At Specialised Health, we’ve seen time and time again how ‘prehab’—a proactive approach to rehabilitation—can set clients up for success. Freddie’s story (name changed for privacy) is a perfect example of how a structured, targeted program can not only prepare a client for surgery but, in some cases, even avoid it altogether.
Starting Point: Pain, Stress, and Limitations
When Freddie was referred to Specialised Health, he was struggling. A torn right supraspinatus had left him in constant pain, with limited shoulder mobility that made even basic tasks, like washing his hair, difficult. His discomfort was compounded by stress over being told he needed surgery to get better, and fear around the implications of this for his work and overall health.
Freddie was resigned to the fact that surgery was his only option. Progress with his physio program had stalled, and he had been provided with light resistance band exercises to see him through to his operation. His surgery date was booked.
Recognising the need for a more targeted approach, Freddie’s referrer transitioned him to Exercise Physiology, with the goal of building strength and improving his readiness for surgery.
The Approach: Focused Prehab and Progress
Freddie began working with Jack, one of our Exercise Physiologists, who immediately identified the key areas to address:
- Poor shoulder strength; Freddie had a significantly reduced forward reaching ability and could only demonstrate an ability to handle 5 & 9kg for pushing and pulling movements respectively.
- Reduced shoulder mobility; Freddie’s overhead and lateral (sideways) movements were also terribly reduced due to significant muscular tightness.
- Pain and stiffness; observed through his posterior neck and globally in the right shoulder muscles.
Not only did these limitations cause difficulty with daily activities such as driving and household chores, but Freddie was fearful of returning to some activities in the workplace. Freddie’s role involved operating heavy machinery and loads of up to 20kg, so a return to full duties seemed entirely out of reach at this point.
Jack tailored a structured program of weekly supervised gym sessions, starting initially with mobility exercises to restore range of motion, and then focusing on strength of the trapezius, deltoids and rotator cuff muscles. Education was also a key component of the program, with the goal to empower him with appropriate strategies to manage his pain. From the outset, Freddie showed a commitment to the process, and the results quickly followed.
As Freddie’s strength and mobility improved, so did his confidence. The gains were so significant that the decision was made to postpone the surgery —an acknowledgment of the progress he was making and the potential to achieve even more.
The Results: Confidence Restored
By the end of his program, Freddie’s progress was undeniable:
- Patient Specific Functional Scale (PSFS): Improved from 13/50 to 47/50, reflecting his regained confidence in his ability to perform daily and work-related tasks.
- RAND-36 Health Questionnaire: Increased from 57% to 70%, highlighting overall improvements in his perfection of health and well-being.
- DASH Shoulder Disability Questionnaire: Reduced from 65.9 to 11.4, showing a dramatic decrease in shoulder-related disability.
Freddie’s shoulder range of motion was restored to near full capacity, with only minor discomfort in extreme positions. He was lifting 25 kg across all planes, a significant improvement from his initial limitations.
As a result, Freddie obtained certification to return to his pre-injury duties, fully prepared to resume his role without restrictions. And the best part – the improvements were so significant that the surgery was cancelled!
When the Prehab becomes the Rehab
Freddie’s experience highlights the often-underestimated potential of a targeted rehabilitation program. With the right exercises and progressive loading, the body is capable of incredible improvements—even in the face of significant injuries.
Addressing pain, mobility, and strength before surgery is known to lead to better outcomes and faster recoveries from surgery. In some special cases, such as this one, it can lead to not needing surgery to return to work at all!
A proactive and targeted approach can dramatically change the trajectory of recovery. Touch base today if that sounds like what your claimants need.
Author: Tessa Nielsen