The initial 6-week recuperation period after a spinal fusion focuses on getting back to feeling good. After this initial period, more advanced exercise should be added to strengthen the back structures and increase overall fitness.
Patients can add more rigor and variety to their routines by using an exercise ball or resistance bands.
The exact timing of when a surgeon will recommend adding dynamic exercises is dependent on both the quality of stability achieved at surgery and the surgeon's personal preference.
Guide to Dynamic Exercises after Spine Fusion: Weeks 6-12
Because these exercises allow for motion of the trunk, many times they incorporate the use of an exercise ball into the program.
Mat Movement Examples
Mat movement exercise strengthens the core by engaging abdominal and back muscles.
Do these exercises on a yoga or gym mat. If you don’t have a mat, try doing them on a rug or carpet.
- Strengthen abdominal muscles with a diagonal curl: while lying on the floor with knees bent, curl the trunk by raising the head and one shoulder towards the opposite hip a few inches.
- Extend the back by alternating limbs: while on hands and knees, raise one arm and opposite leg, then alternate.
Band Movement Examples
Stretchy elastic bands called resistance bands are commonly used for strength training and physical therapy. They are sold in sports equipment stores, big-box stores, and online.
- Stretch the back by using a resistance band wrapped around a stationary pole or column, and leaning back with straight arms.
- Strengthen the abdominals and oblique muscles by performing a diagonal pull with the band: with the band anchored low to the ground, and feet shoulder-width apart, grasp the band and pull from lower right to left shoulder—reverse sides.
Exercise Ball Movement Examples
Ball marching exercises strengthen core muscles for lower back support.
When using an exercise ball, maximizing the range of motion is not as important as staying in control, which takes practice if a patient is not familiar with using an exercise ball. Don't worry about counting repetitions, but perform the exercise until fatigue is evident or control becomes difficult.
A set should last 30 to 60 seconds (so about the length of a commercial break during a television show). One set a day is usually recommended.
- While lying with your stomach on the exercise ball and arms/hands in front, walk forward until it rests under the thighs, then raise one leg at a time.
- With the stomach on the exercise ball and knees on the ground, walk straight out on the hands, but don't let the trunk twist or dip down.
- Variation: With stomach on the exercise ball and feet on the floor, raise head and chest from the forward bent position to a straight (but not hyper-extended) trunk.
- While lying on your back with the exercise ball under the calves, raise the buttocks, hips, and lower back from the floor, keeping the stomach muscles tight.
In addition to stretching and strengthening exercises already reviewed in this article, regular aerobic conditioning should be added starting about 9 weeks after lumbar fusion surgery.
Aerobic exercise is also important to help the fusion set up well. Regular aerobic exercise, even if it is just walking at a brisk pace for at least twenty minutes, will increase blood flow and oxygen which helps with the healing process. It will also burn excess calories, helping to maintain weight and preventing added stress on the back structures and surgical site.
Low-Impact Aerobic Exercise after Spinal Fusion: Examples
Low-impact exercises like walking or swimming prevent muscle stiffness and maintain joint mobility.
Several exercises can provide conditioning. The key is to start slowly with shorter intervals of exercise and increase the duration to 30 minutes a day, in total, as long as the pain is not experienced.
Examples of low-impact exercises include:
- Brisk walking
- Swimming
- Exercising using equipment available in most gyms or for purchase at home, such as stationary bikes, elliptical trainers, and stair climbers.
Not all exercise is suitable, however. Higher-impact exercise that has abrupt stops, starts, and changes in direction can put a fusion that is still healing at risk. This includes exercises such as:
- Jogging or running
- Some forms of dance and aerobics
- Contact sports like basketball or football
None of these types of activities should be undertaken until the surgeon has given a patient approval.
Finally, whatever exercise is chosen, always stop if there is any shortness of breath, chest pain, or dizziness. All these indicate overexertion that could overstress the back and rest of the body
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens, and New Hyde Park – Long Island. Call the Queens office at (718) 215-1888 or (516) 419-4480 for the Long Island office to arrange an appointment with our Interventional Pain Management Specialists, Dr. Jeffrey Chacko or Dr. Sonny Ahluwalia.
