Post-Surgery Concerns for Scoliosis: Exercise and Pain Management Tips

Postoperative Issues After Scoliosis Surgery

Hello Doctor, I have a spinal curvature greater than 40 degrees and underwent surgery 7 years ago, during which steel rods and plates were implanted for stabilization.
My attending physician only advised me to avoid heavy impacts on my back.
Since the surgery, I have experienced severe pain in my lower back after prolonged sitting or standing.
I also feel tightness in my right scapula, and any slight pull can cause tearing-like pain.
I have always had concerns about exercising post-surgery and am unsure which activities are safe and which might harm my spine.
I would like to ask: Is it safe for me to go to the gym for weight training? What impact could weight training have? What common exercises would be suitable for me, and which should I avoid? Regarding my lower back and scapula issues, are there any recommended stretching exercises that could help improve my condition? Thank you, Doctor!

Emily, 20~29 year old female. Ask Date: 2022/08/30

Dr. You Dianqi reply Orthopedics

Hello Emily, based on your description, it has been some time since your surgery, and you are still experiencing some discomfort.
I recommend that you return for a follow-up appointment and discuss these issues with your attending physician.
Thank you.

Reply Date: 2022/08/30

More Info

After undergoing scoliosis surgery, particularly with the implantation of rods and screws for spinal stabilization, it's essential to approach post-operative recovery and exercise with caution. Given that you have had your surgery for seven years, it's understandable that you may still experience discomfort, especially with prolonged sitting or standing, as well as tightness in the right scapula. Here are some insights and recommendations regarding exercise and pain management post-surgery.

Pain Management
1. Physical Therapy: Engaging in a structured physical therapy program is crucial. A physical therapist can tailor exercises to your specific needs, focusing on strengthening the core muscles that support the spine, improving flexibility, and addressing any muscle imbalances that may have developed post-surgery.

2. Pain Relief Techniques: Consider using heat or cold therapy to manage pain. Heat can help relax tight muscles, while cold therapy can reduce inflammation. Additionally, over-the-counter pain medications, such as NSAIDs (ibuprofen or naproxen), can be used as needed, but always consult your physician before starting any medication.

3. Posture Awareness: Maintaining good posture is vital. Be mindful of your sitting and standing positions, ensuring that your spine is aligned. Ergonomic adjustments to your workspace can also help reduce strain on your back.

Exercise Recommendations
1. Low-Impact Aerobic Activities: Activities such as walking, swimming, or cycling can be beneficial. These exercises are low-impact and can help improve cardiovascular fitness without putting excessive strain on your spine.

2. Strength Training: While heavy lifting and high-impact exercises should be avoided, light to moderate strength training can be beneficial. Focus on exercises that strengthen the core, back, and shoulder muscles. Resistance bands or light weights can be used to avoid excessive strain. Always prioritize form over weight to prevent injury.

3. Flexibility and Stretching: Incorporating stretching exercises can help alleviate tightness in the back and shoulders. Gentle stretches targeting the thoracic spine, shoulders, and hip flexors can be particularly beneficial. Yoga or Pilates, under the guidance of a qualified instructor familiar with post-surgical patients, can also enhance flexibility and core strength.

Exercises to Avoid
1. High-Impact Activities: Avoid activities that involve jumping, running, or any high-impact movements that could stress the spine. This includes sports like basketball, soccer, or running.

2. Heavy Lifting: Exercises that require heavy lifting or straining, particularly those that involve bending at the waist, should be avoided. This includes traditional deadlifts or squats with heavy weights.

3. Twisting Motions: Be cautious with exercises that involve twisting the spine, as these can place undue stress on the surgical site and surrounding muscles.

Specific Recommendations for Shoulder and Back Pain
1. Shoulder Blade Squeezes: Sit or stand with your back straight. Squeeze your shoulder blades together and hold for a few seconds, then release. Repeat several times to strengthen the muscles around the scapula.

2. Cat-Cow Stretch: This yoga pose helps improve spinal flexibility and relieve tension in the back. Start on your hands and knees, arch your back (cat), then dip your back down while lifting your head (cow). Repeat several times.

3. Child’s Pose: This gentle stretch can help relieve tension in the back. Kneel on the floor, sit back on your heels, and stretch your arms forward on the ground, relaxing your forehead on the floor.

Conclusion
It's essential to listen to your body and consult with your healthcare provider before starting any new exercise regimen. They can provide personalized recommendations based on your specific condition and recovery status. Remember, the goal is to enhance your quality of life while minimizing the risk of injury. With the right approach, you can manage pain effectively and improve your overall physical function post-surgery.

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