Post-Surgery Rehabilitation: Essential Exercises for Disc Herniation Recovery

Q: Post-Surgery Rehabilitation: Essential Exercises for Disc Herniation Recovery

**Absolutely necessary.** Correct posture is important, but very few people can achieve it. <br>Generally, individuals tend to have an anterior pelvic tilt, causing the upper body to lean backward (especially when holding a child, this posture is easily adopted). <br>If your Engl

Is rehabilitation necessary after surgery?

Hello Dr.
Kang: I am a patient with a herniated disc.
After unsuccessful conservative treatment, I underwent surgery in May of this year, and the soreness, numbness, and pain have decreased postoperatively.
Since I work in education, standing is unavoidable; additionally, I occasionally need to carry my child (15 kg), and now I sometimes feel soreness in my lower back and calves.
I am very afraid of a recurrence of my old condition.
Besides maintaining proper posture, are there any rehabilitation exercises I can do? Or do I need to undergo physical therapy again? Thank you for taking the time to answer my questions!

eva, 30~39 year old female. Ask Date: 2001/01/31

Dr. Pan Yingda reply Rehabilitation

Absolutely necessary. Correct posture is important, but very few people can achieve it.
Generally, individuals tend to have an anterior pelvic tilt, causing the upper body to lean backward (especially when holding a child, this posture is easily adopted).
If your English is sufficient, you can look for books on the Alexander Technique (available at Eslite Dunnan).
*Most patients after lumbar spine surgery are overly cautious and afraid to move their lower back, often relying on back braces for extended periods, which leads to stiffness in the lumbar spine and weakness in the lumbar muscles.
Therefore, stretching and strength training are key components of post-operative rehabilitation, with stretching always performed before strength training.* Lie flat on your back with your feet against the wall, knees bent, and then slowly bring your hips closer to the wall without forcing it.
Take your time to feel the stretch and the tightness in the muscles, relax and avoid holding your breath.
Your feet can slightly internally rotate until your hips are against the wall; this stretches the sciatic nerve.
*Lie face down with your hands on the floor, allowing your upper body to passively arch backward until your arms are straight (do this within your limits, do not force it).
Try to keep your pubic bone as close to the ground as possible.
Perform this up and down motion 25 times, at a slightly faster pace if possible, and do it whenever you have time.
Afterward, lie down and rest for a moment.
This exercise helps to reposition the intervertebral discs.*

Reply Date: 2001/01/31

More Info

Post-surgery rehabilitation following a disc herniation is crucial for recovery and preventing future complications. After undergoing surgery for a herniated disc, such as a microdiscectomy, patients often experience a reduction in pain and discomfort, but it is essential to engage in a structured rehabilitation program to strengthen the back and core muscles, improve flexibility, and promote overall spinal health.

Timeline for Resuming Activities
1. Initial Recovery Phase (0-6 weeks post-surgery): During this period, the focus should be on gentle movements and avoiding any activities that could strain the back. Patients are typically advised to engage in light walking and specific stretching exercises to maintain mobility without overexerting the spine.

2. Progressive Rehabilitation Phase (6-12 weeks post-surgery): As healing progresses, patients can gradually introduce more active rehabilitation exercises. This phase may include physical therapy sessions where a trained therapist can guide the patient through specific exercises tailored to their condition.

3. Return to Intense Activities (3-6 months post-surgery): Most patients can begin to resume more vigorous activities, including sports and heavy lifting, around three to six months post-surgery, depending on individual recovery and the advice of their healthcare provider.

Recommended Rehabilitation Exercises
1. Pelvic Tilts: This exercise helps strengthen the abdominal muscles while promoting spinal stability. Lie on your back with knees bent and feet flat on the floor. Gently tilt your pelvis upward, flattening your lower back against the floor, and hold for a few seconds before relaxing.

2. Knee-to-Chest Stretch: This stretch helps relieve tension in the lower back. While lying on your back, bring one knee to your chest while keeping the other foot flat on the floor. Hold for 15-30 seconds and switch legs.

3. Bridges: This exercise strengthens the glutes and lower back. Lie on your back with knees bent and feet flat. Lift your hips off the ground, forming a straight line from your shoulders to your knees. Hold for a few seconds before lowering.

4. Cat-Cow Stretch: This dynamic stretch improves flexibility in the spine. Start on all fours, arch your back (cat position), and then lower your belly while lifting your head and tailbone (cow position). Repeat several times.

5. Wall Sits: Stand with your back against a wall and slide down into a sitting position, keeping your knees aligned with your ankles. Hold this position for 10-30 seconds to strengthen the legs and core.

6. Core Strengthening Exercises: Incorporating exercises like planks and side planks can help build core stability, which is essential for supporting the spine.

Importance of Professional Guidance
While these exercises can be beneficial, it is crucial to consult with a physical therapist or healthcare provider before starting any rehabilitation program. They can assess your specific condition, monitor your progress, and adjust your exercise regimen as needed. Additionally, they can provide guidance on proper body mechanics, especially since you are involved in activities that require lifting and prolonged standing.

Conclusion
Maintaining proper posture and engaging in a structured rehabilitation program are vital for recovery after disc herniation surgery. By incorporating gentle exercises and gradually increasing intensity under professional guidance, you can strengthen your back, improve flexibility, and reduce the risk of recurrence. Always listen to your body and consult with your healthcare provider if you experience any unusual pain or discomfort during your rehabilitation process.

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