Facing major corrective spinal surgery isn’t exactly anyone’s idea of fun—especially if it’s not your first round in the operating theatre and your spine has already had more metalwork than a car repair shop. Add in the challenge of low bone density, and suddenly the journey to recovery starts long before the surgeon even scrubs in.
That’s where the concept of “pre-hab” comes in. Think of it as training camp for your body and mind before the big event. Done right, it can make all the difference between a rocky recovery and a smoother, steadier healing journey.
Why Pre-hab Matters

Pre-hab isn’t about turning yourself into a marathon runner or mastering downward dog in yoga. It’s about giving your body every possible advantage to handle the stress of surgery and recovery.
Patients who prepare beforehand often:
Heal faster
Experience fewer complications
Tolerate pain better
Feel more in control of their recovery
For those with shaky bone density or a history of spinal “mechanical failures,” pre-hab is said to be the quiet game-changer that sets the stage for success.
A Personal Note: My Ongoing Spinal Journey
This isn’t just theory for me—it’s my reality. My journey began back in December 1998 when I became a paraplegic and had extensive metalwork put in to stabilise my spine.
Fast forward to July 2024, I faced another challenge: a vertebra stress fracture and two damaged discs. Surgery was supposed to help, but things unfortunately didn’t go according to plan.
By November 2024, I was back in the operating theatre for a repair with even more screws and hardware. Just a week later, complications from a CSF leak meant yet another surgery.
Since then, 2025 has been marked by chronic pain and mechanical discomfort. Now, as I write this, it looks like a complete spinal reconstruction is on the horizon scheduled for October—because none of the fixes from last year held.
It’s exhausting, yes, but it has also taught me just how important preparation is. When your body has already been through the wars, “pre-hab” isn’t a “nice-to-have.” It’s essential armour for what’s coming next. The next couple of weeks will be packed with “pre-hab” goodness!
I feel convinced that my “pre-hab” approach this time around will make all the difference and give my body the necessary strength to come out on top this time around.
Why Surgeons Don’t Always Mention Pre-hab
If pre-hab is so valuable, why isn’t it part of every pre-op conversation? A few possible reasons I have considered:
Time pressures – Consultations are short, and surgeons focus on the operation itself.
Different priorities – Their expertise lies in fixing spines, not coaching lifestyle changes.
Healthcare silos – Dietitians, physiotherapists, occupational therapists and psychologists often work separately.
Safety concerns – With fragile bones, unsupervised exercises can be risky.
Patient overwhelm – Facing spinal surgery is daunting enough; surgeons may hesitate to add “extra homework.”
The silver lining? Just because it’s not always brought up doesn’t mean it isn’t worth doing. In fact, patients who take the initiative to prepare often enjoy smoother recoveries and better long-term outcomes.
What a Strong Pre-hab Program Should Include
1. Bone Health Boosting
Eat a diet rich in calcium, vitamin D, protein, and other bone-supporting nutrients.
Discuss with your doctor whether medications or supplements could help strengthen bone density.
2. Targeted Physical Conditioning
Gentle core strengthening and mobility work to support posture and muscle tone.
Breathing and circulation exercises to keep lungs and blood vessels in good shape.
3. Pain & Energy Management
Mindfulness, guided imagery, or relaxation techniques to calm the nervous system.
Gradual stamina-building activities to give your body reserves for recovery.
4. Lifestyle Tune-ups
Quit smoking—it significantly reduces healing potential.
Limit alcohol intake.
Prioritise consistent, quality sleep.
5. Nutritional Tailoring
Focus on immune-boosting foods: antioxidants, lean proteins, and gut-friendly nutrients to help with anesthesia and inflammation recovery.
6. Mental & Emotional Preparation
Set realistic expectations—healing takes time.
Organise support systems: family, friends, or community help for meals, transport, or moral support.
7. Practical Environment Prep
Declutter and remove hazards at home.
Get used to any adaptive aids before surgery, not during recovery brain fog.
The Bottom Line
Pre-hab is like packing for a long journey. Without it, you might still reach your destination—but with it, you’ll arrive in far better shape, with fewer detours along the way.
For patients facing the double challenge of spinal instability and low bone density, pre-hab is not just preparation—it’s a safety net, a confidence boost, and one of the best investments you can make in your own recovery.
Ready to take control of your recovery? Speak to your treatment team about building a personalised pre-hab plan, or consult a physiotherapist or dietitian who specialises in surgical preparation.
Your future self will thank you. I can only hope that mine will get the opportunity to!