preparedness of the individual patient. If you have experienced a surgical procedure, you must have thoroughly investigated your options. Quite possibly, you would have shortlisted the best hospitals, the best surgeons, and the best treatment approaches. A thorough, diligent research and selection process considering all of these variables can be the difference between smooth sailing through treatment, recovery, and post-recovery or complications and prolonged recovery.

Did you know that pre-surgery physical preparation, in the form of an exercise training program, also plays a vital role in how well you recover from surgery and its ultimate success? Pre-surgery training is a way of preparing your body for the physical demands it will be placed under while recovering from the surgical procedure; it will make you more resilient. Let us explain how:

(If you are interested in learning more about pre-surgery preparation or have one of our professional Sarasota based personal trainers design a comprehensive 6–12-week program, click here.)

Pre-Surgery Preparation

Like every athlete that prepares thoroughly for the rigors of an upcoming season, people need to prepare for an upcoming surgery. When we are talking about pre-surgery preparation, we are not only talking about logistics. We are talking about physical priming to increase your physical readiness. This readiness allows you to deal with the rigors of rehabilitation and the compensatory motor patterns associated with the post-surgery itself. Imagine if an athlete shows up for practice on the first day of the season without completing any pre-season training program. It is very likely that, at best, their first few weeks of practicing will be miserable. And at worst, they injure themselves and negatively impact their ability to play, all because they disrespected the physical demands of their chosen sport or activity. Preparing for surgery is going to be a similar process to an athlete preparing for a season. Your body needs to be ready for the physical demands placed on it after the surgery.

There will be both physical therapy demands and the demands of having altered movement patterns. For example, you had knee surgery, so now your other leg has to do more work to move the whole body, and your arms need to be strong enough to help you get up and down out of chairs. Make no mistake that the better conditioned and strengthened you are, the faster you will recover. The surgical effects will be better for you, meaning whatever the surgery was supposed to fix will improve even better if you are more fit. To have a better recovery, go forward, not backward. Do not be like the athlete who shows up out of shape on day one of practice. Do not disrespect the physical demands that you will need to recover. The surgery will not fix anything without your being able to, physically, help it along. Or even worse yet, you could injure something else because it was not ready to work harder during your surgical recovery stage.

Every orthopedic surgery relies heavily on the soundness of your shoulders, hips, and knees, etc. Suppose you are someone who struggles each time you have to get in or out of a chair. If you then underwent hip replacement surgery, would you not need extra strength and mobility? And that is not only going to be the case on the surgical front, which involves trying to recover from the procedure, but also on the non-surgical side because you will make compensations in normal movement patters as a work around. I think you are getting the idea of how crucial pre-surgical preparation is for your safety and success while undergoing your recovery.

The extra strength needed will come from pre-surgery exercises, workouts, and therapy. If, instead, you go into surgery with a weak upper body or weak legs, can you guess the repercussions? You would increase your risks of injury during the post-surgery phase. You will probably have to overuse your hands to get up and down and might resultantly damage your shoulders.

Therefore, the healthier you are before you go into surgery, the quicker and more successful your recovery will be. However, you must note that I am not emphasizing an overzealous fitness routine here. What I recommend is following the simple guidelines below:

(If you are interested in learning more about pre-surgery preparation or have one of our professional Sarasota based personal trainers design a comprehensive 6–12-week program, click here.)

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Pre-Surgery Guidelines

These include:

-Launch your pre-surgery routine at least six weeks before your surgery. Eight weeks or more would be better. You could even leverage this surgery to be the beginning of a new healthier lifestyle.

-If you are new to exercise, seek a qualified fitness professional, preferably one who has a degree in exercise science and specializes in these types of routines. You require a trainer that understands the biomechanical challenges that are involved in your recovery. Additionally, as a new exerciser, you will need someone that knows how to progress you from where you are currently, physically. This progress means they should do a full-body activity readiness assessment and also a medical history check. So, by all means, get qualified professional help. The last thing you need is an injury, right before your surgery, that you caused by trying to do it yourself (i.e., pulling a muscle, exacerbating your condition, strains, etc.). It is worth the money for your safety, success, and peace of mind.

-If you are already a seasoned active exerciser in good shape, great for you. Now what you may want to do to prepare for surgery is seek the advice of a qualified fitness professional, preferably one that has a degree in exercise science and specializes in these types of routines. You require a trainer that understands the biomechanical challenges that are involved in your recovery. A good trainer can show you how to add a few exercises to your current routine specifically designed to help you with your recovery phase.

For some, it may seem counterintuitive as to why they should undergo a pre-surgery preparation program. After all, would it not strain the body more or worsen their condition? Well, it could if you don’t know what you are doing. But the fact is that clinical research has shown that appropriate pre-surgery training helps put patients in optimum condition, and the better physical shape and state of preparedness a person is, the better they recover and fewer complications they have. This preparedness means that pre-surgery physical conditioning programs strengthen joints, muscles, and bones to minimize the possibility of stiffness and muscle loss post-operation.

With that said, let’s now look at another majorly important component of successful recovery from surgery: Post-surgery physical therapy and post-physical therapy progressive exercise to restore normal function and fitness levels.

(If you are interested in learning more about pre-surgery preparation or have one of our professional Sarasota based personal trainers design a comprehensive 6–12-week program, click here. If you are interested in ongoing post-surgery recovery programs to bridge the gap between physical therapy and optimal performance, click here)

Post-Surgery Recovery Training – Bridging the gap between physical therapy and optimal performance.

I have discussed why exercising and getting in the best shape possible from where you are now is essential before orthopedic surgery. At the same time, I also wish to emphasize the necessity of post-surgery recovery training for the same purposes. Your surgery does not magically “fix” your problem if you do not recover to an optimal state of functionality from your surgery. The intended effect of the surgery hinges on your compliance with post-surgery physical therapy, and most often, a willingness to continue training after the physical therapy stage is over. Thirdly, an understanding of exercise progression becomes essential, especially for those that may enjoy exercise and have the potential to overdo it and potentially progress too fast and injure themselves.

This component is where hiring a professional that understands both psychological and physiological issues with recovery is invaluable. Generally, most people will either underdo their post-surgery rehabilitation (or not even comply at all). But there is also the group that may be prone to overdoing it. And I fully understand the eagerness to continue the active lifestyle these people seek. As a professional, I have a great deal of education and experience in knowing when it is essential to give someone a little push of encouragement to do more. I also have the knowledge to understand when a person needs us to pull back on the reins a little to slow them down and give their tissue time to recover and strengthen. If you progress too fast and hurt yourself, you go back, not forwards, possibly even damaging the ability of the surgery to recover 100%.

(If you are interested in learning more about pre-surgery preparation or have one of our professional trainers design a comprehensive 6–12-week program, click here. If you are interested in ongoing post-surgery recovery programs to bridge the gap between physical therapy and optimal performance, click here)

At the time of this writing (9/25/21), I am 53 years old and have had two hip replacements, one in 2017 and one in 2018. The physical therapy for each was two weeks in-home, then 1 to 2 months outpatient. I genuinely designed my physical therapy program and did it on my own (which I do not recommend for someone who does not have the background and experience I do). I was able to do this because, after my first hip replacement, there was a two-week gap between when my in-home therapy stopped and when the outpatient facility had openings to put me into their schedule. Two weeks of immobility and inactivity at that stage is unacceptable because of the tissue remodeling involved. I might advise someone who does not have my education and experience level with exercise in getting professional help for the two-week gap. Or, at the very least, continue to do the prescribed exercises for your in-home physical therapy until the outpatient therapy begins. However, in this case, I started to design my own system using applied principles of corrective exercise and rehabilitation science that I had learned over the years. As I waited for my outpatient physical therapy to begin, the therapeutic workouts I had put together for myself seemed to be going well and included some exercise in the pool.

After the two weeks went by, time had come to go the outpatient physical therapy office for the first session. I showed the therapist what I had been doing. I also explained that I was a trainer and strength and conditioning coach and had a master’s degree in exercise science, with a concentration in performance enhancement and injury prevention. They then said to me, “You don’t really need us… you’re doing great on your own… you are weeks ahead of where most people would be… call us if you think you need help.” But please note from my story… even with my education and experience, I fully planned to attend, and comply with, the physical therapy program that the professional therapists planned for me. So again, don’t try to go it alone. They gave me the go-ahead to continue on my own, and if they had not, I would have continued therapy.

So, at that point, I continued with my physical therapy, and two months went by. I had been doing a better and more diligent job on my physical therapy than would usually be the case for someone working with a physical therapist. The average person working with an outpatient physical therapist would not have seen the same progress. Still, at the end of the two months, I realized I was far from genuinely recovered, even considering that I was probably way ahead of where most people would be. After all, do you sincerely think for one second that myself or anyone else is back to normal after surgery just because two months of physical therapy is over? That would be a ridiculous notion. This situation is not a yes or no/on or off one. It is a progression. So, this only confirmed what I had already known from dealing with injury rehabilitation in the past (my own and my clients and athletes); when medically prescribed physical therapy ends, there is still a massive gap to getting back to 100% function. Therefore, a training plan that takes a person from the post-physical therapy stage back to 100% function is necessary.

(If you are interested in learning more about pre-surgery preparation or have one of our professional trainers design a comprehensive 6–12-week program, click here. If you are interested in ongoing post-surgery recovery programs to bridge the gap between physical therapy and optimal performance, click here)

Then, once you are at 100% function, what would be wrong with taking it even further? About four months after my second hip replacement, my strength levels on my squat and deadlift were very close to my old maximum strength levels from 6 years earlier when I was regularly training those lifts. Note: at this time, I still had some mobility restrictions. But I was also of the opinion that if this was the best my hip replacements ever were going to be (the proverbial, as good as it gets), then the procedure was still worth it and was, in fact, a success. Who would have known about four months later, one year from a second hip replacement, and two years from my first, I would set my personal best records in these two lifts? My old deadlift maximum before late 2019 was 385lbs with the perfect form set about seven years early in 2012. At 5:09 PM on December 27th, 2019, after one year and six months from my second hip replacement, I pulled a 425lb deadlift and probably could have gone up in weight. February of 2020, I broke my all-time squat record of 365lbs for a one-repetition maximum, set in 2014, by doing 375lbs for a set of 3 reps.

Now among strong weightlifters, these are not great lifts. Pretty good but not great. On many powerlifting standard tables, these would be considered the high end of intermediate level or the low end of advanced level. Respectable for someone who is not a powerlifter with two hip replacements, however. I will take it. But, there are still some limitations and movement restrictions that I continue working on and am still getting improvement on to this day.

(If you are interested in learning more about pre-surgery preparation or have one of our professional trainers design a comprehensive 6–12-week program, click here. If you are interested in ongoing post-surgery recovery programs to bridge the gap between physical therapy and optimal performance, click here)

As a 53-year-old athletic man with a history of two hip replacements and record-breaking lifts after those, here is my recommended approach for you:

-Prepare a pre-surgery and post-surgery exercise plan with a qualified trainer. You must work with your trainer to develop a personalized workout routine specific to your special recovery needs. Avoid making mistakes resuming workouts on your own, post-surgery, without qualified guidance, or you may suffer an injury or improper healing.

-If possible, make sure your medical practitioner approves your workout plan from the trainer before exercising after the surgery. At the very least, the doctor should give you what is called “contraindicated movements”. You can share these with your trainer, as doctors do not take any exercise-related coursework in medical school and often have a limited understanding of exercise. Your goal is to heal faster and heal well. If you do not do the necessary recovery work, you risk a poor recovery process and less than optimal results from your surgery.

-While this may sound cliché, I cannot stress enough the importance of a highly nutritious diet during the preparatory and recovery phases. A wholesome diet aids in the healing process and gives your body the energy to resume exercise. Your immune system and body will rely on the right foods for raw materials. The right foods will prevent infections, weakness, and deficiencies in the body and heal your bones, muscles, blood vessels, nerves, and even skin.

-Inspire yourself to pick up your healthy and active routine post-surgery but also remember not to overdo it. Remember to listen to your body when you cautiously resume working out post-operation. If it tells you it is hurting, stop immediately and consult your trainer. A good trainer should be able to guide you on how hard to push. Follow your body’s pace and not your ego’s when you are in recovery.

(If you are interested in learning more about pre-surgery preparation or have one of our professional trainers design a comprehensive 6–12-week program, click here. If you are interested in ongoing post-surgery recovery programs to bridge the gap between physical therapy and optimal performance, click here)

Final Thoughts

Many people underestimate the impact of pre-surgery preparation exercise routines and post-surgery training programs on their recovery. Orthopedic treatment procedures have a significant effect on our bones and muscles and cause immeasurable stiffness etc. But with proper preparation and recovery, you give your body the best chance to keep your bones, joints, and muscles fully functional and hence get the most out of your surgery’s intended repair to your body.

It is important to remember the post-surgery exercise routine plays a vital role in the recovery process. While many believe bed rest and taking it easy is better, the truth is that light exercises can boost recovery. Start with your prescribed physical therapy, as it is likely to be covered by your medical insurance, and is geared toward the post-surgical repair. From there, when physical therapy is complete, a post-surgery recovery training program will ensure a successful recovery for you.

Thanks for taking the time to read this article we prepared for you.

Best Regards,

Bruno

John J. Bruno, MS, CSCS, PES, CSS, FMS, USAW

Master’s degree in Exercise Science – Concentration in Performance Enhancement and Injury Prevention

NSCA Certified Strength and Conditioning Specialist

USA Weightlifting Level 1 Sports Performance Coach

Precision Nutrition Level 1 Certified Nutrition Coach

AIS Active Isolated Stretching Practitioner Aaron Mattes Method

NASM Performance Enhancement Specialist

FMS Functional Movement Screening Specialist (Level II)

NASE Certified Speed Specialist

RKC Certified Kettlebell Lifting Instructor

AKC Certified Kettlebell Lifting Coach

Black Belt in Brazilian Jiu-Jitsu

Certified Associate Grappling Instructor, Harris International

Certified Apprentice L5 Jeet Kune Do, French, Filipino, and Indonesian Martial Arts Instructor

John Bruno Strength and Conditioning

Personal Training

Martial Arts

Nutrition Coaching

(If you are interested in learning more about pre-surgery preparation or have one of our professional trainers design a comprehensive 6–12-week program, click here. If you are interested in ongoing post-surgery recovery programs to bridge the gap between physical therapy and optimal performance, click here)

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