11 Essential Physical Therapy Exercises After Spinal Fusion

Many people fear that they cannot exercise in any capacity after a spinal fusion. In most cases this is a myth. It is actually very beneficial to exercise after a spinal fusion as long as you are performing the correct exercises and not overexeerting yourself.

These are the best 11 exercises after spinal fusion to improve strength and decrease back pain. The best exercises after spinal fusion include gentle back stretches, core strengthening and hip strengthening exercises.

Recovery Timeline

The recovery timeline for after a spinal fusion is divided into 5 stages. These stages may vary on you and your specific surgery or surgeon, however this is a general overview. It is important to listen to your surgeon and follow the phases of recovery in order to achieve full recovery.

• Phase 1 (1-6 weeks)
  • You should avoid strenuous exercise during phase 1 of recovery.
  • You may have lower back pain after surgery and this phase is focused on pain relief while improving mobility.
  • You should avoid bending and twisting movements in the first 6 weeks and avoid lifting anything more than 10 pounds.
  • Exercises in the first 6 weeks will include stretches and static stability exercices which do not require the spine to move from neutral.
• Phase 2 (6-12 weeks)
  • You can now progress your abdominal exercises and perform in quadruped position on your hands and knees.
  • You can also begin to implement some resistance band posture exercises including rows, and shoulder extensions.
  • At this point you are most likely back to work as long as you do not have an overly active job that requires heavy lifting, bending or twisting activtities.
• Phase 3 ( 3 months-6 months)
  • You can progress strengthening exercises and progress intensity of aerobic exercise such as walking and stationary biking.
• Phase 4 (6 months- 1 year)
  • Return to most activities as per surgeon clearance.
  • This may include running and returning to the gym.
  • The fusion is not fully healed until after 1 year so it is important to follow your surgeons precautions.
• Phase 5 (+ 1 year)
  • At this point the fusion should be healed and you can return to pre surgery activities with exceptions according to your surgeon.
  • These exceptions may include power lifting and heavy manual labor jobs that require repetitive twisting and bending or heavy lifting.

Physical Therapy Program

The best exercise program will include low-impact exercises that do not place excessive stress on the spine. This is espcially important after spinal fusion surgery. The best exercises after

1. Pelvic Tilts (Posterior Pelvic Tilt)

• Start by lying on your back with both knees bent and your feet flat on the floor.
• Now slowly tip your pelvis backwards.
• Another way of thinking about this is to draw your belly button inward towards your spine as you contract yoru ab muscles and flatten your back onto the surface below you.
• Hold this position for 3 seconds and then draw your pelvis forwards into the starting position.

2. Wall Squats

• All you will need for this exercise is a wall and your body weight.
• Start by leaning against a wall with your feet 1 foot from the wall.
• Now slowly bend your knees and allow your body to slide downwards.
• Pause at the bottom and then slowly push back up to starting position.
• Be sure to keep your back upright and against the wall the entire exercise.
• You can also perform this exercise with a physioball between your back and the wall.

3. Straight Leg Raises (SLR)

• Start by lying on your back with one leg bent and one leg straight.
• For example, if you want to strengthen the right leg you will keep your right leg straight and your left leg bent.
• Now tighten your abdominal muscles and quadriceps muscle and lift your leg up until it is about the level of your other leg and then slowly lower it back down to starting position.

4. Hamstring Stretches

• Start by lying on your back with one leg bent and one leg straight.
• If you have enough flexibility you can lift the straight leg up towards the ceiling and grab the back of your thigh with your hands.
• Use your hands to draw your leg up as high as you can while keeping your leg mostly straight.
• Hold this position for 20-30 seconds.
• If you want a stronger stretch you can draw your toes towards you.
• If it is too difficult or strenuous to hold your leg then you can use a strap, or towel to lift your leg up.

5. Heel Slides

• Start by lying on your back with both legs bent.
• Now slowly bend your knee by sliding your foot towards your butt.
• Bend it as far as you can and then slowly return to the starting position with your leg straight.

6. Ankle Pumps

• Although this exercise may seem easy it is crucial in improving blood flow and decrease risk of blood clot or DVT after surgery.
• Pump your ankle up and down by pushing your toes down as if you are pushing on a gas pedal and then bring your toes up towards you.

7. Stationary Bike

• Stationary biking is a great way to improve cardiovascular fitness without placing excessive stress on the spine.
• Start with a high seat height and little to no resistance.
• If you have any increase in pain then stop this exercise.

8. Bridge

• The starting position for this exercise is to lie on your back with both knees bent.
• Now tighten or activate your glute and abdominal muscles and lift your butt off the mat.
• Be sure to lift yourself off the ground with your glute muscles and avoid arching or pulling with your back.
• If you feel back pain do not lift up quite as high.

Core Strengthening Exercises After Back Surgery

A strong core is crucial in ensuring a faster recovery, especially after lumbar spine surgery. These simple exercises for the abdominal muscles should be performed with the spine in a neutral position or a straight line. These core strengthening exercises after back surgery include 9. Abdominal Isometric 10. Supine March 11. Bird Dog.

9. Abdominal Isometric

• Start lying on your back with bent legs.
• There are 3 versions of this exercise varying in difficulty levels.
• First try the easiest version which is to place your palms on your thighs and push into your thighs while activating your core muscles.
• Hold this position for 3 seconds and then relax.

• The second and harder version of this exercise is to raise one foot off the ground and push your thigh into your hand.
• Hold this position for 5 seconds and then slowly lower your foot back to the ground..
• Make sure that you are breathing and not holding your breathe.

• The third and hardest version of this exercise is to raise both feet off the ground in table top position.
• Now push into both of your thighs with your hands.
• The key with this exercise is that if you begin to feel back pain it means that your core muscles are fatiguing and your body is cheating by using your back muscles.
• If this is the case then bring both legs down and focus on achieving an abdominal contraction prior to lifting both legs up to try again.
• If you continue to have pain then perform either version 1 or 2 of this exercise.

10. Supine March

• Start by lying on your back with both knees bent.
• Now squeeze or contract your abdominal muscles and march one leg off the ground and then place it back on the ground and march up your opposite leg.

• If this is too easy you can perform the harder version of this exercise by starting in table top position with both knees bent and your legs in the air.
• Now tap one leg on the ground while keeping the other leg suspended in the air.
• You should not actually be placing any weight on the foot that you are tapping on the ground.

11. Bird Dog

• This is a more advanced core exercise that should not be performed in the acute stage of recovery.
• Start on your hands and knees in a quaruped position.
• Now keep your abdominal muscles tight and your pelvis level and reach forward with one arm while extending or kicking your opposite leg back.
• Your leg should be level with your body, not above your body.

When To Start Physical Therapy After Spinal Fusion

Physical therapy can start almost immeditely after a spinal fusion. Often times physical therapists will see patients just a few hours after surgery to teach them how to get in and out of bed via log rolling and start walking.

Outpatient physical therapy will typically begin around 4 weeks after surgery.

Exercises To Avoid After Back Surgery

After spinal fusion surgery, you should not perform any movements that require twisting or bending of the spine. You should also avoid strenuous activities such as running, jumping and heavy lifting. These precautions are typically 6-8 weeks, however may vary depending on your type of spinal surgery or spinal surgeon.

Medical Disclaimer

As always it is important to consult with your healthcare provider prior to starting a new exercise routine if you have preexisting medical conditions, especially after surgery.

Your surgeon will be able to give you general guidelines on any precautions you may have after surgery. Your surgeon is the best medical professional to provide medical advice immediately after surgery as they are the ones who performed the surgery.

Summary

These specific exercises after spinal fusion will speed up your healing process and get you back to your previous level of physical activity as soon as possible. Lumbar fusion surgery is a long recovery, however with the correct low impact exercises you can return to the activities that you love.

This article includes easy core exercises designed to not place excessive stress on the spine. If you are in the later phases of recovery and looking for more advanced core exercises you can find them at 10 Best Physical Therapy Core Exercises For Beginners.