FITNESS Q&A: Returning to exercise after back surgery
Q. I am an active and fit 58-year-old woman who is about to undergo extensive back surgery for scoliosis. Once cleared by my doctor and physical therapist, I want to get back to my regular routine of lifting weights, walking and aerobic exercise. What is the best way to do this? - n.w., Livermore, CALIF.
A. The human spine is the axis around which we are able conduct our everyday activities. Because we stand on two legs and not four, our spines can take a real beating as we sit, stand, twist, turn, reach, lift and so forth. Structured exercise - and physical activity in general - is essential for cardiovascular and muscular strength and endurance, bone density, flexibility and weight control.
After back surgery, your body must be brought back into a place of strength, alignment and balance. Your work with a physical therapist will be crucial in this endeavor. After all, it is easy to see when an incision is healed - that takes a week or two. It is the healing we cannot see - muscles, tissues and bone - that must be treated with caution and respect.
You will probably be told to "maintain spine precautions" by your medical and recovery team. This means that bending, lifting and twisting in daily life - which is also prevalent in aerobics, yoga and strength training - could be put on hold for many months.
According to the University of California, San Francisco (UCSFHealth.org), your first six months will probably be the most restricted, with you performing only activities prescribed by your physicians and physical therapist. It is possible that after six to eight months, you will be able to enjoy swimming and walking.
In eight to 10 months, you could possibly be permitted to enjoy what is called "closed chain kinetic exercises," where your lower limbs move, but only when fixed in place, such as with bicycling.
After 10 months to a year, if all of your X-rays show complete healing, your medical team might green-light activity without restriction. In the meantime, patience and a healthy diet will be essential for your recovery.
Whether you are starting a new exercise program or getting back into one after recovery from surgery or illness, there are five things to keep in mind to avoid back pain as you move forward with physical activity. Denver, Colo. physical therapist Dr. Betsy Annesser recommends the following (posted on SpineUniverse.com):
Check your posture. Allowing your head (which weighs eight to 12 pounds) to hang forward strains the upper back and shoulders. Keep the shoulders pulled back and the head aligned over the spine.
Stop slouching. The pelvis should be lined up below the shoulders, even when sitting.
Stand tall. There should be a vertical line from the ears and through the shoulders, hips, knees and ankles.
Strengthen your core muscles. Abdominal crunches are great, but the muscles of the gluteus and back must be kept in balance as well. Learn to work out with a stability ball to increase core strength.
Start slow, and be consistent. Physical conditioning slips away gradually, and in spite of our microwave mindset (where we can get a baked potato in five minutes), it returns just as slowly. Develop a schedule, and increase resistance and intensity gradually.
By LINDA BUCH
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