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Thread: Physical Therapy Post Op

  1. #1
    Join Date
    Feb 2014
    Posts
    99

    Physical Therapy Post Op

    Hi all-

    Question for those who had physical therapy after surgery. Did you find it useful? Could you give examples of some of the exercises you did, the more specific the better?

    I was thinking of looking into PT, but it won't be easy for me to schedule-wise, so I wanted to see if people found it worth it. I might just continue on my own at the gym, still debating.

    (I've done PT before for my back and found it helpful to a point...the massage work is always nice!)

    Many thanks!
    Olivia
    Surgery Jan 6, 2014 at 38 yrs
    Posterior Fusion T10-L4, osteotomy 1 lev.
    Pre op-Thoracolumbar Curve-50 degrees

  2. #2
    Join Date
    Sep 2012
    Location
    Peabody, ma
    Posts
    81
    I had physical therapy at home and then I went out for physical therapy after my surgery. Fused from t9 to s1. I do bracing, squeeze a ball between my knees, different leg lifts with ankle weights. I also do what is called 4's and 8's, and deep knee bends, which sometimes bother my knees. I also do some exercises with resistant bands. Yes, they help.

    I started doing them on my bed, but now a year after my surgery, I am able to get on an exercise mat on the floor.

    I firmly believe that they help. I feel much better after I do them, even though I hate exercising.

  3. #3
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,569
    Hi Olivia, I started going to PT immediately after the rehab hospital. Early PT was very gentle movements. PT focuses on areas of weakness. For me, it is strength in my R leg and quad strength mostly. Exercises are holding on to my kitchen sink and bending my knees and squatting about half way down and then straightening up. I repeat that about 30 times. I also inch my R foot up my L leg.

    Walking is excellent exercise. Buy a pedometer which is motivational.

    I started having cervical problems so bring my chin to my chest while keeping my neck sort of toward the back. I also do isometric neck exercises.

    I do warm water exercises that involve no twisting or bending.

    The good thing about having a PT that KNOWS about exercises for people with a spinal fusion is that the PT can show you how to do the exercises correctly to preserve your fusion.

    Good luck, Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal Spinal Cord Injury T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw

  4. #4
    Join Date
    Jun 2011
    Location
    Southern CA
    Posts
    2,245
    Your surgeon will not allow you to just go to the gym. You need PT designed for your surgery.
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  5. #5
    Join Date
    Apr 2012
    Location
    San Jose, CA
    Posts
    570
    Quote Originally Posted by mabeckoff View Post
    Your surgeon will not allow you to just go to the gym. You need PT designed for your surgery.
    Melissa, so good to see you!
    I am stronger than scoliosis, and won't let it rule my life!
    45 years old - diagnosed at age 7
    A/P surgery on March 5/7, 2013 - UCSF

  6. #6
    Join Date
    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
    Posts
    3,263
    My surgeon was adamant I should not have PT after surgery. I suspect the reason was that he didn't trust any PT in my area.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  7. #7
    Join Date
    Oct 2007
    Location
    Indiana
    Posts
    1,978
    Hi Olivia! I will just reiterate what others have said... After my initial PT right after surgery with some very basic and simple exercises (like raising up on toes and returning, some flexible band stretching for my arms, etc.) I was not allowed by my surgeon to have any more PT for awhile. Just walking-- and walking and walking. At 6 months I had PT to strengthen my arms and legs and at 11 months I had PT to strengthen my core. My surgeon was reluctant but sent information about what I was NOT to do. The PT helped me a lot as I had grown weak as a kitten from the surgery and from wearing a brace for 5 months. You really do need approval from your surgeon and a PT who knows what he/she is doing with someone who is recovering from fusion surgery. Best wishes!
    67 and plugging along...
    2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15°
    CMT (type 2) DX in 2014, progressing
    NEW 10/2018 x-rays show spondylolisthesis at L4/L5 - Dr. DeWald is monitoring

    Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

  8. #8
    Join Date
    Feb 2014
    Posts
    99
    Thank you so much everyone for your responses. I'm awaiting a call back from my surgeon's assistant so I can get a PT script and hopefully get some relief. I too was wary of going to a PT who wasn't familiar enough with scoliosis, but I think I found a place.

    My doctor left it up for me to decide whether I wanted it or not. Sounds like every surgeon is different and every case is different. He told me to see how I feel after 6 weeks. I'll be 9 weeks this Monday and I still just have a lot of pain trying to sit.

    Trying to give it time and be patient, though. I'm walking a lot and I've noticed I'm gradually walking faster and easier. I think the progress is so small you don't always see it, but I keep a journal to record something positive each week.

    I also found some great exercise videos that a forum member Doreen posted to her blog (Doreen if you're out there-thanks!!

    Thanks again everyone
    Olivia
    Surgery Jan 6, 2014 at 38 yrs
    Posterior Fusion T10-L4, osteotomy 1 lev.
    Pre op-Thoracolumbar Curve-50 degrees

  9. #9
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,163
    Hi Olivia,

    I hope you have luck finding an experienced PT who is really familiar with fusion, and mindful of your activity restrictions. You mention hoping you can find some relief--is there something in particular you are looking for relief for? Or is it general aches and pains? I definitely had significant "aches and pains" still until at least the 6 month point, when they started to get significantly better.

    I had trouble finding suitable PT after my surgery. My surgery was done in Portland, OR, but I live 2 hours away in a town of 50,000. I tried one PT office at around 9-10 weeks post-op and was quite shocked that the PT really did not seem to understand or respect my activity restrictions, nor the nature of the long fusion. He wanted to assign me exercises that clearly violated my "no bending" restrictions (such as exercising on hands and knees with lifting arms and legs alternately) and then argued with me that they didn't really violate my restrictions. It was upsetting, and I told the PT I was not going to do the exercises until I cleared them with my surgeon. When I showed the exercise sheet to my surgeon he was pretty upset and said he did not want me doing any type of exercise like that so early on. He advised me to not have PT since there wasn't a good skilled option in my area.

    The PT department where I had my surgery was just great, and I wish I could have worked with them, but I live too far away. In the end I just walked, and did gentle swimming. It worked out for me. Everyone has a different experience, depending on their surgery and the availability of skilled PT.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

  10. #10
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,931
    Quote Originally Posted by leahdragonfly View Post
    He wanted to assign me exercises that clearly violated my "no bending" restrictions (such as exercising on hands and knees with lifting arms and legs alternately) and then argued with me that they didn't really violate my restrictions. It was upsetting, and I told the PT I was not going to do the exercises until I cleared them with my surgeon. When I showed the exercise sheet to my surgeon he was pretty upset and said he did not want me doing any type of exercise like that so early on. He advised me to not have PT since there wasn't a good skilled option in my area.
    Ack! That's so upsetting. There is an incredible range of knowledge among physical therapists. Before my first scoliosis surgeries, I tried several rounds of physical therapy. Nothing helped, and in fact, I think some might have actually been detrimental. When I finally found a good physical therapist, I was really shocked at how different she was from the other therapists with whom I had worked. My only advice to anyone who has been left to find a physical therapist on their own is to see if you can find someone specialized in spine and/or find some with a PhD in physical therapy.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  11. #11
    Join Date
    Feb 2014
    Posts
    99
    Gayle, your experience with PT after surgery sounds like it was terrible. Thank goodness you didn't stay with them. I too wish I could do PT in Philadelphia under the direct guidance of my surgeon, but it's too far. We'll see what his assistant says. As I mentioned, I think I may have found a place where I live that has experienced therapists.

    As far as what I'm looking for--sitting is just so unbearable for me. My pain is decreasing despite that, but I'm just really nervous that when I have to go in to work I'll be in agony. But maybe by the end of this month things will be better for me.

    I will say I went to sit in the hot tub and "walked" in the pool at my gym for the first time and it was glorious! Man, I wish I had a hot tub.
    Surgery Jan 6, 2014 at 38 yrs
    Posterior Fusion T10-L4, osteotomy 1 lev.
    Pre op-Thoracolumbar Curve-50 degrees

  12. #12
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,163
    Hi,

    Many of us have had issues with sitting for awhile after surgery, especially those fused to sacrum and with pelvic fixation. Sitting was not a position of comfort for me at all for a long time (at least 6 months post-op I'd say). When I returned to work at 14 weeks I could not sit for more than 30-60 minutes max, and even then it was not comfortable. I got up a lot, and went for short walks every hour if possible. It does improve over time, and I am sure over the next few months things will get easier for you, also. Remember to not over do it…you will pay later!

    I am sure the pool felt wonderful. I am a swimmer and I recall my daily visit to the pool and hot tub was the best part of the day.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

  13. #13
    Join Date
    Feb 2014
    Posts
    99
    Thanks, Gayle. It's good to keep things in perspective and comforting to know that others had similar experiences. Sitting for long periods of time was always hard for me pre-surgery. The hard part is that when I finally do go into work I will have an hour and 20 minute train ride (almost 2 hours door to door) but I'll just have to work standing up for part of the day and be thankful I work from home most days.

    Thanks again for your messages.
    Surgery Jan 6, 2014 at 38 yrs
    Posterior Fusion T10-L4, osteotomy 1 lev.
    Pre op-Thoracolumbar Curve-50 degrees

  14. #14
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,899
    Sitting is hard, but it does get better in time.....I used a laptop at the kitchen counter quite a bit in the early days....

    Soft tissues take a long time to heal and can be agitated or inflamed pretty far out from the surgery date. I had a major pain episode at 22 months from pulling down to tie shoe laces. That was extremely painful for 14 days, then suddenly quit on its own. Thankfully I have not had a major pain event since that time in my fusion area.

    I didn’t have a PT program for my spine other than walking and doing heel lifts (for DVT) standing in the kitchen. With the medications I was on, I know I wasn’t about to drive a car, let alone go someplace and do too much. It was basically about moving often.....I also knew I had to wean off my meds and had to put an effort into that which wasn’t an easy thing....Man-o-man! I quit cold turkey at 6 wks since I wanted my mind back, and it took 2 attempts. I also needed to drive.

    I took 5 one hour hot soaks in 106 degree (scalding) water for pain each day for 3 months. I had a fancy hot tub with all the bells and whistles but was afraid of falling getting in or out of it, so I used the master bedroom tub which is a large tub with a sloped back. If you do this, drink plenty of water as you lose quite a bit soaking in hot water and dehydration is a total disaster. It will send you back to the hospital. Drinking or sipping water all day long is so important. I have had 2 co-workers end up in the hospital because of dehydration, and they were not doing a surgical recovery!

    I broke my shoulder 10 days before my scoli surgeries and had that surgery done 8 months after my scoli surgeries. My shoulder surgeon wanted me in PT for the shoulder right away, and did that for 6 months. At that stage, I have to say that the physical therapy was extremely helpful and was doing 20 pull ups after 1 year. The arm bike was great for the paraspinal’s in the thoracic. I really wanted to know if I was fused since non-unions are one of our worries. I didn’t lift more than a dinner plate for 6 months because of this. Since I knew that it takes a long time (12 months) for bone to fuse, I wanted to take it easy in my recovery since I had one shot at it.

    You can see that I took it slow.....and knew that my recovery was going to take 2 years and that’s what it took. I knew this since a friend had a major (fake) aorta procedure from the front and it took him 2 years to recover.....90% in the 1st year, the final 10% took another year. (Battling fatigue).

    I don’t think there was anything I could have done to speed up my recovery.....it happened at its own pace....I also had 4 surgeries in 2 years so that slowed things down a little....

    You will see me ending many of my posts with “Hang in there” and “Take it easy”. Now you know why....

    Take it easy

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  15. #15
    Join Date
    Feb 2014
    Posts
    99
    Thanks for your post, Ed. I thought I had replied but I don't see it here. I'm amazed you were able to quit your meds so early given the pain you had. I basically decreased mine until I no longer had stomach problems. The dose is so low I'm not sure it does much but I'm not quite ready to give up completely.

    I bought one of those foam cushions for sitting which helps a bit. I'm taking your advice and going a little easier on myself.

    Thanks,
    Olivia

    Ps so envious of yr hot tub!!
    Surgery Jan 6, 2014 at 38 yrs
    Posterior Fusion T10-L4, osteotomy 1 lev.
    Pre op-Thoracolumbar Curve-50 degrees

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