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Thread: physical therapy

  1. #1
    Join Date
    Jul 2004
    Location
    Dallas, TX, USA
    Posts
    114

    physical therapy

    at my next dr. visit on the 27th we are going to "talk about physical therapy". i would like to know what people do for pt; what are the objectives of pt; how long has your pt lasted; how successful do you think it was; what questions should i ask; etc. i am looking forward to this next step...thanks!
    Sue


    Milwaukee Brace from ages 8 - 16
    T36 degrees/L56 degrees Pre-Op
    Fused T3 - S1
    Surgery done Sept. 15, 2004
    Dr. Robert G. Viere
    North Texas Spine Care @ Baylor

  2. #2
    Join Date
    Oct 2004
    Posts
    166
    I'm currently in physical therapy (second time post op, 6 weeks each time).
    The objective of my treatment was to relieve the muscle spasams I have. First time, they also worked on range of motion. Didn't have to fool with taht a second time though...
    My treatment currently consists of:
    Ultrasound, myofascial release and massage, some strengthening exercises (with small weights and therabands), a couple exercise machines that work to strengthen up my upper body (a handbike, and another thing that looks kind of like a sitting eliptical machine), and then 15 to 20 minutes of heat.

    My results both times have been quite good. I went from having quite restricted range of motion to having normal range of motion after my first round of treatment. I also had several quite muscle spasam free months following.
    My treatment this time hasn't been quite as effective with relieving my spasams, but I am also a whole lot more active now than I was at 4 months post op, and also a bit stressed out between work and school....

    As far as questions to ask... I haven't really had any. Just basically what they were hoping to accomplish, and what sort of treatment they would be using....
    Blair

    Dec 15th, 2003 @ age of 20
    Posterior Fusion and CD Horizon instrumentation T2-L1.
    Surgery by Dr. Herkowitz- Beaumont Hospital of Royal Oak, Michigan
    Excellent correction of 52 degree single left thoracolumbar curve. Slight curve remains in unfused lumbar region but seems stable.
    February 5, 2005- Failed Scar Revision Surgery
    September 17, 2005- 2nd Failed Scar Revision.

  3. #3
    Join Date
    Jul 2004
    Location
    Dallas, TX, USA
    Posts
    114
    thanks, blair...what--if anything--have you done to develop/increase abdominal strength (or is that part of the upper body work you mentioned)? i have no abdominal muscle tone left at all...
    Sue


    Milwaukee Brace from ages 8 - 16
    T36 degrees/L56 degrees Pre-Op
    Fused T3 - S1
    Surgery done Sept. 15, 2004
    Dr. Robert G. Viere
    North Texas Spine Care @ Baylor

  4. #4
    Join Date
    Oct 2004
    Posts
    166
    I haven't had to do any ab work... I'm really self conscious about my stomach (have been since I had to have an emergency partial splenectomy 4.5 yrs ago, and got a vertical incision a foot long down my belly), so I walk around with it pulled in all the time, and between that and training my horses, my abs are in good shape.
    Blair

    Dec 15th, 2003 @ age of 20
    Posterior Fusion and CD Horizon instrumentation T2-L1.
    Surgery by Dr. Herkowitz- Beaumont Hospital of Royal Oak, Michigan
    Excellent correction of 52 degree single left thoracolumbar curve. Slight curve remains in unfused lumbar region but seems stable.
    February 5, 2005- Failed Scar Revision Surgery
    September 17, 2005- 2nd Failed Scar Revision.

  5. #5
    Join Date
    Feb 2004
    Location
    Perth, Western Australia, Australia
    Posts
    299
    Hi Sue

    One thing that you'll need to make sure is that the physical therapist that your doctor sends you to has lots of experience with spinal fusion patients. And another good thing is to make sure that your doc and the pt person keep in communication with each other and that there's clear guidelines that you, the pt and your doc set down for what you are able and not able to do.

    I began physiotherapy (physical therapy) at about 3 months post op ish. I still go to my physio every three months, five years on; but this is simply by choice (most people don't). Its because I get a wee bit slack with my exercises and stuff as time goes on, and I need to be brought back into line and a change of exercises.

    The objectives when I first started physio were to work on my walking and how I moved in general, simple stretching and movement and to try and loosen my up a bit, and to work the muscles around the fusion (which for me is the abdominals because I'm a high fusion). As time went on it gradually increased, but it was always simply using what my body could do and no weights. This was because my doc is very anti p.t and we went against his wishes but the one thing he said was no weights .

    Physio was the BEST THING we ever did, and very successful. I can't imagine how i would be now movement/flexibility wise and no stiffness wise without it.

    I think the main thing is as long as you like your physio and that you trust them, and if you don't, find one that you do like and trust. 'Cause that's when the most is acheieved :-)

    Alison

  6. #6
    Join Date
    Jul 2004
    Location
    Dallas, TX, USA
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    good advice, alison, thank you! i definitely want to work on my walk...it is not a pretty sight!
    Sue


    Milwaukee Brace from ages 8 - 16
    T36 degrees/L56 degrees Pre-Op
    Fused T3 - S1
    Surgery done Sept. 15, 2004
    Dr. Robert G. Viere
    North Texas Spine Care @ Baylor

  7. #7
    Join Date
    May 2004
    Location
    Houston, Texas now live in Colorado Springs, CO
    Posts
    544
    Hi Sue,

    I have my last PT tomorrow! I started going 3 times a week on Nov. 12th. I was 7 months post-op. I had water therapy two times a week and the third time I usually had an electrical treatment(I forgot what it was called), myofascial release and massage, then a heat pack. The pool was great! The water is so warm that all the pain and tightness just goes away. You do some mild stretching in the water. The second month I had the pool one day and the gym on the other day. I had a lot of muscle atrophy. We did alot of work to help my neck and shoulders loosen up. I'm doing some exercises with 2 pound dumb bells (laying down or sitting) to help strengthen the muscle under my right shoulder blade. I do pelvic tilt exercises for the abdominals. I also do stretches for the hamstrings and the other muscle in the thigh that is on the front of the leg. I have alot of arm exercises also. I take about an hour every night to stretch and exercise. (With the weights only every other day). The objectives for me was to help loosen up all the tightness, gain some muscle strength, more flexibility in the neck. Therapy helped alot!! It's hard work and some days you just have to make yourself do it. If I skip a day of stretching, I pay for it the next day. I would go to therapy after work and come home totally exhausted. Now I have to stick to it everyday. They said that I will need to do it pretty much the rest of my life. I'm hoping that I'll have a quicker recovery if I need to have another surgery to correct a balance issue that I still have. Going into surgery back in April my muscles were in sad shape due to not being able to do things. Hope this helps you out.
    Theresa

    April 8 & 12, 2004 - Anterior/Posterior surgery 15 hours & 7 hours
    Thorasic - 79 degree down to 22
    Lumbar - 44 degree down to 18
    Fused T2 to sacrum
    June 2, 2005 - Pedicle subtraction osteotomy @L3 7 hours
    MAY 21, 2007 - Pedicle subtraction osteotomy @ L2, extended the fusion to S2 and added pelvic instrumentation 9 hours

    FUSED T2 - SACRUM 2

  8. #8
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,935
    While talking to a scoliosis specialist yesterday, we started talking about the issue of physical therapy after surgery. This surgeon is one who has always discouraged his patients from working with physical therapists after they've had surgery. When I mentioned that I didn't think there was any research on the subject, he told me about a study. I found the abstract here:

    http://www.ncbi.nlm.nih.gov/entrez/q...472&query_hl=2

    It showed that a group of fusion patients who worked with PTs 3 times a week for 8 weeks had significantly more pain 2 years after surgery than did patients who did therapy using a controlled video. Unfortunately, it's a Swedish study, so I doubt that the video exists for the U.S. market.

    Regards,
    Linda

  9. #9
    Join Date
    May 2005
    Location
    Perth, Australia
    Posts
    64
    Hi Sue,
    I've been doing physical therapy for the last nine months, but I have 27 years of bad work to undo, rather than a surgery to recover from (previously undiagnosed kyphoscoliosis T9-T11).
    My back muscles were so unbalanced when I began that I literally could not stand by myself for anything more than maybe ten minutes. So you can imagine what my abdominals were like!
    I was referred to a brilliant physio who put me onto a Pilates program. Pilates is all about core strength, so its main aim is to strengthen your pelvic floor and everything following on from that. Abdominals and back muscles appear to eventually strengthen as a result of a stronger pelvic floor - at least that's what Pilates teaches, and it seems to be doing the job for me.
    Hope that helps!
    Martin Hughes

  10. #10
    Join Date
    Oct 2004
    Posts
    459
    Sue,
    I'm currently in PT twice a week for a very stiff lower back. I felt that my everday activities were not getting me back into shape as my surgeon said they would and asked to be sent to PT. He didn't want to send me, but after I explained some things that I was having diffculty doing, he agreed.

    I've been doing mostly ab strengthening exercises, but I'm sure each of us had a different program to work with our individual needs. My therapist has worked with me in the past, knows my history with Scoliosis and is very knowledgeable about Scoliosis itself which helps a lot!

    The office I go to specializes in sports-related and orthopedic issues. My surgeon has a PT office in the same building as his practice but sent me to this other PT office knowing their expertise and specialties....talk with doctor and together, you'll figure out what's right for you.

  11. #11
    Join Date
    Sep 2004
    Location
    Dallas, Texas
    Posts
    82

    Physical Therapy

    Physical therapy was prescribed for me three weeks after surgery. My Pt thought it was a little early, but we moved forward. My Therapy lasted two months then the insurance wouldnt pay for more. My surgeon's nurse insisted I
    continue all the therapy at home. He said my success at healing and being pain free hinged on staying active. I have continued at a good rate. My chiropractor does the myofacial release and some electric stimulation ( all the while he is killing me}. He mentions the scar tissue as being an area which needs continued work -also something about vectors. At six months (August 8) I think I am doing as well as can be expected for a 63 year old. I have had more days when I only have to take 3 hydraco's. My view of life has changed,
    I am thankful for each day expecially when I can work in my garden-which
    I do each night and some mornings (Texas weather is hell!) When other women
    complain about wrinkles with age, I just smile with content at feeling healthy
    once more. Kathleen

  12. #12
    Join Date
    Jul 2005
    Location
    usa
    Posts
    10

    its the best!!

    yur gonna luv pt!! its alot of fun!! it keeps u in shape as well as helps the curves and the muscles to equal out and become the same... i would reconmend Water pysical therapy cuz u work out really hard with out stressing yur boddy to much but as well as reg pt so like both lol ... and also pilotes or yoga is nice... pt gives u homework like u havta to do some specific xerseses b4 bed and when u wake up.. but i promice u will get it better shape thru pt..atleast im better shape since pt well hopefully pt is gonna b as mcuh fun 4 u as it is 4 me! ..oh and b4 u choose a pt instructer look around yur area some are really good but some have no clue wut there doing so look around and ask yur dr wich one he thinks is best.. but mainly jsut look round b4 u choose one ...
    hopefully somtin i said was helpfull...
    nessa

  13. #13
    Join Date
    Jun 2005
    Posts
    62
    Sue,
    I had my surgery in 1966. In the Old Days, no exercise or physical therapy was permitted for the first year after surgery, except for a few leg and ankle exercises to maintain muscle tone while remaining bedridden for the first three months. My recovery from the surgery was uneventful, and I did not focus on any sort of regular exercise or physical therapy for many years. About 5 years ago after having an early menopause, my gynecologist warned me that I was at risk for developing problems in the unfused vertebrae if I didn't increase my calcium intake and start an exercise program. Not having a clue as to which exercises would be appropriate for someone in my situation, I started working with a physical therapist having an office at our local gym. I showed him my xrays and told him that I wanted to increase stamina and lung capacity, maintain bone mass, improve muscle tone and improve my ability to balance on my left foot (which is difficult due to rotated ribcage). After several months of working with the therapist, I graduated to a personal trainer at our gym. The trainer had the benefit of the instructions developed by the physical therapist. As my strength and stamina increased, I realized that I will probably have to go to the gym forever. The gym has improved my focus and as difficult as the sessions can be, it is a great morale booster. My program includes a little bit of everything: stretching, abdominal and core exercises, free weights (no bench pressing), balancing on pressure pads or inverted half ball, cables and most machines. I prefer this sort of balanced program instead of yoga (can't do many of the positions because of the fusion) or even pilates, because it enables me to improve my body with very minimal risk. Then each time I am able to do a few more reps or increase the weight on a particular machine, I give myself a silent congratulations.
    Shelley

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