What You Should Know About Exercising After Spine Surgery

Peer Reviewed

When it comes to recovering from spine surgery, taking it easy is not always so easy. But rushing back to your pre-surgery activities could saddle you with a lot of pain and possibly even set your recovery back.

If you’re eager to get back in the gym after your back or neck procedure, you need to be smart, slow, and steady. To help provide some basic guidelines around safely exercising after spine surgery, SpineUniverse reached out to Dwight S. Tyndall, MD, FAAOS, an orthopaedic spine surgeon at Orthopaedic Specialists of Northwest Indiana in Munster, IN.

Special note: The following information contains general recommendations about exercising after spine surgery—it does not take your specific medical history or spinal condition into account. Above all, follow your spine surgeon’s instructions for safely exercising after spine surgery.
Tired woman on a treadmillIf you’re eager to get back in the gym after your back or neck procedure, you need to be smart, slow, and steady. SpineUniverse: When can people generally go back to their pre-surgery exercise routine after:

  • A traditional, or open, decompression with single-level fusion procedure?
  • A minimally invasive single-level fusion?
  • A minimally invasive decompressive/outpatient spine surgery procedure?
  • A more complex open surgery, such as a multi-level fusion?

Dr. Tyndall: After an open decompression with single-level fusion, most patients can significantly increase their level of physical activity between 8 and 12 weeks after surgery—and that timing also applies for people who have a minimally invasive single-level fusion.

People who have a minimally invasive decompression procedure generally need 4 weeks after their procedure before they can begin incorporating physical activity into their routine. For people who have a more complex open surgery, you may have to wait between 4 and 6 months after your procedure to safely exercise again.

SpineUniverse: Are there regions of the spine that take longer to heal? In other words, do people generally have to wait longer to exercise after neck surgery compared to those who had low back surgery?

Dr. Tyndall: It’s actually the opposite: Low back surgery takes longer to heal than neck surgery.

SpineUniverse: Outside of the general timing guidelines for activity after surgery, how can a person know they are ready to participate in physical activity after surgery?

Dr. Tyndall: One of the first signs is if the incision is fully healed and not painful. Also, depending on the procedure, patients can resume physical activities if the symptoms that led to the surgery are resolved.

Despite these broad guidelines, it’s important to remember that everyone is different. Patient motivation and desire to go back to activities are factors that also matter, in addition to how an x-ray looks or the patient’s physical healing.

SpineUniverse: What advice can you share for people who are eager to get back into their previous fitness routine, or for those looking to establish a new exercise habit after surgery?

Dr. Tyndall: Make sure you are fully recovered from surgery before rushing back. A lot of patients do great after surgery and try to resume their pre-surgery level of activities too soon. You have to allow yourself the time to recover from surgery and gradually work your way back to your pre-surgery fitness routine and fitness level.

An example that comes to mind is Tiger Woods’ multiple spine surgeries. He had microdiscectomy for his disc herniation, and I believe Tiger rushed back after his initial surgery. His early return to golf might have led to a second surgery. After the last surgery, Tiger took a year off from competitive golf to allow himself to heal. He recently finished second in a recent tournament, which is an incredible feat.

SpineUniverse: What exercises or stretches are especially good for recovering from spine surgery?

Dr. Tyndall: After a microdiscectomy or lumbar fusion, core exercises and exercises that stretch the hamstrings are important to helping patients return to their activities. Tight hamstrings can contribute back pain, so getting them loose and flexible will go a long way in aiding recovery.

SpineUniverse: What exercises, if any, should be avoided entirely or performed minimally after spine surgery?

Dr. Tyndall: I advise my patients with disc injuries to minimize strenuous weight training that involves deadlifts or weighted exercise where weight is placed on the shoulders, and therefore, places an excessive load on the spine. Patients don’t need to avoid these exercises completely, but they should proceed thoughtfully and gradually increase their level of exertion.

SpineUniverse: What warning signs should people look out for when working out after spine surgery that warrant a call to their surgeon?

Dr. Tyndall: Patients should call their surgeon if their initial symptoms return. That is the first sign that their recovery may be set back.

Patients should listen to their bodies. Increase your level of exertion gradually and adjust accordingly. You may find that your recovery journey feels like you’re moving 2 steps forward and 1 step back. One day could be good, but the next might be painful. Take things slow and steady, and your spine surgery recovery will be quicker and healthier.

Commentary

Gerard Malanga, MD
Physiatrist
New Jersey Sports Medicine, LLC
New Jersey Regenerative Institute
Cedar Knolls, NJ

I greatly appreciate the thoughts and recommendations by Dr. Tyndall. We should remember that surgery is a traumatic event, and patients need to recover from the surgery itself as well as the underlying disease process that was treated.

The tissues need to heal following surgery—this includes everything from the skin to the tissue underneath the skin to muscles and, in the case of spinal fusion, the bone. Therefore, post-operative rehabilitation requires us to consider all the aspects that can facilitate healing of the tissues and minimize stress to the structures, especially in the early healing process.

The basic scientific knowledge of tissue healing, ranging from healing of skin to healing of the bone, can assist us in our recommendations for patients. We know that bone can heal in 6 to 8 weeks, although it can take a bit longer in the spine—perhaps up to 3 months. We also know that bone requires more immobilization to heal, but that too much immobilization can result in secondary issues, such as scar tissue formation and tightness.

Physical therapy and rehabilitation requires a gentle progression to mobilize tissues according to what has been done in surgery. I fully agree with Dr. Tyndall: The process should not be rushed, and patients should listen to their bodies as they recover. The surgery itself creates the platform for appropriate rehabilitation, so that patients can return to their normal daily functioning and sport activities. This eventually requires strengthening of the muscles that surround the spine (the core muscles), the glutes, and lower extremity muscles. Therefore, an experienced physical therapist who understands functional rehabilitation is essential in the rehabilitation of all patients, especially those who put high demands on the spine, such as injured workers and athletes.

Updated on: 03/28/18
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Should You Exercise When You Have Lower Back Pain?
Dwight S. Tyndall, MD, FAAOS
Orthopaedic Spine Surgeon
Orthopaedic Specialists of Northwest Indiana
Munster, IN
Gerard Malanga, MD
Physiatrist
New Jersey Sports Medicine, LLC
New Jersey Regenerative Institute
Cedar Knolls, NJ
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