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jsully
07-14-2010, 07:48 AM
Whenever I walk by a mirror or window, I can't help but notice that I lean forward when I am walking. I try to remind myself to pull my shoulders back, but this doesn't seem to help much. Has anyone else had this problem????? How long does it last???? I don't feel I will ever be "normal" until I can walk upright. Please help!
Thanks,
Janet:confused:

JamieAnn
07-14-2010, 09:52 AM
Hey Janet,

Just curious if you (or any other people with recent surgeries) are in physical therapy. I would imagine that would help the leaning forward issue, but regardless I'm just curious if it's something most people do or not. My surgery is in late September.

Thanks :)

titaniumed
07-14-2010, 10:32 AM
Janet
I have had that feeling a few times. Its way too early to come to any conclusions as to any possible sagittal imbalance issues....all your muscles have to heal....

Surgeons have to build your lordosis and kyphosis shape into your construct. They also have to re-shape your scoliosis curves, so its a 3 dimensional correction. Many surgeons will use a Jackson table.
http://www.mizuhosi.com/jacksonSpine.cfm

I will feel the forward lean every once in a while, but not often...

Ed

VMosch
07-14-2010, 10:38 AM
Hey Janet! I am almost 16months post op and I still notice myself bending forward, especially in photographs. (grrrrrr) Anyhow, I was naive enough to think that I would automatically stand "straight" right out of surgery, I guess I was thinking the rods would hold me up..LOL. My doctor says my xrays look good and correction was GREAT, sooo, now its a matter of getting my muscles and muscle memory whipped into shape.
Good Luck!!

jsully
07-14-2010, 10:53 AM
No PT yet, just walking and swimming. Of course when I take long walks, I use a walker which does not help things. I feel not just this way sometimes. It is all the time and I am concerned.

Susie*Bee
07-14-2010, 11:12 AM
Janet-- I sent you a PM earlier... don't know if you saw it. I find it interesting about the walker. Practically everyone mentions getting one, but my surgeon does not let you have one, because he says it causes people to bend forward... I did get to have a cane for help going up and down stairs. (And I used it a little on longer walks for security, although he didn't know that-- and took it with me in crowded places as a "prop" so people would know not to crowd in around me!) ;)

pint47
07-14-2010, 11:24 AM
My surgery was March 25th and I still walk leaning forward. I have been off my walker for about a month. I use two quad canes now and think it is helping some- my Dr said he thought i was leaning forward because of the walker. I have just been approved for aqua therapy. Hope that helps. Also my Dr is trying to get surgery adding a concrete like substance in the vertibrae above my fusion to straighten my upper back so i don't lean forward as much. this has not been a quick fix to my problem but I do have a lot less pain in my back and groin.

CHRIS WBS
07-14-2010, 11:26 AM
Its way too early to come to any conclusions as to any possible sagittal imbalance issues....all your muscles have to heal....


No it's not. Just ask Naptown who said she could not stand up straight while still in the hospital following her first surgery. I would definitely let your surgeon know about your forward lean.

My surgeon highly discouraged walker use and said it can cause kyphosis in a healing spine.

Back-out
07-14-2010, 12:17 PM
No it's not. Just ask Naptown who said she could not stand up straight while still in the hospital following her first surgery. I would definitely let your surgeon know about your forward lean.

My surgeon highly discouraged walker use and said it can cause kyphosis in a healing spine.

Great comment, Chris. Super helpful. Don't know why others haven't reported similar advice from their surgeons. Sometimes I think they (surgeons) feel their job is planning and executing the surgery and thereafter it's up to other providers (and the patient) to take it from there - with minimal, if any - guidance. Even (especially) with opiate meds too, things seem much too laissez-faire with many doctors (I think loads more education needs to be part of prescribing such pain meds).

The ultimate success of the surgery can hang on just such pointers/rules, though - especially vital during the immediate post-surgical healing period when the spine is fusing in its final shape. It's not just "no BLT" but posture itself that must make a huge difference in avoiding PJK problems such as Linda has been posting about. (And I myself am in such bad habits now!) Count me as another who thought the surgery itself would make me stand and sit upright - without effort. :eek:

This makes perfect sense - but we should be hearing it from the surgeons. Have others of you gotten such directions about walkers? I see they've been unfavorably mentioned several times in this thread alone. I was counting on mine after surgery, and yet now that I think of it, I am sure I'm walking with much more of a tilt since I started using mine (pre-surgery) . Walker height matters a lot too. (Nb. this was just realized trial and error. No one ever measured me or adjusted it after I got it!).

I think this deserves its own thread - to highlight the importance of this issue. Everyone deserves a "heads up" (haha - NOT!) about the risks of improperly used walkers. It can create a feedback loop, which worsens the problems leading one to reach for walkers (and shopping carts) in the first place!

(Gives me a lot of respect for your surgeon. Also to feel all the more, how much one must think for oneself - and seek out such opinions).

Susie*Bee
07-14-2010, 12:30 PM
Great comment, Chris. Super helpful. Don't know why others haven't reported similar advice from their surgeons.
You must have missed it-- look two posts above Chris', from me... I just said it too. My surgeon doesn't allow walkers. I will go back and highlight it somehow... There, I don't think you can miss it now. :)

jenparker
07-14-2010, 12:50 PM
I had my surgery at the end of January of this year. I was sent home with a walker but realized after a few times around the block that I was leaning forward. I am close to your age (38) and a nurse. I decided that I would keep walking but my whole focus would be on standing up straight because I've seen too many fusion patients walk forward for the rest of their lives.

I didn't listen to my music on my walk but tried the entire time to pull those muscles in my legs and gluts straight. It was tiring. It felt like I was pulling taffy--maybe lying in bed after the surgery for so long had made the muscles tight. But, now I don't have to think about it as much.

Good luck. It's good that you are noticing this sooner than later (as least in my opinion). I wish the doctor's or PT's would address this sooner.

Jennifer

Singer
07-14-2010, 01:02 PM
I used a walker whenever I was out of bed for three months -- and with a severely weakened leg, there's no way I could have walked at all if I hadn't used it. I also used (and leaned heavily on) a cane for a good three months after that. I have no problems with leaning forward. I did have a lot of physical therapy, however -- including gait training, to lengthen and balance my stride. It helped immensely.

Doodles
07-14-2010, 01:04 PM
I still have the same feeling. It seems my head juts out. I try to compensate but know I don't always do well. I had a walker for about 3 months but only occasionally used it the last 2. Janet

Back-out
07-14-2010, 01:10 PM
You must have missed it-- look two posts above Chris', from me... I just said it too. My surgeon doesn't allow walkers. I will go back and highlight it somehow... There, I don't think you can miss it now. :)

Sorry, SusieBee! Indeed, you did - and well said too.

I posted in haste after being left with a strong impression of the dangers of walkers, and Chris' comments were just the most adjacent.

I am struck by the fact that both your surgeons are in Chicago. It must be an integral part of their training/teaching - I picture memos being passed around and perhaps research links too. I wonder why other surgeons aren't coming up with like rules. As you comment, most folks comment on being "issued" walkers and without any words of warning, much less rules.

Again, this puzzles and dismays me. Why do surgeons have so little apparent regard for their handiwork (if not their patients) that they neglect this important finding? Or is is possible that the walker rules (as for me) are based on "common sense" rather than any organized studies showing the risks?

Sometimes when a negative effect seems "obvious", no studies are done as scientists believe it unethical to have a control group (using walkers) subject to a harmful influence.

So the learning curve is "Darwinian" - attached to self-education as through this (invaluable) group and comments like yours. (Not just in this thread, either! :) )

IMO this and other advice shown to have been missed by posters either through mis-communication or neglect. should be collected in a reference section. A glossary too! (Another example is the no NSAIDS during healing rule which " sacket " only learned of here - he was misled by a slip-up when he left the hospital. )

We can't count on David Wolpert's book for everything! (Wonder what he has to say post-surgical walker use).

Back-out
07-14-2010, 01:31 PM
BTW I am adding this to my "ideas for Patents" folder - I toss in notions as needs are called to my attention, especially after searching for a product that doesn't exist. (Dammit! Many have already been marketed and made others a mint...)

This one is easy (though I have a complex version too, involving sophisticated circuitry).

Easy: Something to wear either around the neck or atop the head, It would sound a bell or other alert , when the head tilts at an angle beyond a set-point. Kind of a "level" (think carpenters' bubble type) triggered alert to replace ye old "book on head".

(Maybe, for that matter, a driver alert already manufactured would work - designed for long distance truckers especially. Wakes them up when their heads start to nod.).

Complex: More effective and with more general efficacy, would be a posture trainer I've been thinking about for a LONG time. Would be a long vest (light) with pressure points, attached to a circuit map "drawn" by an orthopedic specialist according the patient's needs. It would buzz (or give a mild localized shock) when the patient's posture goes out of alignment at given points. To accompany PT and exercise.

I'd call it the "Parent" or "Posture Minder". In memory of how my dad used to run his finger down my back when he caught me slumping around the house as a teenager ("Posture!" he'd say, catching me off-guard. I'd jump)

But, of course, the extra attentiveness would only last moments...Hence in the immortal words of parents everywhere, I "grew that way" :p)
Note that although I believe scoliosis for many is a deeply ingrained pattern with genetic, neurological, musculo -skeletal, etc. roots, I also believe early posture training can do a lot to compensate. How many West Pointers/Marines have scoliosis?:cool:

Back-out
07-14-2010, 01:49 PM
Not so far as I know, anyhow.

http://www.postureminder.co.uk/howpmworks.html

For anyone wondering why I haven't "gotten the show on the road" with these ideas, one reason is this problem with patents - how to do the pre-market survey to insure your application doesn't duplicate an idea already extant.

There are programs purporting to do this, but ...:rolleyes:
And companies do it too (this is their own intellectual patent!), though soft-ware to do it is apparently no longer patentable according to a recent court ruling.

mbeckoff
07-14-2010, 04:51 PM
I was allowed a walker right after surgery for about 5 -6 days but then when I went to rehab ,I only was allowed a cane and that is what I have been using at home ever since.

Melissa

jsully
07-14-2010, 06:00 PM
I got it! No more walker. It is gonna be so hard to go for long walks now. My L side/buttock hurts so bad from pulling shoulders back and tucking backside in all day. I had to revert to a pain pill which I am nearly off of, ugh! Much more work ahead. I go to my MD next week for a 6 week check up, I will ask for PT. I have to return to work in 7 weeks:o yeeouuch!
Thanks,
Janet

naptown78
07-14-2010, 06:30 PM
Janet

I think the difference between serious and maybe not so serious is if you can "make" yourself stand up straight. If you look at yourself in the mirror and pull yourself up and can get straight, maybe your muscles are just weak and need time to get stronger. Do as much walking as you can. My problem after my first surgery was more serious. Immediately after surgery, I could not even make myself straight. I remember backing up to the bathroom sink and pulling myself back as hard as I could and I still couldn't get straight. I had a sagittal imbalance and recently had a revision to correct this. Sometimes I find myself leaning forward still but I think its because that is what I am used to and then I get mad at myself and straighten right up! As far as the walker talk, after my first surgery I could not walk from my bed to the bathroom without using my walker due to all my pain. I was astounded that some people were talking of not using walkers because I was having such a hard time. After my second surgery though, I only used one in the hospital and have never felt the need to use one at home. I think it is strictly an individual thing.
You are still so early in your recovery, I would give it more time, but definitely mention it to your surgeon on your next checkup! Good luck....

Back-out
07-14-2010, 06:46 PM
Janet

I think the difference between serious and maybe not so serious is if you can "make" yourself stand up straight. If you look at yourself in the mirror and pull yourself up and can get straight, maybe your muscles are just weak and need time to get stronger. Do as much walking as you can. My problem after my first surgery was more serious. Immediately after surgery, I could not even make myself straight. I remember backing up to the bathroom sink and pulling myself back as hard as I could and I still couldn't get straight. I had a sagittal imbalance and recently had a revision to correct this. Sometimes I find myself leaning forward still but I think its because that is what I am used to and then I get mad at myself and straighten right up! As far as the walker talk, after my first surgery I could not walk from my bed to the bathroom without using my walker due to all my pain. I was astounded that some people were talking of not using walkers because I was having such a hard time. After my second surgery though, I only used one in the hospital and have never felt the need to use one at home. I think it is strictly an individual thing.
You are still so early in your recovery, I would give it more time, but definitely mention it to your surgeon on your next checkup! Good luck....

These are all important points and useful distinctions.

With walkers, I think there needs to be more discriminatory use and definitely careful height adjustment! I discovered recently I could do without much more than I'd thought - as long as I'm not carrying anything.

I wonder about using the side rails on my treadmill too. I 'm sure I've been hunching over a lot more because of my "ambulation aids".

All this will matter much more after surgery! It will be hard to make myself stand straight (provided the correction was done so I CAN, Kristy!), after the spinal muscles have been cut. In fact, I don't really know how people are supposed to be able to pull this off, between the muscle severing and the weakness!

JenniferG
07-14-2010, 07:15 PM
I can fully understand you being concerned but as Kristy says, it is still very early days for you. Are you able to force yourself upright? If so, I would imagine it's just a matter of time and retraining those muscles. I would be ditching the walker as often as possible though, because it's possible it's not helping with your "uprightness". Glad you're seeing your surgeon soon to clarify this and get some answers. It's no fun worrying about these things.

jsully
07-14-2010, 08:19 PM
I can force myself upright, but don't like it much, uncomfortable. I am going to borrow my Mom's cane for long walks, I have NO idea how to use one, seems strange. If I went out w/o anything I can cruz prob 2mph!! Do feel better after taking my pain med and not as uncomfortable to make myself walk upright with it.
Janet

Susie*Bee
07-15-2010, 08:22 AM
Back to the walker "thing"-- I never used one, even in the hospital. If you click on the "pics of me" in my signature, you can see one of me walking the halls, and my only help was a PT member's arm for support (and someone to wheel the IV along). Please pardon the hair-- hadn't given it a thought at this point... Who cares??? I think it was day 6 when a nurse kindly said "you might want to brush your teeth today, dear." It had never occurred to me at all... (Of course, in my defense, I had that ileus and wasn't allowed food or water all that time, so I'm sure they actually hadn't brought it up nor would have let me... maybe. ;)

Janet-- one word of caution about the cane thing-- my surgeon also didn't like those very much. Make sure that it's at the right height so that you aren't tilting to the side at all. It was alright with him that I used it on the stairs because then I had equal support on both sides. I KNOW, all of this leaves one between a rock and a hard place. Probably, just use whatever you need for support but be conscious of holding your body upright. And check on it in store windows and mirrors, etc. and see how you are doing. Best wishes!

lumbar3491
07-15-2010, 08:35 AM
Hi All,

Although I was issued a walker when I came home from rehab, I quickly switched to Nordic Walking Poles. I adjusted them to the right height, and they help me walk without bending over. They help with balance as well. I highly recommend these poles to anyone who tends to bend over.

Karen

Back-out
07-15-2010, 08:53 AM
Hi All,

Although I was issued a walker when I came home from rehab, I quickly switched to Nordic Walking Poles. I adjusted them to the right height, and they help me walk without bending over. They help with balance as well. I highly recommend these poles to anyone who tends to bend over.

Karen

I've read about them in the last few days (since you mentioned them)
They sound interesting! I wonder, though

whether they would be reimbursed by insurance (if prescribed)
whether they can be used indoors.

For those of us in Northern climates having surgery in Winter, it looks like Mall walking will be the thing (God help my budge! :o) I've been worried about my treadmill (but thought I'd rely on it).

Now, though, I'm seriously concerned about its postural effects since I already see I tend to hunch over on it because of the side rails. This iS dismaying to think about (though I'm glad to learn about it). *sigh* One more coping strategy bites the dust!

But these look like ski poles. Can't be healthy for hardwood floors and the Mall designers may have rules against them. Likewise, indoor tracks.

CamsMomKelly
07-15-2010, 10:18 AM
IM not expert either but my son had a walker after his shunt surgery, HEIGHT adjustment plays a HUGE role... When he first got it they had it height for him to stand straight as could be and couple days later when leaving they adjusted it again as he was standing up more.I was told by the PT to watch him with it and make sure he doesnt start to lean when walking or it might need to be adjust again... He doesnt use one at all now but it did help him alot after surgery.

TexEx
07-15-2010, 10:37 AM
Just to put in my two cents worth. I used a walker on my first outing with my PT in the hospital, then pretty much walked with the support of an individual until I was steady on my feet. My kids loved "helping" Mommy around the hospital floor. One held the IV, the other, my arm.

I did have a caretaker or relative walk the neighborhood w/me for the first few weeks, while I was on too many meds to feel secure walking myself, after that I walked on my own.

They did not want me on any assisted devise if I did not need it.

I would think that some PT and retraining of the tight muscles would straighten things out. I am having issues with my back being very stiff and my gait being stiff and different that I am trying to work out with my therapist.

Good luck.

Melissa; 46 years
March 31, 2110 surgery
T9-L5 fusion
Pre Op 60% Curve
Post Op 20% Curve

gmw
07-15-2010, 10:40 AM
I had no walker nor cane. The PT allowed me to use the walker the first time I got up to walk and after that no walker. I was able to handle walking without assistance very quickly for which I am very grateful. With my posture (previously), I probably would have had a tendency to lean forward if had used a walker.

Singer
07-15-2010, 11:19 AM
I don't mean to be cranky about this, but isn't it better to use a walker or a cane rather than risk falling? There ARE post-op people who simply don't have a choice if they want to walk at all....and most surgeons urge all of their patients to walk as much as they can tolerate.

I agree with CamsMom that the height and fit of any assistive device is extremely important. You CAN be conscious of posture while using a walker or cane -- I know I was.

Susie*Bee
07-15-2010, 12:15 PM
Of course you're not being cranky, Chris (or at least I don't see it that way) -- you're presenting a very legitimate point. You had leg problems. Some people definitely need to use a walker. But there are others who don't. I got along perfectly fine without one, at the ripe old age of 56. And I keep reading about all these much younger people with their walkers and wonder about it. And then I read things like this quote earlier in this thread from JenParker and question it even more:

"I decided that I would keep walking but my whole focus would be on standing up straight because I've seen too many fusion patients walk forward for the rest of their lives."

That is scary. Today when I was out walking my country trail (it's 5 acres around our yard, just doing it twice right now) I kept reminding myself to keep my shoulders straight and my head up and not to worry too much about the grass tufts and the mole hills and runs and such, and told hubby if he didn't see me sometime when he comes home, I'd be out on the trail somewhere. :rolleyes: I do lean forward a little going up the inclines, but that's it, and that's natural. Right? Have to admit it is much easier when I do the treadmill inside in the afternoon-- nice and steady, no lumps for my feet. But lumps for your feet are actually good for you; my PT used to have me stand on surfaces that would make you have to balance and shift. It was awfully hot and muggy though-- and buggy too. We are having lots of heat and humidity. A disadvantage of the midwest. (I grew up in CA.) Right now it's 86, with a heat index of 99. Yuck.

gmw
07-15-2010, 12:19 PM
Hi Chris --I didn't mean to sound so opposed to the use of walkers or canes. You have a very good point, and I agree it is better to use a walker or cane for assistance where necessary and that may be the case more often than not. I didn't walk without someone right beside me for support should I need it until I was steady on my feet. I definitely didn't walk alone. I was very conscious of my falling and so were my caregivers. Before the surgery when doing all my planning, I fully expected to be sent home with a walker. I was surprised when they told me I'd be walking without one.

Radiogirl
07-16-2010, 10:25 PM
Janet - Leaning forward is perfecty normal. My dr. told me that it's because your core muscles need to strengthen to hold yourself upright. And...he was right! I'm now 3.5 months out and am now standing straight. But it took about 2 - 3 months to feel like I was standing normal. I did not use a walker except for in the hospital. The more you walk, the more you stremgthen those muscles, too. It will get better!!! Hang in there!

RitaR
07-19-2010, 07:04 PM
I had surgery Mar 1st and I notice myself leaning forward just a tiny bit when I walk. Someone please tell me this will go away? I hate to walk past a mirror. Dr. Lenke in St. Louis says it's just because my muscles are weak and take a long time to heal - well, goodness Mar 1st has been long time ago...

kennedy
07-20-2010, 02:30 AM
Chris are you surouis because my surgeon had me use a walker. i geuss it the surgeon policy

lumbar3491
07-20-2010, 08:03 AM
Hi Backed Out

Actually Nordic Walking poles have little rubber "feet" on the end. They can be used inside (as in mall walking) or outside. They are very good for people who have a hard time walking without bending over and they give us more stability when we walk. Here is an article about these poles:

http://walking.about.com/cs/poles/a/nordicwalking.htm

I don't know if insurance companies cover these. However, it might be worth asking your doctor if he/she will give you a prescription for them. Then you could at least write off the expense on your income tax.

Hope this is useful.

Karen

Back-out
07-21-2010, 06:56 PM
Hi Backed Out

Actually Nordic Walking poles have little rubber "feet" on the end. ,,,

http://walking.about.com/cs/poles/a/nordicwalking.htm

I don't know if insurance companies cover these. However, it might be worth asking your doctor if he/she will give you a prescription for them. Then you could at least write off the expense on your income tax.

Hope this is useful.

Karen
Many many thanks! Just found your reference as I checked out this thread for another reason. (There must be SOME better method to keep track of people's helpful replies to my posts!) .

An aside - I'm amused at the number of variations of my net-name that are abounding. I don't like the real one as is (I'm afraid under one interpretation, it will be a self-fulfilling prophecy - nuff said! :o)

Amazing how different the final preposition makes it read! I DO feel very backed-IN and backed-down, lately! Not to mention backed-UP when I forget my Miralax, and - Oh, I could go on, amusing no one but myself :p.

hdugger
07-21-2010, 06:59 PM
Under "Thread Tools" (at the top of the discussion area) there's a link for "Subscribe to this discussion"

RitaR
07-22-2010, 06:14 PM
nobody told me about anthing other than a walker postop. I wouldn't have been able to be up without it for sure.