The amount of time you spend daily on your prehab depends on a number of factors:

• Your baseline level of fitness as you begin the program.

• The time available before your surgical date.

• The support available from your partners. For example, is someone else taking care of the healthy food?

At a minimum, we hope you are able to commit on average 30 minutes each day for this program. Like most endeavours, the more time invested, the greater the likelihood of success. Depending on your circumstances – including your schedule – some days you may just have 10-20 minutes, while some days you may have an hour. That’s fine.

The amount of time you put into the program matters, but certain types of effort yield higher rewards than others. We like our "little bit often" approach for maximum benefit.

Ideally you will want at least 2 weeks of prehab before your surgery, but … the more time you have to prepare, the better.

However, you can gain the benefits of prehab in a very short time, and some studies suggest as little as 2 weeks can have an impact.  If you have less than 2 weeks you will not be able to make many fitness gains, but you can gain significant benefits from the nutrition content, sleep content and stress reduction content.

Remember, your surgery may be cancelled (even on the day it is scheduled) and you could have more time than you think for your prehab program before your surgery is rescheduled.

No problem … you don’t need to fully embrace all aspects of the program. You can still have significant benefits from the nutrition, recovery, mindset and support content.

The traditional but now outdated approach has been to encourage rest to best prepare patients for their upcoming surgery. However, bed rest is now viewed as detrimental.

Instead, you want to be moving. That is why we have the Movement Pillar. Even if you can’t or don't want to embark on an exercise training program, you can still acquire health benefits by increasing the amount of movement performed on a daily basis. Replacing inactive or sedentary time with light physical activity, even in short sessions of less than 10 minutes, is a strategic way to improve health, especially in previously inactive people.  This can include many easy-to-perform and enjoyable activities such as evening walks, gardening, yoga, or dancing.

We won't try to convince you to do something you dislike. We want you to wake up each day not dreading your training – and perhaps even looking forward to that sense of accomplishment you will have after completing your daily walk.

Great! You may have the most to gain by increasing physical activity.

In general, individuals who are the least fit and the most sedentary show the most improvement when they initiate an exercise program – any exercise program.  Even small amounts of physical training can yield significant improvements.

When you first start training, you don’t have to do much for your body to start adapting. You get a quick response for relatively little effort.

In addition, we will start low and go slow. We suggest you ramp up over weeks, with a focus on small amounts of regular activity. Don’t jump into hard-core workouts right out of the gate – especially if you are new to physical training or returning after a long layoff.

Fantastic! Prioritizing your fitness and health is really going to pay off when it comes to your recovery from surgery.

You may not have much to gain from the Movement Pillar. However, you may have other areas that can be optimized. Sleep? Stress reduction? Nutrition?

If you already take good care of yourself, but don’t have a protocol for approaching surgery, you can still find a few pearls. You might want to increase your protein content, commit to 8 hours of sleep each night, or decrease your caffeine and/or alcohol consumption.

No. We need to be clear on this.

Can prehab fully protect you from the stresses of surgery? Of course not … you won’t be bulletproof.

It can, however, help you recover more quickly and with fewer difficulties than if you hadn’t done it. And if you have any complications after surgery, the research suggests you should be better able to deal with them.

We can compare prehab to training for running a race. Are you guaranteed to win if you train? No. Are you going to do better – and feel better – if you train? Yes.

We can’t control everything that will happen after surgery, but with prehab we can stack the odds in your favour. Like most things in life, preparation benefits outcome. We offer a way to optimize both your body and your mind to increase the likelihood of rapid recovery.

PrehabMD prepares people for the stress of surgery, it is not a weight loss program. There is some overlap, but our primary focus is to prepare you for the immediate demands ahead.

If you are overweight, you probably fit into one of two groups:

• The short-term group includes those of you with excess weight who require urgent or semi-urgent surgery in 2-8 weeks.

• The long-term group includes those of you with excess weight who require elective surgery months down the road, maybe a hernia repair or joint replacement.

Whatever group you fit into, we can help.  For the short-term group, we offer simple, high value tips and strategies. For the long-term group, we have a more comprehensive plan.

Weight loss may happen, or it may not.  Weight change is commonly a result of different but coexisting issues – metabolic factors, emotional issues, level of activity, nutritional habits, etc.   We do not want you to lose a large amount of weight in a few weeks anyway.

Regardless of weight loss, your PrehabMD program should make you stronger and healthier, with more muscle mass.  Some people who gain muscle in a program like this don't lose weight, but their belt size shrinks as muscle replaces fat.

The human body has the remarkable capacity to become stronger at any age.

There is really no upper age limit for benefitting from prehab. However, extra precautions may be required for older people. For example, the movement component may need to be modified if there are significant mobility or balance impairments, or in-person supervision with a professional may need to be arranged.

In addition, the nutrition component of prehab is extremely important for older individuals, as many may be nutritionally at risk or even malnourished.

The support network will also be very important for many older people.

Surgeons want the best for their patients. They want everything to go perfectly and don’t like complications.

So think of this as a partnership. If your surgeon has not discussed prehab concepts, bring them up. Ask if improving your diet, getting in shape, decreasing stress, losing weight, or smoking cessation would be beneficial for your surgery.

Your healthcare provider is the best person to speak to about your personal health issues.

The PrehabMD site is structured so that you can customize it to meet your own prehab needs, but it does not address specific individual concerns.

At this time, PrehabMD does not offer personal supervision, direct communication with coaches or remote monitoring.

You need to ask your surgeon about the following:

• details of the surgical procedure itself

• medication management or testing required before surgery

• post-operative instructions such as the resumption of work and daily activities

The PrehabMD member site uses tools (questionnaires, checklists, etc) to guide you in tailoring a program that will meet your specific needs and fit your life and its demands.

For some people, prehab provides a simple tune-up, while others benefit from a complete overhaul.  Some will get most out of mental preparation, some from physical. Some will have two weeks to prepare, some will have eight. Each program will be different.

We provide a roadmap for your prehab, and show you where to go, and help you define the route – your own strategy – that best meets your needs, preferences and abilities.

Eating healthier, sleeping better, improving your mental fitness and many of our other recommendations all provide significant benefits at essentially no risk.

Physical exercise, in order to be effective, does require some level of risk. In particular, musculoskeletal injuries and cardiovascular events can be associated with exercise. However, in general the benefits of exercise are well established and far outweigh the risks in most adults.

That said, it’s important to train intelligently.  We know that certain types of effort yield greater benefits than others, while also presenting a lower risk of injury. For example, vigorous intensity exercise has a substantially higher risk than walking and similar moderate intensity physical activities, which carry a very low risk.

To maximize safety and benefit, our program incorporates safeguards to manage risks.

Before starting the Movement Pillar, all members are directed to a screening questionnaire. If your responses indicate an elevated risk for exercise-related complications, you will be made aware of this and advised to seek evaluation by a health care provider before starting the exercise program.

Other design principles to achieve our prehab goals and reduce risk include:

• Providing education on warning signs during exercise

• Developing a solid baseline with mobility drills and low volume, low intensity training, with gradual progression over weeks

• Prioritizing training at a pace that is sustainable over the duration of the program

• Using risk averse exercise selection - those with the highest return and lowest impact on your body

• Incorporating mobility training, warm-ups, and cool-downs to reduce injuries

Yes … you already know the interventions that lead to benefit - improving nutrition, strengthening your body and mind, sleeping better, etc. And you can find an unlimited amount of information on the internet. But consider:

• Many of the research studies on prehab require a fee for viewing.

• Finding all the information that may help prepare you for surgery can be very time-consuming.

• The information you find may not always be accurate or evidence based.

• Once you have found the information, you need to be able to make sense of it and apply it.

If you don’t have the inclination, time, energy or resources to do this yourself, consider the value of the membership program:

• We have sifted through reliable research findings and packaged the most important information, making it easy to understand.

• We show you what’s important to do and how to do it with step-by-step instructions.

• We show where to prioritize and what efforts lead to the highest rewards.

• We give you access to the professional knowledge base and experience of our coaches.

• We have designed the program to enhance motivation and decrease barriers to adherence.

There are a few possible reasons.

1. The prehab concept is relatively new. It takes time for new knowledge to become a fixture of daily clinical practice.

2. Doctors have traditionally been the experts on the medical information directly related to surgery, passing on relevant details to patients. But for prehab, much of the research involves other disciplines – dieticians, exercise physiologists, psychologists, and sleep experts, to name a few. With prehab, we are extending far beyond many physicians’ normal realm of expertise.

3. And finally, many healthcare systems and payment models are commonly geared towards treatment rather than prevention. This is a major area of neglect in many funded systems.

Traditionally, the standard care of pre-surgical patients involves patient education, smoking cessation efforts, medication review, and optimizing medical conditions such as diabetes, hypertension or sleep apnea.

More recently, many hospitals have invested in Enhanced Recovery After Surgery (ERAS) protocols to further improve recovery after surgery.

However, starting a new multi-disciplinary prehab program in a hospital takes a tremendous amount of effort, time, and resources. It usually requires a “local champion” to advocate for the program, a return-on-investment analysis, and a payer to fund the new program.

Not only are resources in short supply in most health care systems these days, but the prehab expertise may not be present either.

If you are fortunate enough to have a multi-disciplinary prehab program at your hospital, it may only be for the highest risk patients. So access may be an issue for many.

Despite areas of excellence, no system of health care is perfect. Your personal and active engagement in the process can offset the effects of any deficiencies in your local health care system.

We are not interested in adding any more stress to your life.

If you have signed up by mistake, or are unhappy with our program, let us know. Full refunds are guaranteed for the first week of the program.

You will have access to the member site for 6 months after you sign up. If your surgery is delayed and you need it for longer, let us know.