PreHab: How to Get Ready for Hip Replacement Surgery
The number of hip replacements taking place each year in the US is skyrocketing. In fact, a study that tracked hip replacements over a ten year period saw the number of procedures more than double from 138,700 in 2000 to 310,800 in 2010.
The increased popularity of hip replacements not only represents a growing medical trend, but also indicates a sprouting bank of knowledge surrounding the procedure. It’s an exciting time because we now know more than ever how to the reduce the risk and improve the outcome of hip replacements. Among these learnings is that the overall success and recovery time of your hip replacement is largely determined by what you do the weeks before your surgery.
Actively putting this scientifically-proven knowledge to use prior to surgery is something called “PreHab”.
What is PreHab? It’s everything you actively do—mentally and physically—in the 2-8 weeks leading up to a surgery to optimize your health, reduce risk and increase the benefit of that procedure.
PreHab: 6 Ways To Prepare For Your Hip Replacement
We’ve spent the last year grooming through years of medical research and working alongside leading medical professionals to build PeerWell’s PreHab program for joint replacement candidates.
Continue reading as we share some key take-aways from our program on how to have a better hip replacement surgery with a faster recovery.
1. Enlist the Support of Others
We recently spoke with Dr. Trevor North, a sought-after orthopaedic surgeon at the Cleveland Clinic. In our discussion, he shared that the support of family and friends is “absolutely an indicator of overall success and recovery time of a joint replacement patient." Having supportive family and friends helps to reduce the length of your hospital stay and the likelihood you’ll request to enter a rehab program. Most importantly, the support of peers increases physical and mental preparedness in the weeks prior to surgery.
Dr. North added that a vital part of overall prehab and pre-op support is speaking with other patients who have undergone a hip replacement. Communicating with those who are ahead of you in the hip replacement surgery and recovery cycle offers deeper insight and alleviates anxiety.
Why the Support of Others Matters:
- Peers hold you accountable and help you achieve PreHab goals like keeping up with daily exercises, quitting smoking, or losing weight.
- Having a peer group to cheer you on keeps you motivated and focused on completing the PreHab lessons that will benefit you in the long-run.
- Connecting with other hip replacement recipients will encourage you to follow-suit and reach a healthier tomorrow
A community of support is the centre of PeerWell’s Prehab program and is one of the most important elements in preparing for a hip replacement and enjoying a speedy recovery.
2. Eat for a Better Outcome
Before a surgery, it only makes sense to nourish your body with foods that help derisk a procedure and speed up recovery. Foods that are rich in calcium, fiber, protein, and vitamin C and D, provide your body with the building blocks to promote fewer complications and faster healing after your hip replacement.
What You Should Eat and Why:
- Calcium and Vitamin D—Calcium is an important part of strong bones and the healing of your bones after surgery. Vitamin D allows your body to better absorb calcium. What to Eat: Vitamin D fortified yogurt and cheese, fatty fish and whole grain fortified cereals.
- Iron and Vitamin C—Having a diet rich in Iron and vitamin C boosts pre-operative red blood cell levels and reduces postoperative anemia and blood transfusions. What to Eat: Lean red meat, dark leafy greens, raisins, oranges, tomatoes and strawberries.
- Protein—Protein is essential for an incision repair and overall healing. What to Eat: Seafood, white meat poultry, eggs, beans, peanut butter and drink Ensure.
- Fiber—Fiber helps to control blood sugar (which if uncontrolled can increase wound infection, blood clots and lead to the need for revision surgery) and works to counteract constipation caused by prescribed painkillers. What to Eat: whole grain bread, quinoa or brown rice and vegetables.
3. Exercise Key Muscles
In the weeks leading up to surgery, performing daily exercises that strengthen the muscles surrounding your hip is vital. The stronger and more flexible your muscles are, the easier it will be to bounce back and enjoy a happy, active life. These low-impact exercises will reduce fatigue, muscle soreness, swelling and the risk of blood clots.
These exercises should focus on your hip flexors, hip abductors and glutes. Working on core strength is also important for balance and alignment.
3 Simple Exercises with Impact:
- Lie on your back in bed with your legs straight.
- Squeeze buttock together and tighted buttocks muscles.
10 reps, 2x per day
- Lie on your back.
- Bend your surgical knee by sliding your heel toward your buttocks
10 reps, 2x per day
Side Leg Raises
- Lie on your side in bed with your legs straight.
- Keep your hip straight and lift the “up” leg 2-3 inches.
- Hold for 5 seconds and then lower the leg in a controlled manner.
10 reps, 2x per day
4. Become Your Healthiest Self
PreHab ensures you’re at your physical and mental best before surgery and actually increases hip replacement success, benefit, and the overall speed of recovery. To have the best possible shot at a seamless hip replacement, it’s important to control what you can and eliminate unhealthy or risky behaviors.
How to Be in Your Best Health
- Quit Smoking—For smokers, quitting is the single most impactful thing you can do improve your safety and recovery. Smoking is associated with complications like wound infections, pneumonia, stroke and death. For those who are unable to permanently quit, taking a 2 week break from smoking before surgery is the next best thing.
- Lose Extra Weight—Shedding some extra weight before surgery cuts down your risk, improves recovery time and lessens the pressure put on your new hip.
- Manage Blood Sugar—Pull out all the stops to manage stress levels and blood sugar before surgery. Diabetics must form a meal and medication plan for the week leading up to surgery.
- Avoid Dental Work—Dental work, including cleaning can release bacteria into your bloodstream. This bacteria can increase your chances of infection. It’s better to be safe than sorry—avoid elective dental work.
5. Develop a Pain Plan and Practice Mindfulness
The most common questions during pre-op assessments is, “how much is this going to hurt?” and “how long will it take to recover?”. Understandably, no one wants to be in prolonged pain and uncontrolled levels of pain actually slow down recovery. Learning about pain management options, developing a plan, and practicing mindfulness before surgery helps to put your mind at ease and lets you focus on healing.
Learn to Better Manage Pain by:
1. Understanding Your Pain Medications
Prior to surgery, patients are often on medications to help alleviate arthritic pain. These medications come in many different varieties and are classified as: 1. Acetaminophen-based (tylenol) 2. Anti-inflammatory based and 3. Narcotic-based.
Anti-inflammatory based medications should be stopped one week to four days before surgery. Acetaminophen-based medications can be taken through to surgery day. However, because acetaminophen is a common over-the-counter pain reliever as well as an ingredient in a most prescribed post-surgery narcotics, you have to be extra careful not exceed the maximum daily dose. Speaking to your doctor about pain medication dosage, scheduling, and effects should be done in your pre-op visit 1-2 weeks before the procedure.
During the PreHab period, narcotic-based opioid medications must be stopped as early as possible. Using opioids prior to surgery increases postoperative pain, the length of hospital stay, as well as the need for revision surgery.
2. Learning About Spinal Blocks (Spinal Anesthesia)
A spinal block (also known as spinal anesthesia) is a medical procedure that is used during hip replacement surgery instead of general anesthesia Spinal blocks are less risky than general anesthetic and patients who opt-in take fewer narcotic painkillers after surgery, have a reduced hospital stay and lower rates of blood clots.
Choosing a spinal block could be beneficial and is something to discuss with your doctor and surgeon in your pre-op visit.
3. Practicing Mindfulness
Similar to meditation, practicing mindfulness allows patients to pay attention to the present moment on purpose and with fresh eyes. When exercised effectively, mindfulness can be used to manage pain, reduce the need for painkillers, and help alleviate feelings of anxiety, depression, frustration and stress.
When asked about the importance of mindfulness, Dr. North explained, “Being mentally prepared and in a positive space leading up to a surgery helps patients recover faster” Studies agree with Dr. North, and show that hip replacement patients with anxiety or depression during the PreHab period have more complications throughout the procedure.
Mindfulness breaks the negative feedback loop and helps to get you out of your own head.
6. Prepare, Prepare, Prepare.
Prior to surgery, it’s difficult to put yourself in the position of your future self. However, you must keep in mind that in the days following your replacement, you will be pretty well out of commission.
How to get prepared:
- Pre-order and Test Walking Devices—Make sure your mobility equipment will arrive before surgery day. Being able to test drive your preferred assisted walker is ideal.
- Pack an Overnight Bag—Pack everything you may need for your hospital stay including important documents like Advanced Directives, hand-carry equipment like a reacher and loose clothing.
- Prepare Your Home—Prep your home by clearing high-traffic “roadways”, removing furniture that may get in your way and cords you could trip on, creating a stairless living space and installing an elevated toilet seat.
Other things to think about: transportation to and from surgery, collecting mail, arranging meals ahead of time, getting assistance with laundry and general housekeeping.
Hip replacement surgery is a game-changer that will give you the gift of a new and improved life. If you’re in pain, now is the time to take advantage of one of modern medicine’s greatest miracles.
Sign-up for PeerWell’s PreHab program to gain full access to our scientifically-proven method for increasing joint replacement success. PreHab your way to a better life with a community of peers who will be undergoing a joint replacement at the same time as you.