Core Strengthening Exercises After Spine Surgery: Safety and Recommendations

Core exercises after spinal surgery?

It has been four months post-surgery, where screws and a cage were placed in the lumbar spine at levels L4 and L5.
I have two questions: 1.
What exercises can I do to increase core strength? 2.
When lying flat, performing an abdominal exercise with arms and legs suspended in a small V shape, is there a risk of injuring my spine or causing the screws to break? Thank you.

Chen Wei-jie, 20~29 year old female. Ask Date: 2021/07/12

Dr. Wang Shouji reply Orthopedics

Hello, it is important to first confirm whether a joint fusion surgery has been performed.
If so, verify whether the fusion site has healed.
Core strengthening exercises targeting the back and abdomen can enhance spinal stability.
Exercises such as sit-ups and push-ups can be beneficial.
You may consult with the surgeon regarding this.
Once the fusion is complete, the risk of fracture is minimal.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2021/07/12

More Info

After undergoing spine surgery, particularly involving instrumentation such as screws and cages, it's crucial to approach core strengthening exercises with caution and proper guidance. At four months post-surgery, your body is still in the healing phase, and while you may be eager to strengthen your core, it's essential to ensure that any exercises you perform are safe and appropriate for your condition.

1. Core Strengthening Exercises
To enhance core strength after spine surgery, consider the following exercises, but always consult with your healthcare provider or physical therapist before starting any new exercise regimen:
- Pelvic Tilts: This exercise helps engage the abdominal muscles without putting too much strain on the spine. Lie on your back with your 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 releasing.

- Bridges: This exercise strengthens the glutes and lower back. Lie on your back with your knees bent. Lift your hips off the ground while keeping your shoulders and feet on the floor. Hold for a few seconds and then lower back down.

- Modified Planks: Start on your hands and knees, ensuring your back is straight. Engage your core and hold this position for a few seconds, gradually increasing the duration as you gain strength.

- Bird-Dog: From a hands-and-knees position, extend one arm forward and the opposite leg back, keeping your back straight. Hold for a few seconds, then switch sides. This exercise promotes stability and balance.

- Seated Marching: Sit on a sturdy chair with your feet flat on the ground. Lift one knee towards your chest, then lower it back down and repeat with the other leg. This helps engage the core while being gentle on the spine.

2. Safety of V-Sit Exercise
Regarding the V-sit exercise where you lie on your back with your arms and legs raised to form a "V" shape, caution is warranted. This position can place significant strain on the lower back and may not be advisable, especially in the early stages of recovery. The risk of injury, including the potential for dislodging screws or cages, increases with exercises that require significant spinal flexion or tension.

General Recommendations
- Consult Your Surgeon or Physical Therapist: Before starting any exercise, it's vital to discuss your specific situation with your healthcare provider. They can provide personalized recommendations based on your surgical procedure and recovery progress.

- Listen to Your Body: Pay attention to any pain or discomfort during exercises. If something feels wrong, stop immediately and consult your healthcare provider.

- Gradual Progression: Start with low-impact exercises and gradually increase intensity as your strength and confidence improve. Avoid high-impact activities or those that involve twisting or heavy lifting until cleared by your physician.

- Focus on Stability: Core strengthening should emphasize stability and control rather than just strength. Exercises that promote stability can help protect your spine and improve overall function.

In conclusion, while it's essential to strengthen your core after spine surgery, safety should always be your top priority. Engage in exercises that are gentle and supportive of your healing process, and maintain open communication with your healthcare team to ensure a safe and effective recovery.

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