PDA

View Full Version : Exercises to ease pain on rehab - 6 months post-op



richardis
08-27-2016, 01:39 PM
Hi,

I am past the 6-month milestone since my surgery.

I wake up every day with a strange pain around the fusion. I am not sure what is the cause of pain: muscles weakened, tense muscles, under-stretched muscles.I have been very careful on this first six-months by restricting movement on the fused are to the limit and by limiting bending, twisting and lifting to a T. Now I have loosen up this limitations and I would like to combat pain by exercising myself.

Sometimes I feel like my spine has been put on a jail. It is not a long fusion- t3 to t10 with ten screws an two rods. It feels like I am in a cage, but I am lucky because indeed I am as my fusion is on the rib cage.

Anyway, the most reliable source I have found online was this: http://orthoinfo.org/PDFs/Rehab_Spine_5.pdf
It is a spine conditioning program proposed by AAOS (American Academy of Orthopedic Surgeons). I am not sure if it is adequate for scoliosis surgery rehab.

What do you guys think?
Tips for managing pain ( no meds-based) are welcome.

I am 30 years-old.

jackieg412
08-28-2016, 08:51 AM
Hi while my fusion is much longer I can say for me walking is key. It helps with pain control naturally and boosts well being feeling. I am sure it increases blood flow and helps with continued healing.
The caged feeling will decrease in time. The body adjusts to the new normal.

titaniumed
08-28-2016, 11:37 AM
I would ask your surgeon about any therapy....It seems that many donít want us doing anything but walking for the longest time, but some like some sort of managed therapy. Since we have seen non-unions in 25 year olds around here, its hard to say ďdo this or do thatĒ. What ever you do, start slow and pay attention to your pain levels. I had a soft tissue injury at 22 months that felt like a soldering iron in my lower spine. This was from stretching too hard for skiing. I would also refrain from using weights for now. If you do, keep it light...

The first thing I do for any pain is to simply lay down. Hot water also works well, shower or hot tub. If you tub, drink plenty of water so you donít get dehydrated.

Defining our pains can be extremely difficult sometimes....Its nice to know exactly whatís causing our pains, and many times we donít know. After time passes you will become aware and know what you can do and get away with.

Sometimes pain is pretty straight forward. Simply remove the crocodile from the nipple, and you will be fine. We wish we could be that lucky. He he

Comedy works well for pain....

richardis
08-28-2016, 02:43 PM
I would ask your surgeon about any therapy....It seems that many don’t want us doing anything but walking for the longest time, but some like some sort of managed therapy. Since we have seen non-unions in 25 year olds around here, its hard to say “do this or do that”. What ever you do, start slow and pay attention to your pain levels. I had a soft tissue injury at 22 months that felt like a soldering iron in my lower spine. This was from stretching too hard for skiing. I would also refrain from using weights for now. If you do, keep it light...

The first thing I do for any pain is to simply lay down. Hot water also works well, shower or hot tub. If you tub, drink plenty of water so you don’t get dehydrated.

Defining our pains can be extremely difficult sometimes....Its nice to know exactly what’s causing our pains, and many times we don’t know. After time passes you will become aware and know what you can do and get away with.

Sometimes pain is pretty straight forward. Simply remove the crocodile from the nipple, and you will be fine. We wish we could be that lucky. He he

Comedy works well for pain....

Thank you Ed!

My surgeon said "physical therapy is not necessary". Although, he recommended swimming, mostly backstroke and crawl. He did not advise any sort of managed or supervised therapy.

I am into isometrics, like plank or abs training while lying on bed. At the 4 months appt, he even said I could lift anything as long as I was in a bench press with the spine supported on the bench.

My point is not to be fit or to get a toned body, I only care about pain-management.

I had my surgery at 30, so my ribs are more deformed than those who had the op at 18-20yo when skeletal maturity is reached. I am having a hard-time at finding the ideal resting position of my shoulders over the rib cage. My left-shoulder is always high and tense ( I am trying to retrain those muscles to be relaxed, but as I get distracted they tense up again). So my goal is to treat the imbalance of the muscles of my rib cage and shoulders.

This 6 months of restrictions made me very stiff. I know my mobility will improve but those muscles are weird. They still act like they did on my pre-op times. And those muscles who attach to the ribs and scapula are thinking : "what is going on over here?"). Obviously, the rib cage has moved so the origins and insertions points of the muscles have different length, I mean some insertion points are closer to the origin now, some are farther away. And it is so difficult to target and work some muscle in particular. They all seem to get recruited for every movement I do.

Those who did physical therapy and water aerobics, what exercises did you do?

Those weird sounds on the fusion site sill remain. It makes me wonder about the progress of the fusion.

jackieg412
08-28-2016, 04:03 PM
The issues you mentioned about your shoulder and scapula can be helped by targeted PT. It is a retraining of the muscles and you are right it is difficult to isolate the exact muscle or group of muscles.
You will need an order . Ask your doctor if it is time. They can also help relax the tight group. Then it's work and more work to maintain.

richardis
08-28-2016, 05:10 PM
The issues you mentioned about your shoulder and scapula can be helped by targeted PT. It is a retraining of the muscles and you are right it is difficult to isolate the exact muscle or group of muscles.
You will need an order . Ask your doctor if it is time. They can also help relax the tight group. Then it's work and more work to maintain.

Thanks Jackieg412!

My doctor does let me do PT if I want, he just thinks it might not be necessary.
But at this phase of my recovery it might be an option. Sometimes it is best not to damage the work the surgeon did and where I live there are not many certified and trustworthy PT. Now, PT is safe enough so I might give it a try.

richardis
08-28-2016, 05:51 PM
The issues you mentioned about your shoulder and scapula can be helped by targeted PT. It is a retraining of the muscles and you are right it is difficult to isolate the exact muscle or group of muscles.
You will need an order . Ask your doctor if it is time. They can also help relax the tight group. Then it's work and more work to maintain.

Hi again Jackieg412,

Forget to mention that this could be useful to both of us: http://orthoinfo.org/PDFs/Rehab_Shoulder_5.pdf

To anyone interested:

on this url
http://orthoinfo.org/topic.cfm?topic=A00672

you can find rehab programs for:

Rotator Cuff and Shoulder Conditioning Program
Knee Conditioning Program
Hip Conditioning Program
Spine Conditioning Program
Foot and Ankle Conditioning Program

jackieg412
08-28-2016, 06:48 PM
The first one I actually have. It is key to engage the scapula and then do the exercise. You do have to think hold the scapula. For me it was the Serratus Anterior muscle that holds the scapula that failed. Since that muscle also assists in breathing, that part did not fail. In other words that part of the muscle works fine. The part that failed on me was the one that holds the scapula to the ribs. Thus I developed scapula winging. Not a lot of fun. After the muscle transfer, I had to work hard to encourage the muscles that hold the scapula close to the spine to engage or the scapula still wanted to drift to the side and down. It has improved a lot since this round of PT. I will have to work hard to keep it in place. Maybe always.
My upper trap muscle is flared but the surgeon says it has to stay that way to hold the scapula up. It can be uncomfortable but I just keep stretching it. Now when the rotator cuff muscles get in a snit, that is painful. Hopefully that decreases in time.
I would say try the exercises but go slowly. If PT isn't an option at least have a trainer watch you at first. It is hard to think engage the muscles by the spine and the do the movement. Very light weight bands at first and light weights. As my PT says it isn't about stressing the muscles it is about proper movement and then strengthening the muscles. I do a lot of what exercises that are on the Web sites.