For men who have been diagnosed with prostate cancer, surgically removing the prostate, or a prostatectomy, is a popular treatment method. Working with a physical therapist before surgery can pave the way for a smoother recovery.
“Research shows that patients can get better faster, but most importantly, physical therapy prepares them,” said Sara Eck, a physical therapist with UCHealth SportsMed Clinic who specializes in pelvic health. “Instead of seeing them post-op and having to catch them up on what they should be doing, they already know.”
Both Eck and Kim Miles, clinical supervisor and physical therapist with UCHealth SportsMed Clinic who also specializes in pelvic health, are part of the Prostate Prehab Program. The program was started thanks to collaboration with a number of physical therapists from UCHealth Poudre Valley Hospital in Fort Collins.
As part of the program, Eck and Miles meet with a patient two to four times before surgery, covering topics such as the role of the pelvic floor, healthy bladder habits and what to expect after surgery.
During physical therapy, techniques for properly contracting pelvic floor muscles are taught.
After prostate surgery, the urinary system is healing and a small percentage of patients experience urinary incontinence, especially early on in the post-operative period. Urinary incontinence improves week to week during the post-operative period, but exercising pelvic floor muscles can help expedite the improvement.
Verbal cues, physical cues and use of a biofeedback program, in which patients can see their muscle activity, reinforce proper technique.
“These cues can show you if you’re holding muscles or straining, and not letting them out completely,” Miles said. “It’s not just strength, but it’s also coordination. Like working any muscle group, there’s a certain timing that needs to happen. If you do exercises incorrectly all day long, you likely won’t get anything out of it. But with proper technique, you can do a shorter set and get a lot out of it.”
The physical therapists also develop a home exercise program for each patient, so he can begin to gain coordination, strength and control before surgery.
All of the work before surgery can pay dividends after surgery.
“Doing therapy before surgery is nice because you can get a baseline of where a patient is,” Miles said. “And they learn how to contract the muscles properly and develop some muscle memory. After surgery, that learning curve is much shorter and they feel like they have more control.”
Plus, the work provides a peace of mind that can be incredibly helpful post-surgery.
“They’re getting out of surgery and they’re facing changes with their body that can be so overwhelming,” Eck said. “With prehab, they have the tools to start doing what they need to do.”
This article first appeared in the Steamboat Pilot & Today on Nov. 28, 2017.