Hello guys. I 'm about 11 months after L4-S1 fusion. Overall, it's seems to be a success. Many times I have little or no pain which is great. My question is what exercises do you guys do on a daily basis that has helped to keep the back strong and lessen the pain?
I'v seen a few physical therapists and it seems they have conflicting ideas of what exercises are beneficial.
At eleven months, you should be able to do just about any type of exercise (assuming your bone growth is proceeding at the average pace!). It will be important going forward that you do exercises that will keep your core and back muscles strong and stretched.
I do the usual exercises for core and back that most PTs give to their patients. I also bought a yoga DVD specifically designed for people who have had back surgeries. Many people swear by Pilates but you really need to take a class under the supervision of a certified instructor so you don't end up hurting yourself.
With a lumbar fusion, you generally want to avoid anything that puts the spine in extension (bending backward). Depending on how you swim, this can include some swimming strokes that are done on the stomach.
I had some segment reconstruction in addition to my 3 level fusion and I will always feel I need to be careful in selecting my activities. But I know people who have resumed all their former activities, including mountain climbing, kayaking, running, etc. I didn't do those things before fusion, so now would NOT be the time to take them up!!
I guess regarding the conflicting advice you've received from PTs, if you've been told you are fused, gingerly try what you want and let this adage guide you: "If it hurts, don't do it."
One more thing -- try to rotate activities so all the various muscles get a work-out over a period of time. Keep your muscles stretched out and make a point of always using good body mechanics and posture.
When people get into trouble after a successful fusion, it is often because they are "good" about keep up their PT activities for awhile, are careful about gaining weight, posture, mechanics, etc. but then, sooner or later, they revert to all the old bad habits -- stop exercising, slump on the couch in front of the TV or video games for hours at a time, use poor posture when sitting in front of the computer, eat too much, and before they know it, the back starts hurting again....Just keep reminding yourself, "once a spiney, always a spiney." There are things you need to do to keep your back strong and healthy.
Good luck. Hope you find some activities you enjoy doing and find the time to do them!
Any good physio should have a list of them and tell you how many to do. Besides you should be seeing one or have seen one. And they should have gone through this with you several times. Usually do them about 10 times each twice a day. This is only a guide as I said, see a physio. They will show you how to do these properly. Also breath don't hold your breath.
1. Transverse abdominal and pelvic floor squeezes on your back. Feel the muscles tighten with the fingers just inside your pelvice.
2. On your side squeeze the lower back muscles and feel the muscles tighten, lift pelvic floor and tighten lower abdominals.
3. Same in a sitting position. pull up the pelvic floor and lower abdominals along with the lower back.
4. While sitting squeeze your butt muscles.
5. Laying on your tummy with one foot pulled up to the back of your knee. Like a 4 shape. Squeeze the butt muscles. Do both sides.
6. With a pillow under your knee tighten the thigh muscles until your leg straitens and pull the foot up also not the toes.
7. On your back pull your knee up with your hands then straiten leg up, start with both knees up feet on bed or ground..
8. Standing and pushing up with the calf muscles on to your toes.
Oh well that is a start, along with a 30 minute walk building to 60 minutes a day. There are loots more I am sure but these are the ones I do and have helped me so much. It has been less than 2 months for me though.
25-Nov-2010: ALIF fusion L5-S1. 9 years of Chronic lower back pain. Nearly 18 months of pain across my upper pelvis, through my butt and down my left leg into my foot. Sciatica relieved by surgery.
The Following User Says Thank You to allanbruce For This Useful Post: scoopy (01-21-2011)
If you can possibly arrange it, I think you should call your surgeon and ask for a referral to a physical therapist. If you cannot afford a course of therapy, you could still go for one or two sessions and ask for a list of exercises that would benefit you.
I am not necessarily recommending this but you can find various exercises on the internet that are recommended for specific spinal conditions, and for people who have had lumbar fusion. It might take a bit of looking around, but there are many good sites out there. Again though, with these exercises, even though there are basic things that most PTs recommend, it is still personalized to your particular issues. There are many video clips also available online that might provide some help to you. Many are done by physical therapists.
When I first read your post, I thought I would post a couple exercises that have all been recommended by four different PTs I've been to in past years. But after reading through Allan's list, I am really surprised at how different what he is doing from what I was given to do after my two lumbar fusions. "My" exercises are almost completely different...so I think you really need to be careful if you are working without being supervised.
I suppose being 11 months out, you are hopefully mostly fused by now...so the need to be really careful is less. But you also need to be a bit careful because doing the wrong things can still cause a flare that can be very painful, and set back your recovery.