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Writer's pictureVanessa Mansergh

Discover How Prehab Pilates Can Boost Your Pre-Surgery Fitness in 4 Steps

Updated: Jun 27

As a certified APPI (Australian Physiotherapist & Pilates Institute) Pilates rehab instructor and Cancer Rehab instructor, I cannot stress enough the significance of being physically fit and prepared for an upcoming surgery - whether it is eye, abdominal or joint-related surgery. There is evidence that a fit body can help improve surgical outcomes and reduce the length of stay (LOS) in hospital.


Too often, patients rely solely on post-operative rehabilitation, neglecting the crucial preparation phase. According to one heart surgeon I spoke to, patients post-surgery become overly dependent on nurses for basic tasks, such as making the bed. This might sound a little harsh but it does highlight the restrictions on every day activities when hospitalised.


How Effective is Existing Pre-Op Exercise Support?

I did some research on the pre-op care for a hip replacement at the Royal Berkshire Hospital. A June 2023 fact sheet gives a good overview of the benefits, and the importance of preparation for surgery to aid recovery by staying active:

  • Strengthening the muscles around your hip

  • Keep up any gentle exercise, such as walking and swimming, in the weeks and months before the op


However, the only support on offer before the op is a group session, possibly virtual, run by physiotherapists, occupational therapists and nurses, where the patients will be given vital information and exercises to aid a quick and safe recovery. The emphasis being on the aftercare. Who is going to do exercises correctly or routinely without guidance? I wouldn't!


Speaking to one of my clients having a hip replacement, even private health insurance only covers post-op physio with a pre-op assessment. "Physio school from the Circle Hospital is on offer but mainly covers advice on what to expect in surgery and afterwards."


Is Pilates the Answer Pre-Op?

The same client said "Pilates compliments the physio’s hands-on manipulation of my leg muscles and back muscles which are compromised due to my hip not allowing proper movement when I walk".


Quoting Glenn and Elisa Withers, the founders of APPI, the goal of pilates is for "the client to be able to regain a correct, positive sense of movement". As physiotherapists, their focus for the APPI pilates method was rehabilitation by modifying Joseph Pilates' original exercises to make them accessible for the general population.


Preparing for surgery is a big deal. Not just physically, but also mentally. This is the time for a focused mind-body form of exercise like pilates.


4 Rehab Pilates Exercises to Support Your fitness Pre-Surgery





  1. Breathing better to help release tension in the body. Take 5 mins a day to focus on your breath. Lie down or sit somewhere quiet. Close your eyes and observe your breath. Inhale and at the end of the inhale, hold your breath for 3 counts. Repeat with the exhale until your body relaxes.

  2. Centering: the ability to engage your deep abdominal muscles, deep back muscles and pelvic floor muscles while breathing freely to support your spine. Take 5 mins a day to actively engage your core. Find them by putting both hands onto a shelf or cupboard at shoulder height with straight arms. Press down with 100% effort. Feel anything around your tummy area? Try again with less effort (50%). And again (25% ). Now keep it on while you do 8 bicep curls with cans of soup.

  3. Postural alignment: by restoring the natural curves of your spine, you will have optimum movement and may even prevent the need for more surgery. Stand in front of a wall or lie down on the floor. Stand away from the wall with your bottom, and upper back against it. Legs bent. Straight legs on the floor (without head/knee cushions). What feels uncomfortable? Is your back pulling away from the wall or lifting off the floor? Is your chin lifting up to the ceiling (lying down) or miles away from the wall? Try to gently tuck your tailbone under a little until your hips are in line with your pelvis and engage your core as above. Try to lengthen the back of your neck by gently nodding your chin slightly towards your chest. Better? Bring this better alignment into your everyday activities - seated at a desk, carrying shopping, exercising.

  4. Whole body work out with strength, stability, mobility and balance exercises. Here are a couple of exercises to get started with. Pic 1: One leg standing: Stand in front of a wall with good posture, finger tips touching the all and try lifting one leg up. Use all the tips from 1-3! Repeat x 5 each side. Then repeat by closing your eyes. Progress by holding for longer and standing on a cushion. Pic 2: Shoulder bridge: Lie on the floor with your legs bent, cushion between knees or resistance band around knees and heels close to your bottom. With your core engaged, lift your hips to the ceiling, keeping your tailbone tucked and lower with control. Your buttocks will be working hard! x 8



If you'd like to learn Prehab Pilates exercises designed for you and to feel as fit as you possibly can pre-surgery, find a Pilates instructor with rehab experience or a physiotherapist teaching pilates.


If you'd like to book a 1:1 session with me to discover your capabilities in a safe environment and to prepare you for surgery with a prehab pilates program, please fill out the contact form here









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