Presurgery Preparation

Before my aunt 's hip operation and my father 's knee surgery, I told each that they needed to prepare their bodies for rehabilitation. Both of them told me later that doing the exercises I suggested before going into the hospital had proven very helpful. Two essential goals for people facing surgery are maintaining cardiovascular fitness and building strength. Cardiovascular fitness improves your overall recovery, while strength enables you to perform functions that you might currently take for granted. If your joint has become so aggravated that you have difficulty doing your normal aerobic activity, you need to identify an alternative, at least until the surgery. Keep doing some walking, since this is a functional activity and one that you will be doing after surgery.

I emphasize simple strength exercises that focus on two functions: the ability to rise from sitting to standing position using primarily one leg, and the ability to support your body weight (with arm strength) while using a walker or crutches. You will be in better shape for surgery if you are already doing some strengthening activities as part of your fitness program. If not, these exercises are even more crucial. For lower-extremity strength, I suggest a combination of wall sits, straight leg raises, and sit-to-stand practice using a single leg.

One of the modifications I suggested to my dad was the single leg wall slide —a partial squat with the back against the wall, using one leg. It is more difficult than a regular wall sit, but it is an excellent strengthener, which you can do in sets of 10 repetitions. Concentrate on strengthening the leg that will not be having surgery, but if possible, also do the exercise with the leg that will undergo surgery. For any of the single-leg exercises, hold on to a stable chair or other heavy object.

The straight leg raise is actually designed for neural activation, so you can perform sets of 15 repetitions. You must be able to perform this motion after surgery in order to get your leg off the bed for transferring and other activities. To progress this exercise, add a small cuff weight to your ankle, as long as it does not irritate your knee. You can do these strength activities at home every day before your surgery.

If you have rubber tubing, add some strength exercises for your hamstrings, quadriceps, and hips, using the more traditional strengthening guidelines discussed in chapter 4. I recommend that you do knee extension and flexion movements —either the closed chain standing exercise or the open chain sitting exercise will work. To strengthen the hips so that they can support you during transfers and walking, do hip extension, flexion, and abduction exercises.

Single-Leg Wall Squat

Straight Leg Raise

Seated Press-Up