The physiotherapists on the ward will assist with walking and provide any required assistive devices such as walking frames. They will also advise you on what you can and cannot do in the first few weeks following surgery.
Weeks 1 – 6:
- Avoid sitting longer than 20 or 30 minutes at one time.
- Sleep in any position that does not cause back pain.
- Use log roll technique to get in and out of bed.
- Avoid bending at the waist. Instead bend at the knees and squat down to reach ground.
- Avoid lifting or carry anything heavier than around 2-3kg (e.g.a kettle of water). This means you should not lift a laundry basket, grocery bags, or small children. No overhead lifting.
- For the first 4-6 weeks walking is the only form or exercise you can do and so you should aim to progressively increase your distance daily, avoid hills.
WEEK 6 - 3 MONTHS
Physiotherapy may commence from around 6 weeks post op. Overhead lifting, excessive bending and extending or twisting will still be avoided as the bone continues to heal. 3 Physiotherapy at this stage will involve a controlled and progressive exercise programme of stabilisation and functional strengthening exercises which may include:
- Activating the deep core muscles through Pilates based exercises to provide increased stability for your back.
- Exercising in functional body-weight movements such as walking (at least 30 minutes 5 days per week), sit to stands, heel raises, lunges, squats or step ups.
- Balance exercises such as single leg standing.
- Manual therapy to release any muscle tightness or joint stiffness that could hinder progress.
- General manual handling/ precautions guidance to protect your back.
- You can commence swimming/ hydrotherapy once the wound has healed.
3 - 6 MONTHS
Exercises will be further progressed and weights may be added. No overhead lifting yet! Swimming is encouraged. Exercises to strengthen postural muscles may be added as well as increased cardiovascular work.
6 -12 MONTHS
Overhead lifting can commence if cleared by your surgeon. Further strength, balance and agility exercises aiming to return to pre injury level of function. Remember, after a spinal fusion, there is increased stress placed on the levels of the spine above and below the fusion. For this reason it is very important that you maintain the stability and strength you have gained through your physiotherapy rehabilitation programme, as well as the manual handling education you received, to reduce the risk of further injury to your back. 4 And lastly, stay active!
REFERENCES
1: Burgess LC, Wainwright TW. What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review. Healthcare (Basel). 2019;7(3):92. Published 2019 Jul 18. doi:10.3390/healthcare7030092
2: Zieve, D (2019) Spine surgery – discharge, Available at: https://medlineplus.gov/ency/patientinstructions/000313.htm (Accessed: 16/01/2020).
3: Sherman, J. (2019) Spinal Fusion Surgery Recovery: 1 to 3 Months After, Available at: https://www.spine-health.com/treatment/spinal-fusion/spinal-fusion-surgery-recovery-1-3-months-after (Accessed: 16/01/2020).
4: Hashem, M. (2019) Lumbar Fusion Rehabilitation, Available at: https://www.physio-pedia.com/Lumbar_Fusion_Rehabilitation (Accessed: 16/01/2020).
