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Thread: Trunk exercises with fused patients

  1. #1
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    Default Trunk exercises with fused patients

    I've had surgery 18 years ago and was fused from T3 to T12 and L1 to L3 (2 separate rods).

    I have recently signed up for Physio - trunk strengthening exercises but have already hit problems with one of the exercises (single leg kick). I'm wondering if anyone else had undertaken a programme like this with a fusion.

    It seems to be tailored more for flexible backs and after already having sustained a bit of an ijury, am reluctant to continue....

    Thanks!

  2. #2
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    Default Re: Trunk exercises with fused patients

    Is the physio you are seeing aware that you have a fused spine and do they have experience with such patients? I think that's the question I would want answering before I underwent any exercise regime. Any exercises should be properly tailored to take account of the inflexibility inherent in your fused spine or they could cause more harm than good.
    Me, a Mod? Nah ... I'll always be a rocker

  3. #3
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    Default Re: Trunk exercises with fused patients

    Hi Gilly,

    I did inform the physio and I was referred by the consultant, who assured me that this would help with lower back pain. It is however an exercise class with many others who I suspect do not have fusions. The physio said that I still need to 'activate' certain muscles in my back but I'm still not easy about it - he won't be the one suffering the problems if it goes wrong

    Here are some of the exercises which I have been prescribed, but not yet taken

    http://www.physioroom.com/prevention...trength_4a.php

    What do you make of them?

    Apart from the last one, I don't fancy 'em!

    There are a few more which are less 'scary' which I have printed on a sheet, I'll try and scan them in.
    Diagnosed Feb 89 with 60 degree curve (S shape). 2 spinal ops, 2 weeks apart, Sept 1990 RNOH, Stanmore. Mr Ransford. Fused with Harrington and sublaminar wires from T3-T12 and L1-L4.

    Recently developed occasional pains, some achy, some more nervy. All occur in left, lower back/pelvis and radiate down left leg. Suspected pseudoarthrosis in L3/4 and some early disc degen in lowest disc L5/S1. Not sure which is responsible for pain (one, both or neither)

  4. #4
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    Default Re: Trunk exercises with fused patients

    Oh my, I don't think my fusion would be very happy if I tried most of these Of course, you need to remember that I'm a complete wimp - and a rather elderly one at that

    Seriously though, the physio I was under was very conservative about what I should do so as not to put any extra stress on the mobile segments between fused and unfused levels (ie the areas above and below the fusion) How much of that is age-related I'm unsure, but I tend to err on the careful side anyway.

    I think any exercises which would build your core stability muscles would be of great benefit as these muscles act as a kind of corset around your spine and help to support it. Beyond that I think all you can do is listen to what your body tells you and don't try to do anything which feels 'wrong', if you see what I mean? Not very helpful I know, sorry
    Me, a Mod? Nah ... I'll always be a rocker

  5. #5
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    Default Re: Trunk exercises with fused patients

    EEK! I don't think I could do any of these! When I joined the gym, the instructor tried to get me to do some core exercises which involved doing a sort of half press-up - I tried it but knew straight away it was going to cause me problems. So I guess i'm stuck with my flabby belly for good

    As for other core exercises, I reckon the exercise bike and cross trainer is good for these, if you consciously hold your tummy in and keep your back as straight as you can.

    Having said all that, I know what you mean about not being completely satisfied that these people really know how to treat people like us (although my fusion is very short, as it wasn't done to correct my scolisis). I want to join a pilates class but i'm afraid that i'll be taught in the same way as everyone else. I know it's a gentle form of exercise, but I have specific things that set me apart, like the fact that I have a dropped foot, and therefore can't balance on my right leg at all, especially if i'm not wearing my orthosis (am I right in thinking you have to do pilates barefoot?) What we really need is a fitness instructor/physio who has the same issues as us - some hope!

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    Default Re: Trunk exercises with fused patients

    I think you are right to be wary of those exercises! The ones I'd be most concerned about are are the first and the sixth. That said, I would be concerned with most of them that weak core muscles (the very thing they're trying to treat) mean that they're less safe for someone with a fusion than for someone who has a more normal back. Looking at them, if I was wanting to do them myself, I'd be getting myself back to the gym, and back to doing my weights program in order to get strong enough to then do those exercises better, but of course that is just me and knowing how my body is.
    Diagnosed at 15 with 50 curve, but probably juvenile IS. Fused in kyphosis (by non-specialised ortho) with a/p surgery T10-L2 @ 21, posterior only revision surgery to correct kyphosis @ 29. Now 38 with further revision surgery and extension of fusion to sacrum required to correct residual kyphosis, restore lordosis and address spinal stenosis.

  7. #7
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    Default Re: Trunk exercises with fused patients

    So I'm not alone in being wary!

    I'm starting to wonder if I can rely on anyone, certainly the physio's don't ease my fears.

    I've now got to make a decision:

    i) do the programme and risk more injury/damage
    ii) screw the programme and just undertake things like walking and swimming. They don't specifically target 'core' muscles but better than nothing I suppose.

    I have heard that sitting on a swiss ball for part of the day can 'switch on' your core stability muscles. I suppose it won't do much harm......

    This whole thing is getting me down....I'd like to be able to switch off my brain and let the experts take over.....I don't feel like I can though!
    Diagnosed Feb 89 with 60 degree curve (S shape). 2 spinal ops, 2 weeks apart, Sept 1990 RNOH, Stanmore. Mr Ransford. Fused with Harrington and sublaminar wires from T3-T12 and L1-L4.

    Recently developed occasional pains, some achy, some more nervy. All occur in left, lower back/pelvis and radiate down left leg. Suspected pseudoarthrosis in L3/4 and some early disc degen in lowest disc L5/S1. Not sure which is responsible for pain (one, both or neither)

  8. #8
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    Default Re: Trunk exercises with fused patients

    I'd opt for ii) if I were you

    Swimming is an excellent all round exercise and a brisk walk with core muscles engaged would also be beneficial - and safe to do with a fusion.
    Me, a Mod? Nah ... I'll always be a rocker

  9. #9
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    Default Re: Trunk exercises with fused patients

    I do some of those exercises at pilates but not the middle two ones

  10. #10
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    Default Re: Trunk exercises with fused patients

    I think I will play it safe. For some reason, my back is sensitive to certain movements/positions. lying on a bench, with my feet touching the floor makes it feel like its being strained (ie like someone trying to bend a twig). Because of this, years ago, I used to bench press with my feet UP on the bench (my whole body at one level).

    In my physio class I did an exercise where you lie flat on your stomach and (straightening your legs) life one off the ground. That caused a pulling/tension feeling at the top of my back......a month on and its still a bit sensitive! The top half of my rod never seemed to be buried deep enough, you can feel the top six inches of it and my top fused bone does protude slightly!

    It's probably quite hard for a physio to look at an exercise and tailor it for my specific back, so I have to make a guess at what is going to be dangerous
    Diagnosed Feb 89 with 60 degree curve (S shape). 2 spinal ops, 2 weeks apart, Sept 1990 RNOH, Stanmore. Mr Ransford. Fused with Harrington and sublaminar wires from T3-T12 and L1-L4.

    Recently developed occasional pains, some achy, some more nervy. All occur in left, lower back/pelvis and radiate down left leg. Suspected pseudoarthrosis in L3/4 and some early disc degen in lowest disc L5/S1. Not sure which is responsible for pain (one, both or neither)

  11. #11
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    Default Re: Trunk exercises with fused patients

    could you ask to be reffered to Hydrotherapy?

  12. #12
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    Default Re: Trunk exercises with fused patients

    Hiya - I had a physio session this afternoon and she wanted a Consultant letter detailing what was wrong and the levels fused and where the problem vertabrae were. She said physio needed to be very gentle on a fused and painful spine, so there were just a few core strengthening exercises to do and go back in 3 weeks and she will see if she can add any more. What was good, was she was able to make sure (by pressing on the right bit!) that I was doing it correctly or not.

    If anyone would like me to explain the exercises - I will have a go

    I have my first hydrotherapy tomorrow morning, (10:30) wish me luck! Specially with my wet skin fear!
    I will add that to my already extensive list of worries for hydro - which include: not being able to do what they tell me, trying not to drown, (it's quite deep), looking awful in a swimsuit and if I get through the session, will I be able to stand up/walk afterwards. When I had hydro many years back, I remember being so unsteady on getting out of the pool I had to sit down for a while. Should be interesting.

    Hope you do ok with your physio - I think it's best to be ultra careful to begin with from what I was told today. So do take care, xx

  13. #13
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    Default Re: Trunk exercises with fused patients

    Ohhh Cassie, I loved hydrotherapy, I wish I could have some more sessions ...

    Your physio sounds very careful, mine was the same. He specialised in spines and my surgeon referred me to him by name, so I always knew I was in good hands.

    If you can manage to explain the exercises that would be very helpful for people - I'm rubbish at explaining things

    Good luck with the hydro
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  14. #14
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    Default Re: Trunk exercises with fused patients

    I loved hydrotherapy too! All those little bubbles and the warmth felt fantastic when I was recovering. As I wasn't able to walk for a good 3-4 months, just standing up felt weird (and wobbly) but great

  15. #15
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    Default Re: Trunk exercises with fused patients

    Quote Originally Posted by Cassie View Post

    If anyone would like me to explain the exercises - I will have a go
    If you could please!

    I was referred to a physio by the consultant and he looked at my X-Ray, so he knew what he was dealing with........but I've lived with this fusion for 18 years now and I'm uneasy about it.
    Diagnosed Feb 89 with 60 degree curve (S shape). 2 spinal ops, 2 weeks apart, Sept 1990 RNOH, Stanmore. Mr Ransford. Fused with Harrington and sublaminar wires from T3-T12 and L1-L4.

    Recently developed occasional pains, some achy, some more nervy. All occur in left, lower back/pelvis and radiate down left leg. Suspected pseudoarthrosis in L3/4 and some early disc degen in lowest disc L5/S1. Not sure which is responsible for pain (one, both or neither)

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