Train for surgery like an athlete: How prehabilitation transforms recovery
By Dr. Andrew Mock, Medical Director, Hoag Compass
If someone said they were about to endure strain and pain in hopes of physical triumph, you might think they were about to compete in a triathlon or weightlifting competition. But they could just as easily be describing an upcoming medical procedure.
Thinking about surgery in the same way that we think about physical competitions is important, and it can flip the script on how patients recover post-operatively. As the new medical director of Hoag Compass, I’m working with physicians and surgeons throughout Hoag to improve outcomes and improve quality of life through evidence-based physical activity interventions.
Just as runners train for marathons, I am working with surgeons to encourage their patients to “train” for upcoming medical procedures. Known as prehabilitation, the use of physical activity and nutrition to improve surgical outcomes is gaining momentum in medicine, and I’m excited to help Hoag grow its program.
Patients who undergo surgery can experience physical fatigue, loss of muscle mass, and difficulty enjoying their daily activities. These effects of surgery can last a few hours to a few months, or even years. But a growing body of evidence suggests that prehabilitation can improve a patient’s readiness for surgery, which can lead to shorter recovery periods after surgery.
A review by the American Thoracic Society, for example, found that preoperative exercise training reduced pulmonary surgical complications by 48% and shortened hospital stays by two days. This is a significant improvement for people who are undergoing heart, lung and other complex surgeries. Coupled with Hoag’s already stellar safety record and low complication rates, a robust prehabilitation program could further improve the lives of Orange County’s aging population.
I have the honor of serving on the boards of the Medical Fitness Association and the Physical Activity Alliance, where we are working with Congress and groups like the American Heart Association to make the prescription of physical activity a standard in healthcare. I have come to see just how much lifestyle medicine can serve as the first line of treatment for nearly everything, including cancer, diabetes, and heart disease.
Many of Hoag’s institutes already offer prehabilitation courses, exercise programs and lifestyle interventions. My goal is to expand on those offerings and make sure that everyone benefits from the optimal dose of safe, evidence-based physical activity and dietary interventions before undergoing medical procedures.
Working with your surgeon, you can strengthen your health, so your body is better prepared to heal after elective surgery with reduced risk of complications and shorter recovery time. Many patients who participate in prehabilitation programs also experience improvements in their symptoms prior to surgery. In some cases, patients who were initially considered too high-risk for surgery have been able to improve their health enough to safely undergo the procedures they need.
So, don’t be surprised if your doctor prepares you for an upcoming surgical procedure with a structured program of cardiovascular and resistance training. Surgery places real demands on the body and preparing for it means strengthening the systems responsible for healing. The result is often a faster return to wellbeing and maintaining—or improving—your quality of life.
Hoag Compass Medical Director Dr. Andrew Mock is the reigning four-time California Strongman and holds four board certifications in preventive medicine, lifestyle medicine, family medicine, and obesity medicine.
