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Can I Exercise after Spine Surgery?

Question: My doctor told me I should have spinal fusion surgery, but I'm worried about the recovery. I'm a very active 65-year-old woman: I enjoy exercising, especially yoga, strength training, aerobics, and walking. How will I be able to keep up my exercise routine while recovering from surgery? And will I ever be able to exercise as much as I do now? I'm worried that I might do something to mess up the fusion while I'm exercising and I don't want that to happen! —Newtown, PA

Answer: I can understand your concern! Let me reassure you right away: exercise is always good for you (when done properly). Especially considering your activities—yoga, strength training, aerobics, and walking—you will be able to exercise again after your surgery.

However, you will have to take it slow as your fusion heals. You won't be able to exercise at your normal level right away because you have to let your body heal.

There are several parts that have to heal. Usually the first thing to heal is the skin. That generally takes between 7 and 14 days after an open procedure (when you have a relatively large incision). The skin healing process takes a bit less time after a microscopic or minimally invasive surgery (where you have several small incisions).

We can't see the rest of the healing process, since it occurs under the skin. Muscles and other tissue that was manipulated during surgery must heal. Lastly, and most importantly, the bone must heal or "fuse." This usually takes anywhere from 6 to 9 months, and your surgeon will be able to see if the bone has fused completely by using an X-ray or a CT scan.

We have a phrase in spine surgery that we use a lot as patients recover: "maintain spine precautions." What we mean is that you should take great care with your back as your body recovers from surgery. "Maintain spine precautions" is the blanket phrase for: no heavy lifting, bending, or twisting. In other words, don't put excessive strain on your back.

For you, that means that as you ease back into exercise, you'll need to be extra cautious of any movements that will cause motion in the area of your back that is trying to heal and fuse. The purpose of a fusion is to allow this area to become solid, which will stabilize your spine. However, repetitive excessive movement in this area will cause the fusion to fail—in addition to causing great pain.

For example, in yoga, some of the poses involve twisting, flexion, and extension of your spine. I'd recommend talking to your surgeon, nurse, or physical therapist about specific poses that may cause pain, unwanted motion of the spinal levels trying to fuse, or even fusion failure. I know that you don't want to do anything to keep the fusion from healing properly, so work with your health care professional to figure out what's best for you and your body.

As the fusion heals, you can do low-impact exercise. Of your current activities, you should be able to continue walking for sure. Walking is a great low-impact exercise because it avoids unwanted motion to the spine and actually aides in bone fusion (growth). Also, now may be a great time to start swimming. That gives you an amazing total body workout in a very safe (for your fusion) environment. The water will support your body weight, so your back won't be carrying as much weight as you work out.

After the fusion heals and after you've gotten permission from your surgeon, you should be able to resume your typical activities. So yes, you can still be a very active person after spinal fusion surgery!

You should know, though, that your spine may feel stiffer after your surgery and even after your fusion heals. Depending on your prior flexibility, you may need to adjust your expectations. Again using yoga as an example, you might not be able to stretch quite as far in the poses, but that's okay. You'll still be exercising and doing a great job of taking care of your body.

I think it's terrific that you want to maintain your active lifestyle after your spinal fusion surgery. I'm a very active person, too, so I know how good exercise can make you feel. And as a nurse, I know how important exercise is to keeping your back healthy (and the rest of you healthy, of course). Your activities are especially beneficial because you're getting that key mix of muscle toning and cardio exercise as you mix up your routine with yoga, strength training, aerobics, and walking. Good work on your healthy choices, and I wish you the best in your spinal fusion surgery and recovery!

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