Flexability

[DebbieM]

Being fused from around T3 to the sacrum, how much flexability will I have? And does the flexability get better over the years. Will it ever come back?

I'm having surgery Oct. 2007

Debbie

[dianeh]

Flexibility

This is my very first post on this forum. I had my fusion in Jan. 2006 and have had no one to share my feelings with. Imagine finding everything I had
worried about all in one place. I've been addicted to my laptop all weekend. My account was just activated and I just had to post something to get started. Concerning flexibility, I am now 51 and was fused from T3- sacrum. It has been a long recovery but my flexibility is excellent. I can almost touch my toes, I'm about an inch from the floor with my knees straight! I'm working on that last inch. To change the subject, some of you have written about sciatica and leg pain. I have been struggling with both for a long time. I'm a retired nurse who went back to school for music. Instead of taking care of sick children, I'm teaching piano to well ones. My heart needed a rest from hospitals, although I loved being a nurse. Three months after my surgery I tried to go back to work part time. One evening the pain shooting down my right leg was so severe I had difficulty accelerating the car. In PT I was told I was overdoing it, but I never was quite sure what I was overdoing. I took the summer off to rest and the pain went away. I tried again to start teaching and got the same pain in my left leg. I ended up not teaching by Dec. 2006. Needless to say I was very upset and frustrated that no one could tell me what was wrong. I started researching and discovered something called piriformis syndrome- a small muscle in the buttock that can get irritated by too much sitting(driving, practicing piano) and contracts, putting pressure on the sciatic nerve, causing the leg pain. Since I don't have any discs where the fusion was done I was pretty sure this must be the reason. I found a doctor in Manhattan who specializes in this and was officially diagnosed 2-3 weeks ago. I've been put on a drug called Lyrica to calm down the nerve and a very specific PT program for 2-3 weeks. I'm afraid to jinx myself since I've been on some form of hydrocodone since the surgery, but I think the pain is getting better! What a relief! I go back in two weeks so we'll see. I'm very excited to be on this forum-everyone seems so nice and supportive. Has anyone else heard of this? Has anyone else been on pain medication for one and one half years after their surgery? My surgeon says I'm totally fused and is very pleased. I am too but would love to be off pain meds.


Thanks for listening,
dianeh

[structural75]

dianeh,
I can't speak to all of your questions/curiosities, but I can comment on the sciatica/piriformis issue. Piriformis syndrome is very common amongst people with and without scoliosis. In fact it is more often the cause of sciatic compression/impingment than actual true sciatica from the lumbar spine. Given that your fused to the sacrum the piriformis muscles on either side of the posterior pelvis are working very hard to establish some semblance of balance to the spine. It sounds like your script is an intelligent one for specific PT work. With scoliosis the piriformis muscles are usually found to be in a state of enuequal length relative to one another and therefor imbalnced tension... one is working/contracting chronically musch more than the other which will often compress the sciatic nerve traveling under/above/or even through the muscles in some folks. Sitting directly on this muscle puts further pressure on the nerve and the seated position also stretches the piriformis muscle causing it to become very taught and again compresses the nerve.

Keep up the PT and you should be able to get off the lyrica soon after.

Debbie,
Flexibility of a fusion from t3 to the sacrum will come mostly from your hips (where the leg meets the pelvis) in forward bending and such. In fact many movements such as walking, running, sitting, etc will have to happen predominantly from the hip joints so be mindful to keep them limber and flexible. At the first sign of immobility, stiffness, pain, piriformis syndrome!, etc... get some help with mobilizing and stretching this region. Those would all be signs that the excessive movement and forces happening in that region are overworking, stressing and compromising their function. Stay on top of things and you should do well.

Best to you both,
structural

[crepehanger]

Welcome, Dianeh

glad you found us, I personally would not have made it this far without these great people! That is some good info you and structural75 brought up about the piriformis muscle, i wasn't aware of any of that, but i sure hurt if I sit very long- Good to know that PT will help to overcome the muscle fatigue if it doesn't go away with normal recovery. Is there any special stretching or exercises we can do to help strengthen it before it becomes a problem? Lisa

[structural75]

Lisa,
Lay on the floor on your back. Bend both legs so your knees are up and feet flat on the floor. Take the ankle of the side that the pain is on (pain/tight piriformis on right = ankle on right) and rest it just above the knee on the thigh of the other leg. Your legs will be in a semi crossed leg position... the kind that you often see men sitting in with the knee of the bent leg hanging off to the side (woman tend to cross the legs fully over one another).

Reach through and take the knee of the leg that your ankle is resting on and draw it towards your chest. Don't worry about how far you get, just move in that direction. As you do this try and keep the knee that is hanging out to the side away from you as you're drawing the other knee towards you. You should feel a stretch in the back of the hip, and possibly the leg, on the side with the tightnes/pain.

It's simple once you figure it out... decsribing verbally makes it sound far more complicated than it really is. I hope that isn't too confusing.

Do this on both sides... The painful side is not necessarily the shorter muscle... it is often the longer over-stretched piriformis that creates the problems. So if you go to a PT or the like, find out which piriformis is over-stretched and which is shortened. Then do this, and any other relevant stretch, twice on the side that is shorter and once on the side that is longer.

structural

[bsprings]

Does anyone have any words of wisdom on stretching the hamstrings or how long it takes? I am 46, am 7 months post op and fused T4-S1. My hamstrings are so tight I can not bend over very far at all. I can't lift my leg straight up when sitting in a chair either- it is like they are about half the length they used to be! So I have been bending at the knees all the time and now my knees are very painful. I go to PT and they just stress the stretching exercises and also getting my legs stronger so that it takes the pressure off of my knee joints. Has anyone else had these problems?
Cathie

[crepehanger]

I tried it! Thanks, structural!

I can feel the stretch, a good stretch. It kind or reminds me of those pelvic stretch exercises they used to have pregnant women do. I am so glad you wrote about it and explained it- It's so nice to be able to do something to prevent a problem! Sitting is the worst for me. Thanks again !!

Cathie- in rehab,for the hamstrings, they had me lay on my back, one at a time, grab my knee with both hands and pull it toward my chest, so it pointed straight up in the air, like a 90 degree angle- straighten my leg to the point of tightness, and then relax it by letting it bend at the knee for a few seconds. you might not be able to get it up that far, so take it very easy- They had me do 10 to start with on each side. Good luck and go over it with your PT. Lisa

[crepehanger]

Flexibility...

Debbie- I meant to put this in the previous reply- I am surprised at my flexibility that's starting to return. you have to wait until your fusion heals before you stress it, but if you keep up the stretching exercises, your muscles will compensate. My doctor pretty much told me to expect to lose most flexibility after lumbar fusion, so i was prepared for the worst. But, it's slowly coming back-

[rainbow2010]

To stretch hamstrings, try putting your foot on a step and pulling your toes towards you. You don't have to lean in to try to touch them. Work you way up the steps. I do my stretching in a pool. It is the only place I can exercise anymore!

[trulyaries]

Correct me if you think I'm wrong, but I have been led to believe that anyone with lumbar/sacral fusions should avoid excessive forward bending (i.e., touch toes), even if you have a solid fusion. This puts additional pressure on unfused vertebrae, or on the hip joint, and it's better to "squat" if you have to reach something. Yes, yes, I know - if you're a certain age like me if you squat you might not be able to get up again!

The other exercises mentioned sound okay, but I'm not too sure about touching the toes. Comments?

[structural75]

trulyaries,
Yes, you're correct generally speaking. Forward bending with straight legs does put excessive stress on the hips and fusion alike because the hips and pelvis are responsible for allowing ALL of the movement/stretch/mobility. Stretches that can be done by eliminating the force of gravity are the safest and most advisable in my opinion. There are many ways to go about stretching the hamstrings... forward bends for folks in this situation should be used conservatively if at all for some. Seated forward bends over the legs while sitting on a blanket or such to lift the pelvis up is a good option and just as effective as standing folds. Also laying on the back while using a strap around the foot is another excellent option.

[dianeh]

flexibility

Hi Trulyaries,

Sorry if I confused anyone. I don't do exercises bending forward and touching my toes, just at my last visit to the surgeon I was asked to do this and the measurement of how close to the floor I could reach without bending my knees was recorded on my chart. The doctor said I had alot of flexibility for my age. Every once in a while I check how far I can bend, and as I heal I get closer to the floor. I agree it probably wouldn't be a good idea to do this regularly.

Hope that clears things up,
dianeh

[dianeh]

flexibility

Hi Lisa!

Thanks for the welcome. The exercise mentioned by structural is the one I do. I've been told by PT to do it 4x/day and hold it for 1-2 minutes. You can also do it seated and push down the knee on the affected side.

dianeh

[trulyaries]

Dianeh:
Thanks for clarifying that. Yes, I have been asked to do that test for the docs also. Sorry I misunderstood, but glad you are not doing it as a regular exercise.

BTW, you originally asked if anyone had been on medication so long after their surgery. Sad to say, I have been on one kind of pain med/NSAID/muscle relaxant or another ever since my first surgery in 2000. I have high hopes for this most recent surgery, but would not be surprised if I need at least some meds to keep me going after all is said and done. (Before anyone calls me out on it, I was on NSAIDS only after my first fusion was determined to be solid. )

[dianeh]

Flexibility

Hi again Lisa,

Just did my daily stretches and realized I mis-spoke last night. To get a good piriformis stretch when seated, cross the affected leg with the ankle on the opposite leg and lean forward. Sometimes during the day I just don't feel like lying on the floor.

dianeh