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Post op rehab Spinal fusion

Nov 7th, 2018

Good morning all,

 

I am currently going through rehab post spinal fusion and right hip key hole.

 

I’m in desperate need to get back to good flexibility, fitness and mobility levels but feel I could do with some of your help.

 

I’m just wondering what you offer in house as I, understandably, have temporarily lost a lot of flexibility, mobility and strength in the obvious areas around my lower back going down into my legs. I went back to yoga last night and realised how apparent this is!

 

If someone could get back to me that would be great, my number is 07392082491.

 

Thank you

 

Bert

The Guru Responded:

Hi Bert

 

Sorry to catch you in a meeting.

 

My thoughts were along the lines of if you’ve had a fusion – which in essence is to prevent any movement across the joints, then I’m not sure stretching (to gain more movement), despite feeling stiff is the right way forwards.

 

You probably feel less flexible because you’ve had an op to limit motion and the muscles in the surrounding area stiffen up to protect joints (back and hip). Getting rid of the protection with having adequate stability or strength is possibly not the best way forwards.

 

Be aware of what feels less flexible – do the joints or do the muscles that surround the joints? You need to know which as it’ll give you the answer to the next step.

 

We “split” our treatment between hands on manual therapist to get your stiff joints moving better and rehab physios to control the bits which are painful and move too much.

 

Don’t be tempted to go for the easy, visible but short term results – go for longer more resilient and favourable results.

 

The Guru

 

Bert replies…

Thanks for the email.

 

The main areas of concern for me are targeted around the sight of the fusion at lower back L5/S1 (achy, sometimes sharp pains and limited movement) and right knee pain with extremely tight hamstrings, calves, glute med, hips flexors & adductors all on the right side which is the side I had the hip surgery.

 

I have just started a “couch to 5k” programme which is getting me back on a treadmill and putting some load onto the hip very gradually but my hamstrings and calves keep cramping up and I think this is due to my hamstrings just not really “firing” up or doing anything thus are extremely weak compared to previous years.

 

It’s a bit of a mind field but I am progressing slowly was just curious as to what you guys offer as I work next to your Moorgate clinic.

 

Kind Regards,

 

Bert

 

Hi Bert

 

C25K is great – follow it to a tee and it’s pretty optimal loading for your back and hip…as long as it’s not soon post op (I’m not sure of the dates).

 

You’ve got a bunch of symptoms, which need respect but not chasing – whether it’s hammie or calf, the cause – lack of stability, strength, control etc is key. This is where you need to target.

 

More often than not,  when there’s a stutter post op it’s because you don’t have the ability to move well enough through your thoracic spine to take the excessive pressure/overload off of your lumbar spine fusion – the fusion itself doesn’t get rid of the cause of the problem.

 

I agree with your comments that it’s a mind field and sometimes we forget that as Physios we have seen this lots and lots, but as a patient – with pretty much zero experience and exposure, it’s the fear of the unknown.

 

We’ve got the curse of knowledge and we need to allow you to get up to speed so you can be the master of your own destiny.

 

Let me hook you up with Jules who runs the Moorgate clinic and arrange a time when you can drop in – have a look and ask a few Q’s.

 

Good luck – you’ll do great with the right input.

 

The Guru

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