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Old 12-02-2011, 02:47 PM   #1
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post-op PT

Hi all --
So, I finally started PT and had my initial consult yesterday (really closer to 4m out than 3m since it took time to wean from the brace). I had two prior PT experiences, all in different places....one was very good, the other felt a bit too much like a factory assembly line.

This guy seemed good. He left a bigger place recently for the precise reason that it felt too factory-like and they made his schedule too tight to give good care. He said that I'm welcome to use the equipment any time (mentioned I will resume my old gym membership that I paused but can't renew after it runs out in a couple months). He listened and did some general tests of strength and flexibility...said I'm stronger than he'd expect but pretty stiff (I always am, even as a youngin'). He said we can add in work on some of my silly vanity muscles in addition to those functionally needed to recover.

We mostly did the consult but did a bit of work. Seriously shocked at how hard doing a basic "superman" (on belly, raise arm and opp. leg) was (past the BLTs and okay to do such stuff for the right reasons but careful outside the PT realm)....raising my right arm was TOUGH and I don't recall it being before. But that's to be expected. I def felt sore last night even after the little we did but was a good bit better by the morning.

He mentioned he uses a lot of the Mckenzie method ideas. I did Google a bit but has anyone here had firsthand exp with it?

 
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Old 12-02-2011, 05:19 PM   #2
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Re: post-op PT

Well, congrats. This is a big milestone you've been waiting for ever since your surgery!!

I'm a little surprised he uses a lot from McKenzie after a lumbar fusion, as it is almost all based on putting the spine in extension. It apparently works great for a disc herniation issue where most of the pain is in the leg. The idea is that the pain moves up from the leg into the back and then eventually heals without intervention.

Perhaps he employs parts of McKenzie that I am not familiar with as I just can't see how it would work for a lumbar spinal fusion. I would think it would aggravate the adjacent discs and cause them to degenerate faster than with normal aging. The point of a fusion is to prevent motion in that segment, which already puts additional stress on the adjacent discs. By forcing the back into a position it has been surgically altered to avoid doesn't make sense to me...but, what do I know?

Hopefully someone will have used McKenzie after fusion and will be able to offer you some perspective.

 
Old 12-02-2011, 05:23 PM   #3
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Re: post-op PT

I had similar musings. He def works with fusion folks. Though it was interesting to find out that in the nearby hospitals they NEVER do anterior approaches. He said he'd seen them from folks a bit north (Altoona)of us but not directly in the State College area (we're one town over though he used to be in SC).

 
Old 12-02-2011, 05:41 PM   #4
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Re: post-op PT

That's interesting, too.

The McKenzie method is based on the lordotic curve. When this curve is distorted from poor body mechanics, using poor posture for sitting, bending, picking up and lifting, etc., the spine becomes straighter. This puts stress on the spine and results in damage to the discs, etc. McKenzie exercises are designed to strengthen the back and core, and return the lordotic curve to a more normal position.

You will see products advertised that are for this purpose, such as lumbar rolls, night rolls, etc. all designed to support this curve.

Because I had spondylolisthesis and my spine was not pulled back into "normal" alignment during my surgeries, I have some loss of the lordotic curve. Doing McKenzie exercises would try to force my spine into a position it is not really capable of doing now and the adjacent segment would give way as a result.

Can your dad advise you about this?

 
Old 12-03-2011, 06:54 AM   #5
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Re: post-op PT

Dr Dad already got an email :P He said he'd ask his in-house PT Monday

 
Old 12-03-2011, 07:25 AM   #6
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Re: post-op PT

I look forward to his response.

Interesting that ALIF is not commonly done in one community, but I've found this "regional" disparity quite common. It is the same with the "popularity" of using a neurosurgeon vs an ortho spine surgeon, and vice versa, for back and neck issues. This varies quite a bit around the country. In some area, you can hardly find an ortho spine surgeon, but in other areas, they outnumber the neurosurgeons.

In my current area, neurosurgeons tend to do anterior/posterior fusions whereas orthos do one or the other, depending on the issues, but less commonly do the "360."

How are you feeling now without the brace? I gather you are getting stronger every day (week?).

 
Old 12-03-2011, 07:32 AM   #7
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Re: post-op PT

Thanks for asking. I think I'm over the hump. I am frustrated with still having a good level of pain (2 at the best, medicated, up to 7 or even 8 sometimes) after almost four months. I've still been on high pain meds but am weaning a bit b/c I just need to try. A little frustrated with the docs lack of guidance on that....Dad was a bit of help in setting some goals....I kinda like to be TOLD what to do on that front and he said they really won't do that but helped me set general goals for progress etc. He also reiterated that there IS a reason I need more meds...I get tolerant VERY quickly (as a kid, I had to change fall allergy meds yearly b/c they stopped helping) and had used pain killers for years prior to the back stuff for the endo (NOT a daily use, but even once a week was enough to make darvocet a joke to my body).

But I'm trudging through and focusing on the fact that I did see growth on the xray. As you know, I'm happy I get to take a more active role in working on it now and that is a big mental help.

 
Old 12-29-2011, 07:29 PM   #8
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Re: post-op PT

How's pt going Cheryl? I start next week, which is just over 3 mths post op.
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Old 12-31-2011, 03:38 PM   #9
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Re: post-op PT

Didn't see this when I replied to your other post....

I am still dealing w/ a lot more pain than I expected but I really love PT. My guy is awesome....he figured out fast that I'm one he needs to pull back more than push which is good. But he also def works me....I'm actually usually there for TWO HOURS when you include 30min walking, 10-15 on heat and stim, and 10min manual stretching (added in after the re-eval...I kinda knew the little chair hammy stretch he had me doing wouldn't cut it...he does just a push on the hams and the hip flexors). The rest is assorted strength work, incl a few vanity triceps thrown in b/c I mentioned "missing" them. More than my prior two PT stints, he really makes every program unique and focused on the patient...obv there are exercises he favors and that many of us do, but even the PT I liked before (one in Boston rocked, didn't like one in the Philly burbs) seemed to have most folks on the same basic program which is not the case here. He actually left a bigger office b/c they made him run through too many patients a day and he couldn't keep the level of care he prefers. This is a chain but it is just him in this office so pretty independent.

I also find it just a neat little social world....I go late AM so I'm usually the youngest by far at 34....there are some hilarious ladies, esp when I need to go a bit earlier.

 
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