Have you recently had a lumbar fusion? Maybe you have been told you need one and want to try to avoid it? Or maybe you have been told to get stronger before your operation?

At Complete Pilates we see hundreds of people who are also in the same position. We work with people before and after lumbar fusion surgery to help reduce pain, strengthen their muscles, improve movement and help them get back to doing what they want.

In this article, we outline how Pilates can help pre and post-lumbar fusion surgery and answer all of your burning questions.

Pilates and Lumbar Fusion

Can you do Pilates with Spinal fusion?

You can do Pilates with a spinal fusion. However, it is important to remember that you may have a permanent limitation of movement in the affected section of your spine. Therefore it is important to have a realistic expectation of what flexibility you can achieve. You will need to avoid or modify some exercises to accommodate this.

It is important that you discuss your Pilates programme with your consultant or your physiotherapist. If you are working with a Pilates instructor who is not also a physiotherapist, put them in touch with your physiotherapist who can advise them appropriately.

Can Pilates after back surgery aid recovery?

Pilates is a great way to work on recovering following all types of back surgery. However, during the post-operative recovery period it is important to work with a physiotherapist to ensure you are doing exercises that are appropriate for you as not all of the Pilates repertoire is suitable.

The benefit of doing Pilates for your recovery is that there are many different levels of exercise – so it is quite suitable for taking you through from early on in your recovery right through to returning to your day-to-day activities and even sport and exercise.

If you are working with a Pilates instructor it is a good idea to put them in contact with your physiotherapist and they can work together to provide the best care for you.

Pilates exercises for spinal fusion

Dead Bugs

Femur Arcs

Bridging

Advice from a spinal consultant

Meet Mr Alexander Montgomery. Below, he is answering all the questions we hear on a daily basis in the studio and online! Remember, if you want to know more just ask us.

What is a lumbar fusion?

“In the spine, each vertebra is separated by discs and cartilage (see the spine handout) which normally move against each other. This is the reason we have spine mobility.

A spine fusion is an operation which takes away the mobility between two of these vertebrae by removing the discs and cartilage, inserting metalwork (normally screws, rods and cages), and encouraging the two vertebrae to become one by growing bone between them.”

Why would I need a lumbar fusion?

“You would only be suitable for a fusion if you have not responded to any other form of treatment. This includes Physiotherapy, appropriate one to one Pilates, pain management, and injections.

It is only completed if it is thought that the source of your pain arises from the movement between the two vertebrae.”

Can I move after a lumbar fusion?

“In short, yes. Although two of the vertebrae are fused together, it is important that the rest of your spine moves well.

When you can get up and walk depends on exactly what has happened during the operation. Your Consultant will discuss with you their post-operative guidelines, the exact operation that you have had, and how many levels have been fused. You may get the opportunity to get out of bed the same day, but otherwise the aim is to get up and walking the following day.

Over the two weeks following your surgery, you will be expected to gradually increase your mobility. At this point you will be expected to go to clinic to have your post-operative follow up appointment.”

What is the recovery time after a lumbar fusion?

“This obviously depends on the nature of the fusion and how many levels were fused together. The best thing to do is to ask your Consultant directly.

In general, for a one level operation you will be encouraged to walk as soon as possible. The inpatient hospital Physiotherapists will then give you basic stretches and exercises to complete for the first few weeks.

The wound takes approximately two weeks to heal and shortly after this you will be asked to start Physiotherapy. Patients are often capable of going to one to one Pilates classes with an appropriately trained instructor at 3-4 weeks. Ideally, by week four you are on an exercise bike in the gym, and your rehabilitation will progress from there.”

When can I go back to work after a lumbar fusion?

“When you go back to work depends on the nature of the surgery, your job, and your commute, but is typically around 5-6 weeks. However, you must check with your Consultant whether the fusion is a one stage, or two stage procedure.”

Can I exercise after a lumbar fusion

“Yes. You will be encouraged to walk as soon as possible and do the exercises that the Physiotherapists in hospital give you. However, this does not mean that you can go home and start HIIT classes or start going to the gym.

When and how you progress your movement depends on the nature of the surgery, how many levels are done, and your general fitness levels. Physiotherapy, or appropriate one to one Pilates is encouraged by week 3. The aim is to slowly increase your activity from then onwards, which will be directed by your Physiotherapist.”

Will I have a big scar after a spine fusion?

“Most of the time big scars can be avoided as minimally invasive techniques are used to reduce the amount of muscle cutting. Most people are suitable for minimally invasive surgery, but it does depend on how many levels need to be operated on.

For lumbar spine fusions, there is often a small scar at the front of your stomach below the belly button, with one or two small scars in the lower back. However, sometimes there is only one scar which is in the lower back.

For neck fusions there is normally a small scar at the front of the neck which can sometimes be hidden in the natural creases. Occasionally there is a scar in the back of your neck as well.”

How long am I in hospital for after a lumbar fusion?

“As ever it depends on the technique being used, nature of your fusion, and the number of levels done.

Often surgery in the lower back is done in two stages. Often the first stage is through the front of your abdomen, and the second through your lower back. These operations are normally done one or two weeks apart.

Each operation will keep you in hospital on average a couple of nights. However, some patients do go home after one night after the first procedure. If you are only having a one stage operation you are often in hospital 2-3 nights.

Make sure to check with your Consultant which type of operation you are having.”

Can spinal fusion cause problems later in life?

“Spinal fusion surgery reduces movement in the section of the spine that has been operated on. Research has shown that some patients may later develop pain associated with excessive motion in the sections of the spine above and below the site of the fusion. However, it may be possible to reduce the impact of this by maintaining mobility throughout the whole spine and in the hips.

In this way, movement forces are distributed throughout many different joints and the overall impact on one area is lessened. Working with a physiotherapist or Pilates instructor to improve mobility throughout your body is a great way to proactively address this problem. ”

What causes spinal fusion?

“Spinal fusion can refer to a number of different conditions of the spine.

Spinal fusion can be a result of a congenital condition where one or two spinal segments don’t fully differentiate from each other and remain blended together.

Spinal fusion could result from an acquired health condition, such as ankylosing spondylitis, where the spinal segments fuse together as a result of inflammatory processes within the body.

Spinal fusion can also refer to the surgery to join two vertebrae together in order to improve stability and or reduce pain.”

Conclusion

Pilates can be a great way to work on your strength and mobility prior to lumbar fusion surgery and can also help you recover from your surgery. However, we would recommend that you are always working under the guidance of a medical trained professional if you are recovering from surgery.

Here at Complete Pilates we have instructors who are qualified physiotherapists and clinical Pilates instructors who work closely under the guidance of our physiotherapists so you can ensure you are always in the best care.

Do you need expert advice about lumbar fusion recovery? Please don’t hesitate to get in touch with us and ask to speak to one of our qualified physiotherapists You can work with one of our Pilates instructors at a 1-2-1 Pilates class in West London. You can also visit us at our Pilates studio in Angel or our Pilates studio near Aldgate.

Education is key:

These blogs are designed to give information to everyone, however, it is important to remember that everyone is different! If you have not seen one of our therapists and have any questions about injuries, what you have read or whether this may be useful to you, please just ask. We are more than happy to help anyone and point you in the right direction. Our biggest belief is that education is key. The more you understand about your injury, illness and movement, the more you are likely to improve.

If you are not sure whether this is for you, simply get in touch. We are here to help!
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