Our OHL Physiotherapy team works with several elite Melbourne-based spinal surgeons and, although it is fairly uncommon, we do see patients needing a surgery pathway for their back pain (+/- leg pain) situation. When these patients present to us (as encouraged by the spinal surgeon prior to their surgical date) we hear many common questions, including what can I do prior? How can I get the best outcomes for myself? Do I still need to do any specific exercises before my procedure, and how quickly can I move afterwards? When do I see the surgeon and the physio after my surgery? When can I go back to work? Each of these questions (and more) are important to answer individually, because we believe the more information we can share will help each patient to better understand their upcoming journey and, yes, realistic expectations are very much linked to positive outcomes of spinal surgery.
Stepping back, lumbar surgery occurs in the lower section of your back. The lumbar region is the region located between your ribs and pelvis, and consists of 5 vertebrae and there are numerous injuries that can occur in this region. Outside of the bony and disc structures, the lower back is also greatly supported by the surrounding muscles which include the abdomen, obliques and gluteal muscles as well as the muscles in your legs and upper back. Common surgeries in this region include a microdiscectomy, laminectomy and a lumbar fusion procedure (which are commonly called a PLIF or an ALIF).
As we mentioned before, there are lots of common questions about lumbar surgery, but the answers are best shared when it is specific in each patient, their work/life scenario, their injury/ condition itself and the proposed surgery. However, we have tried to distill our key messages into this Optimal Tip…
So, how do I best prepare for surgery?
Tip 1: Seek out your physiotherapist for a prehab program:
Book in with a physio to discuss a set of specific muscle strength and mobility exercises that are positive movements to do prior to surgery. This phase is called the pre-habilitation phase. A common question we get asked at OHL is ‘’is it safe to exercise prior to surgery’’ the answer is yes. It is important to strengthen the muscles around your core and glutes prior to surgery as this has been proven to help post operative outcomes, strength and the ability to recover quicker. Your physio can provide you with a set of 4-5 exercises that will be safe and assist in improving these factors prior to surgery.
Tip 2: Organize assistance for after your surgery as you will not be able to lift:
Speak to your family, friends or loved ones about getting physical support after your lumbar surgery. Commonly after these surgeries you will be unable to lift for a few months with only light lifting (max 1-2kg) allowed. Having assistance from family and friends is important to ensure you have safe outcomes and a good recovery after surgery, but it also allows your household to continue functioning (in terms of washing, cleaning, cooking) without you straining yourself. They can also be helpful for the period of time when you are unable to drive after the surgery.
Tip 3: Prepare some food:
Preparing and stocking your fridge/ freezer prior to surgery is an absolute blessing in those early weeks post-operatively. Commonly patients will struggle to stand for periods of time and lean over a bench after lumbar surgery, so pre-prepared meals will ensure you do not have to do this task and you can focus on building your movements according to your fatigue.
Tip 4: Prepare the house for ease of mobility:
Simply, look around your house and see how you can make your first 6-weeks after your surgery easy by moving onto one level of your house (as stairs are tiring). Small things like moving your bedroom onto one level (if your bedroom is upstairs), getting a shower chair/ commode and/or making sure you have a chair to rest on can all be helpful, as it can be difficult to get up and down in the bathroom or stand in the shower for initial weeks. Other options include ramps, rails and stairs adaptations can be implemented in more advanced scenarios, but these are often not required.
Tip 5: Ensure your appointments are booked in after surgery:
Get your diary out and ensure you have an appointment with your OHL physio around 3-4weeks after surgery. Commonly people have many questions about ‘what are appropriate pain levels’, wound care, medications, mobility restrictions and return to work planning, and yes your physio can guide you through these things points before week three if you need. At the week 3-4 we start discussing tailored spinal exercise rehab plans, check wounds and ensure you are walking safely and correctly.
Although these 5 points are simple tips, these all help in both the preparation and recovery process post-surgery. Lumbar surgery can be a long recovery but implementing good preparation ensures outcomes post-surgery and the ongoing rehab starts smoothly and improves at a good pace.
Did you feel like this is relevant to you? Checkout our online availability to book with a physiotherapist or call now on 94315955.
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