How to improve flexibility after the recovery of scoliosis surgery?

[richardis]

On my last follow-up appointment with my surgeon he said swimming helps with flexibility.

He told me this because I asked him what are the benefits of swimming and why he recommends it. I asked him:
-Is it because of cardio benefits, muscle building or what?

He said:
-Mainly for cardio, well, somewhat. For muscle building not so much.
And he added:
- to improve flexibility and to reduce stiffness

Then I asked him:
-Can I go to the pool everyday and do 5x100m for cardio?
He said:
- You don't need it.

So to sum things up, for an intense cardio work-out, swimming may not be the best exercise ( that was what I understood). Walking and indoor static bicycle may be better choices.
I was surprised.

But I want to return to the topic of this thread: flexibility and how to improve it.
What are your suggestions?

I used to trim all my body hair with clippers, now I am still afraid to do it.
Do girls over here have difficulty doing legs depilation or intimate care after a thoracic fusion?

What tasks that required flexibility seemed to be easier to do before the fusion and now seem to be more difficult?

[Pooka1]

Well, first I would not be asking a orthopedic surgeon about personal training even with a T3-T10 fusion.

How do you know if you lost any flexibility after fusion? Maybe you have not.

[leahdragonfly]

I hear you saying you are afraid to try various motions, but that your surgeon had given you the ok to move more. Really the best way to improve flexibility after fusion is to start doing more motions, pushing against your fusion a bit, see what you can do. If you are solidly fused, which you should be by now, you can bend against the fusion and feel what your actual physical limitations are, rather than mental limitations. I mean this in the kindest way possible, because I truly understand how it feels to be scared to hurt your fusion. The only way the regain flexibility is to start moving your body more. Try doing some of the personal care tasks you mention, slowly and gently. If you do, in time you will realize you have regained flexibility. I felt improvements in flexibility even after the 2 yr mark.

Good luck, give it a try slowly and let us know how it goes.

[Pooka1]

Gayle's answer demonstrates why patients should mainly be answering these questions and not parents like myself. I think she gave you the advise you were looking for.

That said, unless you have something unusual, it is my understanding that once fused, you are back in the general population pool for doing things. The only restriction my daughters have is bungee jumping which the surgeon said nobody should be doing. And they have a longer fusion than you do. They were released to do anything else at 8 months. This is also why I suggested an experienced personal trainer over an orthopedic surgeon for physical fitness. You are either back in the general population or you are not. Your surgeon can tell you.

One of my daughters works out with a personal trainer twice a week. She is fused T4-L1. I have ZERO qualms about this.

[LindaRacine]

If you don't use it, you'll definitely lose it. I can attest to that from experience.

We've been telling you for months that you've probably lost very little flexibility. Do not restrict your activities.

--Linda

[green m&m]

My flexibility just came back to pre surgery level around post-op month 18. I wasn't working out hard trying to gain it back and in fact had started slowly loosing strength due to an unrelated issue causing cord compression at C2 (Since resolved). It came with just doing everyday normal stuff while pushing past the mental block that told me "STOP" constantly.

Obviously, I have no movement on the levels fused (so no slouching, etc) but everything else feels my normal.

I was doing self care at near-normal level, a bit with more pain and stiffness and in a different way less than month post-op. But I hate depending on anyone and was alone during the day so had no choice.

Just start doing your normal. It is hard to get past the mental block but try what you were doing pre-op go easy and stop if it causes pain, that's it. Everyone is different and what works for one may not work for another.

[Irina]

For me, zumba is the best cardio workout that also greatly improved my flexibility. Plus, it's great stress reliever and fun! I started doing it at two years mark. I have never done it before the surgery because of pain, but always wanted too. My first zumba class was exhilarating! I remember smiling for the whole hour because I couldn't believe I was able to do it without pain.

Is it something you might like? You can do as much as you are comfortable, just keep moving.

[Pooka1]

Richardis, I am hearing that your surgeon removed your restrictions for swimming. If your fusion will not be affected by swimming then I wonder if that is his way of telling you that you have no more restrictions on physical activity. Maybe your surgeon actually told you that you have no more restrictions? I am just saying that my daughters' surgeon told them point blank to their face at 8 months that they have no physical restrictions (besides bungee jumping) and are back in the general population on this.

[richardis]

will a topical anti-inflamattory cream, like voltaren, help with to ease the pain on the area? Is it safe to apply after 8 months since surgery?

It used to help me feel more mobile (before surgery)

[Pooka1]

With your fusion, I would be shocked if your surgeon restricted you from doing anything physical (besides bungee jumping) or using any topical remedy. Ask your surgeon if you are back in the general population on all these things (just like my daughters who have a longer fusion).

[richardis]

hi,
sorry if I don't answer what you ask, but I have been busy lately so I am afraid I may be skipping some of your questions.

I have been thinking about the content of this thread.
Maybe my surgeon suggest swimming to combat this also https://www.laserspineinstitute.com/...sue_formation/ . The link talks about deep scar tissue reduction.

So, in high-school we used to touch out feet without bending the knees in the PE classes. Now, it seems more difficult to do it. My surgeon told me that I could and I would be able to bend my spine till I touch my the feet. I am afraid that the muscles of my legs are still under-stretched because if I bend with the hips (using that axis of rotation) I feel them tight. Plus, the angle of that rotation has nothing to do with spine mobility. This link may come in handy also http://sequencewiz.org/2015/03/18/ho...ressing-spine/

Before surgery, I used to overstretch the area of the fusion to relieve pain. I am slowly start to loose the fear of stretching those muscles. I feel relief now if I breath in at max and stretch those thorax muscles.

BTW, has anyone had issues with deep scar tissue formation? I don't mean skin scar tissue.

[Pooka1]

Check this out...

A Silver Medal Winner at the 13th World Wu Shu Championship 2015 17 months after Selective Thoracic Fusion for AIS: A Case Report.
Chan, Chris Yin Wei; Aziz, Izzuddin; Chai, Fong Wei; More
Spine., Post Acceptance: July 1, 2016

Study Design. Case Report.

Objective. To report the successful rehabilitation and the training progress of an elite high performance martial art exponent after selective thoracic fusion for AIS.

Summary of Background Data. Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS) will result in loss of spinal flexibility. The process of rehabilitation following posterior spinal fusion for AIS remains controversial and there are few reports of return to elite sports performance following posterior spinal fusion for AIS.

Methods. We report a case of a 25-year-old lady who was a national Wu Shu exponent. She was a Taolu (Exhibition) exponent. She underwent Selective Thoracic Fusion (T4 to T12) using alternate level pedicle screw placement augmented with autogenous local bone graft in June 2014. She commenced her training at 3-month post surgery and the intensity of her training was increased after 6 months post surgery. We followed her up to 2 years post surgery and showed no instrumentation failure or lost of correction.

Results. Following selective thoracic fusion, her training process consisted of mainly speed training, core strengthening, limb strengthening and flexibility exercises. At 17 months of post operation, she participated in 13th World Wu Shu Championship 2015 and won the silver medal.

Conclusion. Return to elite high performance martial arts sports was possible following selective thoracic fusion for AIS. The accelerated and intensive training regime did not lead to any instrumentation failure and complications.

Level of Evidence: 2

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