Physio Led Pilates for Spinal Surgery
What are the benefits?and when can I start?
A small number of patients with back pain will require spinal surgery, particularly if they have leg pain or weakness. Spinal surgery is a big operation and often decided upon after trying other treatment options like a caudal epidural, facet joint injections, physiotherapy, chiropractic treatment or combination of all. It can be a daunting process and understandably you will want to be very protective of your back. Surprisingly after most spinal surgeries you can get moving very quickly and more often will be up and walking the day after surgery. It is recommended to regularly change your position and not to stay still for too long. Most importantly It is about pacing yourself!
There are three main types of spinal surgery; laminectomy, discectomy and spinal fusion and this can be performed throughout the spine but is more common within the lumbar region.
A laminectomy is the removal of the lamina to allow the nerve root more space, sometimes
this is combined with shaving the facet joint to allow even more space for the nerve root.
A discectomy is the removal of part or all of the disc which is causing the compression of the
A fusion is where they use metal work and sometimes a bone graft to fuse either one or
more levels of the spine to limit movement at that segment.
Rehab will differ for each patient and post surgery rehab is never linear there will often be bumps in the road. All patients can start with the foundations of pilates centering in the very early stages and will often get taught this in hospital.
All rehab is guided by the surgeons recommendations and this can differ between individuals. Typically patients who have had a laminectomy, disecectomy and one or two level fusion can normally expect to start physio led pilates as soon as they feel ready as pain allows and typically will be guided through a 6-12 week rehabilitation program.
Those patients that have had a multilevel fusion will typically start pilates at week 6-8 and expect a 6 months recovery period.
Why is Pilates recommended post spinal surgery?
Within Pilates you learn to use your muscles again to stabilise the spine, reducing pressure that is put on your discs and avoiding compression of the tissue. You will be taken through a gradual program tailored to your needs and body capability, gently loading the muscles as they advance. Most importantly tailoring it to your lifestyle allowing a smooth transition towards your activity goals.
If you are able to start Pilates pre surgery this will enhance you rehabilitation post surgery as you will learn the foundation of centering, breath control and can optimise your muscles.
Your Multifidus is a muscle that assists with supporting movement around the spine, when the back is experiencing pain, this muscle is inhibited it turns the muscle into fat which is shown as the white in the muscles on a MRI. It is important to reawaken this muscle and build on its strength to help optimise movement patterns.