The do’s and don’ts of exercising after a spinal fusion.

 

I was on a popular spine health forum talking with a few people about spinal fusion and reading some of the answers they were giving…mind BLOWN! Now I truly understand why they say be careful what you read on the internet! By no means do I think I am the expert and my information trumps all other medical advice but the difference between what I tell you and what a lot of other people will, is to always consult with your physician FIRST. You have to understand exactly what your situation is before diving into anything. What I want to teach you today are some key points you need to keep in mind if you are looking to get back into the gym after a spinal fusion.

 

This kid had 10 discs fused using a metal rod trying to fix scoliosis and was looking for advice on ab exercises that wouldn’t damage his back further. About 4 replies down somebody piped in and said weighted decline sit ups. I couldn’t believe my eyes! I literally almost had my blueberries and cottage cheese come out through my nose (I was eating it for lunch at the time)  I won’t go into detail on why you shouldn’t do any spinal flexion when it comes to abdominal exercises so if you want to get a more in-depth look check out this article here.

In this article today I am going to briefly touch on the do’s and don’ts of time in the gym after a spinal fusion. This can be ANY kind of fusion whether you had it done in your neck or cervical section, your mid back or thoracic section or your lower back also known as the lumbar section. Spinal fusions are normally done on people who have some kind of degenerative disc issue or severe case of spinal deformity. For example, If I were to push the envelope with my doctor, I would probably be a good candidate for an L5-S1 Spinal fusion due to my now degenerative disc. It makes perfect sense. The disc in between the two vertebrae can no longer give the support it needs to so I would just fuse the two discs together. In some cases this procedure brings relief but most of the time there are usually complications.

The pro’s and con’s to getting a disc fusion are not what’s important here. What I want to make you aware of is what to do once the procedure has been done.

spinal-fusion-1
This is an image of an L5-S1 spinal fusion using rods and screws.

 

 

To be honest, the recovery time can vary. For most, the first few months are the hardest but once you overcome this first obstacle, movement gets much easier. The important thing to remember with a spinal fusion is the fact that you just had your discs fused together. This means you took two hard boney structures that used to have a spongy discs between them and screwed them together (not always the exact procedure but pretty common). When you screw them together, you’re basically turning two separate discs into one big one. Think about the effects this has on the spinal column. Think about how the spine is used to support the body under heavy loads as well as twisting, flexion, and extension. Each vertebrae was designed to move off of the other.

When it comes to exercising after a disc fusion, proper lifting cannot be taken lightly. Everything you do, you need to always consider the load the movement is placing on the fused discs. It’s impossible to only use one part of the spine. To move fluently you need the entire column and its discs to move along with you. The thing about a spinal fusion is that now the discs above and below the fusion are forced to work even harder. This is where a lot of people run into more spinal fusions 5-10 years down the road after their first one. They think that by fusing the discs,  the issue is taken away but in reality your putting a greater potential risk on the discs above and below it.

What to do in the gym after a spinal fusion.

 

Besides constantly working to maintain a healthy range of motion after the procedure, you want to be very cautious when doing something that directly affects the fused area. For example, someone who has had any range of cervical fusion should stay clear of doing exercises that require repeated flexion or extension of the neck. Exercises like sit-ups with their hands pulling on the back of their head or repeated squats with the neck in a hyper extended position. Over time these movements are going to wear on the discs above and below the fused area. This isn’t because these exercises are not healthy (besides the sit-ups) it’s just that now these other discs have to carry the weight of the now fused discs. Make sense?

“It’s not the discs you had fused that you need to worry about, it’s the extra weight the discs above and below it are now responsible for”

 

The best thing to do is consider the load that will be placed on the specific area before committing to the exercises. One of the trainers at my gym has multiple fusions throughout her spine and still maintains a healthy exercise program. Her routine consists of a lot of dynamic movements that work on balance and endurance. She says her main goal is to constantly train in a way that throws her body off balance in order to strengthen the spine stabilizers.  You won’t see her do anything with repeated neck flexion or heavy loaded exercises. She is in great shape despite the obstacles she has overcome. The people who normally have the biggest difficulty years after a fusion are the ones who continue to train the same way they did before the fusion. I can’t stress this enough, keep an open mind to training in a way that protects the spine from future damage. Having a spinal fusion doesn’t mean you have some bionic part that makes you stronger. Fusions come with responsibility and the ability to adapt to a change in lifestyle. The people who can respect that are the ones who you can never tell had a fusion done.

Key Takeaway: Get cleared by your physician first before starting anything. Seek to train the body with your spine in a neutral position. Until you are fully recovered, repeated bending, twisting, and excessive loads need to be minimal and progressive. Pay close attention to the what you’re doing with the area that was fused. Stay away from bending, twisting or loading that specific area. There is always an alternative exercise you can do. If you are experiencing a progressive pain as the workout goes on dial back are-assesses the movements the exercise requires and make the changes if needed. Email me at fitness4backpain@gmail.com with any questions on specific exercises!

If you remember nothing from what you read above remember these 4 points.

A) Take out flexion-based exercises for the core. This means no more sit-ups, crunches, leg raises, flutter kicks etc.

B) Be mindful of the position of your spine while exercising. Fusing your discs takes the mobility our of that specific joint. If you treat your spine the same way you did before the fusion the discs above and below that fused joint will now take all the pressure.

C) Fill your workout program with lots Anti-Rotation and neutral spine work like Stir the Pots, McGill Crunch and Pallof Presses Circles.

I put together a FREE mini course of all the essential elements when it comes to exercise after a spinal fusion.

If you’re wanting to get back into the gym but have no idea where to start pick this up.

This is my gift to you!

 Click here or the image to access the download

 

If you found any value in this article, would you share it with someone you care about? You could really help them out!

Thanks!

Talk to you soon,

William

 

 

66 comments on “The do’s and don’ts of exercising after a spinal fusion.

  1. First off, you keep saying fusing DISC. They don’t fuse the discs. They fuse the VERTEBRAE. Discs are generally removed and bone, fake bone, or cages are put in place, so the the area becomes solidly fused as a unit. I just had my discs between L4-L5, L5-S1 removed and hardware put in and the vertebrae are fusing together.

    1. Kevin,
      Of course, you are 100% right. It’s more of a personal way of organizing whats going on to the body for me. You are right though, the disc itself is not being fused rather the vertebrae above and below it. I process it as the fusion is not allowing the disc to do its job therefore it’s fused or controlled by hardware. That’s backwards and I can see how that may confuse someone. Thanks for the heads up.

    2. Hi Kevin,

      How is your recovery going on and what is your suggestion for a person who is on the verge of getting the same surgery as yours.

      Thank you,
      Reddy

    3. Kevin, I had the same; L5-S1: and then L4-L5, 9 months later…both with hardware. Do you care to expand on how you are healing? How long it took? Do you have any residual nerve pain (I developed neuropathy in my left leg/calf, forefoot and toes). It’s pretty severe and debilitating. Also, are you on an exercise program? Thanks and best wishes. Cindi.

    4. Hi Kevin,I have had my L5-S1,L4-L5 fused for the front ( calll AFL fusion) plus L4-L3 full disc replacement to stop further deterioration in my spine.The disc L M-6 mimics the full motion of the normal disc.
      My op was done on 21 of July this year ,so far I’m doing fine, but my left leg was pretty bad before op,so I still have some pain in my left leg that comes and goes.Spasms I think is normal when I’m starting to be more active. I’m seeing my surgeon on 30 this month, finger crossed,,,,,,,

  2. Hello

    I love your website and all the information on there, plus the downloads are really interesting. I am a 59 year old lady from the UK with degenerative discs in my spine, particularly lumbar, which causes agonising pain throughout my back, buttocks and legs (particularly right one). I have been on various painkillers (which I try to avoid), physio, injections, caudals, etc etc, all to no avail. I have also had breast cancer which obviously resulted in having aggressive chemotherapy, radiotherapy and medication for five years, I now have osteopenia and a lot of my health problems are linked to breast cancer treatment. Anyway, my surgeon has recommended spinal fusion, L4,L5,S1 and I am very worried, hence this email. I have tried to read up on it but the internet stories are frightening, mostly negative. I just wondered if you have had any contact with anyone who has been through the exact operation and can help in any way? I do have a 50% slip of L5 over S1 with narrowing of the spinal canal at that point and I have lost almost 3 inches in height. My hobbies all include movement – I love walking, dancing and gardening etc and I am terrified that I will become rigid after the op and no longer able to participate in my interests. I have to go back to see my surgeon in a few weeks and so I am trying to find out all I can in the meantime.

    Thanks for anything you can offer.

    Kind Regards

    Jean.

    1. I can understand your fear as I was in the same position two months ago. I had the lower lumbar fusion and fixation (plates, screws, rods and bone grafts). Surgery took about ut 4 hours and the pain was managed in the hospital and at home. All the pain I had prior to surgery was completely gone, immediately upon wakening after surgery. Basically, it requires a lot of patience to heal as you can’t bend, twist, or lift. Incidentally, I am 66 years old and in excellent health otherwise. Now, I just need to heal, low impact exercise, walking… and on the upswing. So happy I did it. Best of luck. It’s scarier before the surgery than after. 👍

  3. Is an elliptical or bowflex better after you’ve had L4 -S1 Fusion surgery with hardware; it’s not a fresh surgery and I’ve had some pain flare ups in the last year. I walk at least 5-6 days per week but would like to start doing something different. I did yoga for years and for quite awhile after surgery but it makes me hurt too much that’s why I want to try the elliptical or bowflex. Thanks

  4. Is it safe to do a squat using a ball against the wall to support your back after a spinal fusion? Are preforming dead bugs shown in your video safe after spinal fusion? What cardio equipment do you recommend to start with?

    1. Hey Trish,

      It is safe as long as your not in pain. I prefer starting with doing sit backs on all 4’s and working through fundamental core exercises to strengthen the muscles that make up your trunk. After a fusion, I always suggest starting from the bottom (basic fundamental movements like pelvic floor contraction, breathing and introducing leg movements while doing these things)

      You can experiment with the ball squats just start in small increments and listen to your body. Make sure your trunk is stable and your spine is neutral.

      William

  5. Hi- I am one year post op for a burst fracture of a lumbar vertebra. I had a cage, two rods and several pieces of hardware placed in lumbar vertebrae.
    After the first surgery, the cage had moved and a second surgery was required 2 weeks after the first one.
    The cage was re- situated and more hardware required to stabilize the spine.
    Before the surgeries, severe pain in left leg and surgery was indicated.
    After the second surgery, PT was ordered for12 weeks. It was determined that nerve damage was limited to left thigh area. Pt exercises continued at home, now walking with a cane, previously a walker. It is now 13 months later, walking with a cane, and again in PT as I am not standing straight. The exercises are helping but still in pain with soreness in lower back.
    I lost two inches in height and my upper body is compressed, no torso just a larger stomach starting right below my breasts. Is this common? I have lost 10 lbs. since my surgery and have kept it off. I’m doing more stretching now, in the hopes of maintaining a straighter, more neutral spine. Any suggestions as to body changes with post op spinal fusions?

    1. Hi, I cannot believe what I just read–you just described exactly what I have been going through since my surgery in Nov. 2015. I have 2 rods, 16 screws and 4 cages in my back. I did 5 mos. of water therapy and have been going to the Y 3 times/wk. I, too, have the larger stomach starting right below my breasts and always seem so tight–sometimes hard to even breath. One year after the surgery I had to have one screw and part of the rod removed as bone had deteriorated around it. I often wonder if it was worth it but then I think back on how much pain I was in before surgery and I just wanted it fixed. I don’t think I asked the right questions and probably should have had someone with me when surgery was discussed. I honestly do not remember being told about the loss of mobility. Anyway, 4-5 mos. ago I had a neurostimulator implanted in the hopes of getting off of pain meds. So far, it’s not working. Anyway, I have an appt. with another orthopedic surgeon in Pittsburgh, PA early October to discuss having all of the hardware removed. The doctor that did my surgery said I would be able to have it all removed. I don’t know what else, if anything, can be done other than some reconstructive surgery at the top of my spine. (I also have scoliosis–it is down to a 10 degree curve from 27 degrees).

      I am so grateful that I came across your post. Please feel free to stay in touch.
      Best,
      Linda

      1. Hey, Linda!

        I am so happy you find this content! Any way I can help let me know! I have been off the grid as of late due to relocating to Florida only to turn around and evacuate from Irma (the storm) ! I am getting back to normal so email should be a safe place to reach out!

        William

  6. 14 levels including the SI joint on both sides with 80mm long screws, quite a sight on an x-ray. Im 3 months out and had no therapy as of yet. I think I will buy an exercise bike with arm attachments and stick it in front of the TV, yeah, I think I like that idea.

  7. I saw your article online about lifting after a cervical fusion. Since March 2016…I have had a big knot between my left scapula and spine. It has caused a lot of pain. MRI revealed a bulging disc c5 c6.

    I had treatments from a chiropractor, masseuse, spinal epidurals, trigger point injections, acupuncture…nothing helped. So in December I had a cervical discectomy and fusion. It’s been 3 months and I still have the same knot and pain. The surgeon said the knot would subside after surgery…but no luck. I have recently tried dry needling. The knot will not go away and still have same pain one year later. Is there anything else I should try? Thank you.

    David

      1. I’m just jumping in here as I literally just had my fusion on L5 S1 as well as two additional decompressions six days ago. I am not a gym junkie but constantly active gardening, attending to my animals, hiking, playing tennis, or basketball, etc with my grandsons. I was told no lifting over ten pounds, take it easy, and walk. Walking feels good no problem there. But, is it ok to squat or bend over to tie up my plants, weed, pick tomatoes…. Can i bend or squat to remove animal waste daily from my yard or load and unload my dishwasher. My neuro surgeon expected me to be unable to move this much without pain but I’m finding I can do these things without too much difficulty. I do not want to deter my healing though. I would appreciate your input very much.

        1. Hey Andrea,

          As long as you have been cleared to resume “normal activity” then yes it’s okay.

          BUT

          You have to be very mindful of HOW you’re doing these things as you continue to recover and rehab. It’s not about whether squatting is good or bad for you, it’s a matter of how you’re doing it that is bad.

          Feel free to read through the “Start Here” section for a lot of great free content on this topic. If you want a little more detail and instruction I cover this heavily in Breaking The Pain Cycle

          William

  8. Hi, I’m almost 6 weeks post op from a L5/S1 fusion having had a partial discectomy just over a year before. I’m 51 and wanting to improve my core strength to help protect my back but don’t know what is safe to do. I’m English but live in Spain and I’d like to know what I can do at home as we don’t have a gym nearby and it’s not really my thing anyway. My surgeon wants me to walk in chest deep water, starting in another 3 weeks and I’m aiming to walk for an hour a day at the moment. I’m generally not in too much pain but can’t quite do without pain relief. I’m taking Enantyum 8hrly and Gapabetin morning and night for a small amount of nerve pain. I’m able to do my normal chores about the house but I’m not lifting anything heavy and am only bending with my hips and knees so to keep my back straight. Any advice greatly appreciated as I really want to get back to being more active over the next few months and to strengthen my core. I’m not in a great rush, I don’t want to mess this up! Thank you

  9. I am a competitive cheerleader, and former gymnast, and on my team I’m a flyer and a tumbler (I get thrown really high in the air, and I do flips). 3 years ago I had terrible back pain and I found out that I have spondylolisthesis at l5-s1. I wore a brace, and did physio until my symptoms were completely gone. I’ve had mild back pain that comes and goes, and it seemed to be unrelated as I didn’t feel pain in the same area. Now however, the pain is back, and the disk is displaced twice as far as the last time. If my symptoms get worse, my doctor recommends spinal fusion, but as of now, the pain is predictable and not constant. If I end up getting surgery, is there any way I could come back to cheerleading, or would spinal fusion be the end of my competitive career? The sport requires explosive movements, some back extension, and impacts from takeoffs an landings during tumbling. I’m still young (17), so I still have time before the average cheerleader retires. Should I go for the surgery?

    1. Hey India,

      I am in no position to say whether or not to get the surgery or not but I can give you my own advice. At your age, most coaches aren’t really thinking about their athletes spine. They just want you to perform. What you have to take on for yourself is building a support system around your spine that will help naturally support what you have going on. If you were to say naaahh I don’t have time for that, then all you have left is to wait until you are forced into surgery. If you do have the surgery, I wouldn’t say that your career is over but it will be a slow recovery and you still won’t have the support system your spine needs since you chose not to take the time and train for it. Make sense?

      Odds are your coach doesn’t know the right way you should be training your core to help build that stability you need. Best thing you could so is get connected at a place like this and learn how to do it the right way.

  10. I am an extremely active person. I was a firefighter for 10 years & personal trainer for about 2 years when I hurt my lower back at work. I changed my workouts & made them more calisthenically driven, but continued to battle the lower back pain (2 herniated discs w/ a pinched nerve). 2 years after initially injuring myself the pain had gotten so bad I finally elected for a spinal fusion as opposed to the lasectomy procedure to avoid having multiple procedures. I had surgery (L5-S1 fusion) just over 12 weeks ago. I did a lot of walking when possible as my suregeon said movement would help the healing process. The strength greatly improved & shooting pain in my right leg was completely gone. After my first post op X-ray I was given the green light to begin light exercises & sporadically started light weight & cardio. After my 2nd post op I further advanced my workouts & running & occasionally jumping rope with no issues. I was then begin my physical therapy program along with my exercises & was trying to get back to the regularity I was accustomed to. I noticed when standing upright & tilting my head down I would get a thoracic ache/pain/discomfort & told my therapist. He has since been working on my thoracic area & I did cupping for the first time last week. After the cupping I was very bruised & sore & just assumed it was routine. 2 days later I expressed my soreness & the therapist then used a metal scraper type of instrument to break up abrasions in my mid back. This was excruciating but I assumed it should be painful. After that session I went to gym, stretched & jumped rope & felt a pull at bottom of my lat muscle. It’s now been about 3 weeks since the thoracic pain initially occurred & I am now worse off than when I started physical therapy. I’ve needed pain medication to sleep & the pain is now thoracic, wrapping around the right side of my ribs. Sitting, getting up, head tilt, bending over I experience pain. Rolling over while sleeping is excruciating. I have been trying to stretch for long periods & workout thru all of this & nothing seems to be helping. I’m REALLY worried this will be more than a bump in the road & want to nip it in the bud. Do you think I should completely shut down my exercising program? I have a very hard time not being active. It’s very depressing for me & I’m having a difficult time knowing when to push thru & when to lighten up. I just want normalcy. Any suggestions & thoughts would be greatly appreciated…

    1. Hey Vincent,

      Thanks for sharing your story. A few things that come to mind just by reading this.

      1) Never work through back pain. there is a reason for your discomfort and working through it or doing anything that is making the discomfort INCREASE is not taking you in the direction you want to go.
      2) Yes, I would shut your program down to simply walking for now until you can desensitize your lower back and symptoms. This is not forever but the worst thing you can do is continue to workout and further irritate what you have going on.
      3) I would never suggest to stop seeing a medical professional you trust but encourage you to ask questions and try (the best you can) to lead your rehab…don’t just follow protocol. This takes research and a better understanding of what’s going on (which is what your doing here)
      4) Not knowing a whole lot about the specifics of your training program, it sounds like you have a lack of spine stability. A simple test you can do is attempt the same movements you do that cause such as bending, getting out of a chair, rolling over in bed etc. with a braced core. This is key to any movement is knowing HOW to brace the right way for the given activity.
      5) Lastly, and the area where I see the most people fail is mastering basic mechanics such as how you sit, stand and bend. Not only in the gym but with EVERYTHING you do in your life from brushing your teeth to tieing your shoes. Good form not only needs to be addressed in the gym but when you bend to grab your gym bag and leave is when it needs to continue.

      This is literally the single misunderstood thing about back pain I see the most. People accumulate too much time in poor positions and use poor mechanics way too much.

      1. William, I can relate to Vincent’s story, especially the need to keep active, and I found your reply very helpful.
        I thought his activities to sound like a lot for that soon postoperative, and the hands on therapy — cupping and what sounded like graston — seemed soon. As firefighter and no doubt more youthful than me, maybe not so extreme. I wanted to say I admire him for working so hard on his recovery, and for his awareness of his body’s reactions and for sharing. He can be proud of himself. Your reply to him is very helpful to me, too. Thanks again.

  11. Thanks a lot. I had seen the Bird Dog and Stir the Pot but had not tried them because they appear to incorporate a twisting motion. Right?
    I will attempt them tonight. I do the other two, 1-arm Farmer and Plank.
    I am very cautious, because after nearly two years of severe pain, I woke up from 3 3/4-hour surgery with no pain whatsoever. Still get emotional over no pain! Needed no pain pills, not even a Tylenol.
    When I ‘overdo’ as in everyday housework, I feel a tight back ‘ache’. Maybe lame but fear I might hurt it. Has anybody else felt that way?

    1. There shouldn’t be any twisting going on. Your spine should be neutral and stable.

      Key thing is to make sure your “pain-free” moments don’t allow you to lower your standards when it comes to how you sit, stand and bend. Always be working on your mechanics to ensure you don’t become a repeat customer!!

      1. Thanks William. I am now at 18 weeks post. Surgeon says I’m doing fine. Can increase miles and speed of walks, but still no bend, twist, lean, lift. I get backache whenever I overdo, which is too long car ride, sit or getting in and out of car too many times a day on errand/shopping day. Been walking on beach and yesterday encountered soft sand areas which take more effort, and some boardwalk stairs over dunes. I haven’t had many stairs to climb since surgery so have been left more sore this time. Also jogged 1/8 of a mile on hard beach sand day before. Will take a few recover days. Do you think I could do long term damage with that activity this many weeks postoperative? Thanks again, Sandra. Daytona Beach

        1. Hey Sandra!

          I would listen to your body. It sounds like you love the active life which is great! But you have to keep in mind the health and longevity of your active career. You want to move and exercise as pain-free as possible. Be careful with the running simply because of the jarring that it creates. Keep your pace and distance at a place where you can recover and not be in pain. Pain means you went to hard. I would spend some extra time learning how to properly brace your core while doing activitie such as getting in and out of the car. I did a recent post on this exact thing. Check it out

  12. Great article! My spinal fusion was l4-l5. I am 16 weeks postoperative and anxious to get working out again in and out of a gym. I’ve been a distance runner for 30 years and missing that too.
    I am a 75-year-old very active person, dying to get going again. What specific exercises should I avoid now and/or forever.
    Thanks!

    1. Hey Sandra!

      It’s all about how your body is reacting to what you’re doing. I am not one of those “let your body guide you” kinda people but when it comes to testing the limits and staying within the boundaries of what’s it healthy for your body, you have to use this natural instinct.

      The number one rule to coming back from a spinal fusion is to watch excessive bending and twisting. If anyone tells you that twisting should be in your exercise program RUN. Don’t judt blindly do things because someone else is doing them.

      Exercises to master and do daily.

      Stir the Pots
      Bird Dog
      1 Arm farmers carry
      Plank

      Hope this helps!

  13. Hi
    I’m glad I found your post.
    I had a l4-s1 alif in March 2014 and it was almost debilitating for 6 months. I started swimming and the following Janruary I did my first 1k swim and all felt fine. I did a half marathon 4 months later then half ironman that December.
    In June this year I did my first full marathon and all still seemed absolutely fine. My training (under the guidance of my brother, who trained as a PT to train me, then when I got faster than him said I need a professional coach to continue developing), while I was with him my training was slow, controlled and I was always very aware of my body and if I wasn’t Justin was.
    I started with a coach and within 3 weeks had terrible pains. After an X-ray the surgeon saw pseudoarthrosis and I had a midlf with hardware.
    What I’m scared of it not being able to compete again. Any advice?

    1. Hey Mathew,

      What you don’t know is whether or not the current injury diagnosis is from the time spent running with your brother. Even with great technique and form, we will pay for our hobbies eventually. Most pain is cumulative or a flare up of what once was an injured area. It sounds like while you were with your brother, not only was he in-tuned with what you were doing but you were pretty in-tuned with what you were doing as well. The one thing a coach can’t do is read your mind and know how your body is feeling. This is where you are the expert. I would take a step back and start fresh with a slower pace and see if you can get back to where you were without this new coach. Once you are there pain-free, try to progress on your own at your own pace. Injury spots can be very sensitive and don’t need much to throw them back into a pain cycle. It sounds like you have done really well staying off that pain cycle but may need to make some adjustments to your training.

  14. I was in a motorcycle accident in 2011 and broke a lot of bones: both femurs ankle back. The doctors fused from L2 to T12 and placed rods in both my legs. My left knee is held together from scar tissue they say and the tendon that connects to the knee is not connected. How did this happen, I was driving to fast and slid into the side of an overpass and was ejected Over the top and fell down under the bridge 60-70 feet down. Surprisingly I am doing really great I only have the fusion and I have dropfoot in my left leg so I have to wear a brace. It really hasn’t limited me much I still golf and ride bicycle and work with cattle and lately started lifting weights again. After reading this article I would just like to know what I should stay away from with that fusion so that I don’t end up hurting myself down the road. Mostly I do weights where my back is supported or on a bench. I do use an AB machine with lighter weight but not sure now if I should be. Thank you for the article and any help or advice you have on this.

    1. Wow, Jeff!

      My little brother is a Honda bike specialist and rides as well so this hit home for me. Glad you’re doing okay.

      As far as what you should or shouldn’t be doing will all depend on your pain tolerance and limitations from the accident and also surgical procedures. The main thing you have to understand is since the fusions have been done its the discs above and below the fusion that are now taking the brunt of the force. It’s not so much what you shouldn’t do but how well you do what you’re doing. If that makes sense. Pay close attention to your bending and make sure your hip hinge ability is on point. Listen to your body and get someone to help coach with more compound exercises such as Deadlifts and Squats if you choose to do them. I personally would stay clear from loading the spine too much with a bar. I would rather preserve what I have and spend more time doing single leg stuff with less weight.

      Hope that gives you some direction!

      Thanks for reaching out.

  15. Hi William,
    What an awesome website thank you. Im a 40-ish mum of 4, im an accountant so i sit – alot! I’ve had a rough year with a laminecromy L5/S1 in January 2016 complicated by a csf leak 4 days later and back in surgery. I ended up having good a fusion L5/S1 in July as the disc got worse, and had severe nerve root compression. I’m up and back to my old routine – well mostly. If it hurts, I don’t do it. But in the mornings, or if I haven’t been moving for an hour or so my lower back aches. It’s so stiff and sore and I battle to get it “loose”. Any suggestions?
    All the best, thanks again 🙂

    1. Hey Ray!

      Thanks for posting!

      There is a mind body connection that I personally am still learning about. This is the first thing to comes to mind when I read what you wrote. I know for me personally My L5-S1 issue which is leaps and bounds better then it was 5 years ago, still gives me random muscle tightness and stiffness around the area if I have been spending a lot of time in “bad positions”

      This is what I would suggest you consider.

      1) Your fusion has changed the mechanics of how your lumbar region operates. This isn’t a bad thing it’s just the reality of having a fusion. With this come great responsibility of controlling and being mindful of what aspects of your “old routine” could be causing some irritation.
      2) Your mind wants to protect that area at all costs and unfortunately how our mind tells our body to do that is through stiffness. Our brains think more stiffness equals more stability which equals a safe joint. What this means for you is that you have to teach your mind how to trust the way you move and to allow that area to relax. You do this by exception movement habits over and over and over. This is where I am still learning myself.
      3) What I have seen work. Being hyper sensitive to the way you sit, stand and bend. These are the fundamentals of our life. If you can do these well and safely your body will begin to trust your movements and be able to relax.

      Since your back is already super sensitive you have to be very mindful of the subconscious activities and movements you do. Even down to brushing your teeth needs to be on your radar as to how you’re bending. The less stress you put on that fusion the more the surrounding muscles will be able to relax.

      I would suggest you take this information and apply it to what your physio (if you’re seeing one) is suggesting.

      Hope this helps!

  16. I had a lumbar L2-L5 fusion done in 1999. Recovery was absolutely horrible but the results were outstanding! I always said I’d do it again if I had too; I’d cry my eyes out, but I’d do it again. Well, here I am going on 17 years later and gradually been having unbearable pain in my lumbar/hip/pelvis region . . . so bad some days that I just want to lay in bed and cry. I truly do not want to have surgery again and hoping someone out there has some positive info for me, like exercises, self-therapy, something.

    1. Hey Tammy,

      It sounds like you have some cumulative issues going on. Not sure of your history but most back issues are a result of poor mechanics over years and years of movement.

      I would suggest you do a complete audit of your daily habits and start fixing the way you sit, stand and bend. You can start with this

  17. Hi,

    I came across this site and I’m glad I did. Aug 15th I had my L5-S1 fused. I had my first post op visit with my doctor today (Sept 27th). The fused disc look good and I no longer need to wear the brace. In the office I could hardly bend over and touch my knee. Doc said this is normal after surgery. He wanted me to start physical therapy for a month. I got him down to two weeks. I really want to go back to work. Doc obliged but said if I needed more time to let him know. Especially if I plan to go back full time.

    I’m flat on my back as I write this and feel sore and totally stiff. Feels very different without the brace. I’m no longer taking any pain meds other then Tylenol. It took me 4 weeks to ween off of Tramadol. The worst ever withdrawals and now with insomnia. I was taking Tramadol for eight years.

    I want to work out in a pool and see if that would help me with the addition of some stretching? My question I have is that once I took the brace off I feel it’s difficult to move around and it hurts but not enough for me to go back on pain meds. Is two weeks enough time to get some flexibility? Also, will the pool help? I plan on being very active the next two weeks.

    Yes, I will be working with a physical therapist.

    The doc did mentioned I was more active in my recovery and getting off the pain meds compared to most of his patients.

    1. Hey Jason!

      Glad to hear of your recovery going well so far!

      I would definitely suggest you keep your doctor close by as you work through this new level of pain but it sounds like everything is going smooth.

      Getting back into an active lifestyle can be tricky and needs to be taken slow. DO NOT rush anything. You may FEEL good but your body is still healing and if you don’t give it ample time, you will get right back into a pain cycle.

      I think the pool is a great idea. Go slow and always underestimate what you think you can handle.

      As far as time goes, you never know. From what I see, it is a case by case situation and actively pursuing a life of healthy movement along with safe and slow rehabilitation is key.

      While you are starting to get around read this article and take to heart everything it says. You need to fix the root cause of the fusion in the first place.

  18. Hello, I am 51 yr old female who is 3 years post op L4-L5 spinal fusion. I play tennis , yoga, and now weight training. I have been seeing a trainer, but am afraid some of the exercises are hurting my back. My current other issue is arthritis in my knees. One of my knees has a floating bone chip, and I slight meniscus tear. My trainer is giving me light load exercises to do. However, at times my knees hurt worse, and so does my back. We have done bent over rows, squats (in the beginning used hack machine, but not anymore). My last visit, i walked around the room carrying a kettle bell hanging at my side with one arm, and then walked switching to the other arm. My back really hurt after this training session. Maybe it’s because the muscles around the fusion are just sore from being worked, but I don’t want to mess up my back (or opportunity to play tennis) with the wrong exercises. After 3 years, and active, what exercises would you avoid in the gym?

    1. Hey Tracy!

      Thanks for stopping by!

      When it comes to working with a trainer it’s a tough call for someone like me looking in. I have no idea how proficient your trainer is or what kind of education or background he has. I actually use 1 arm carrys in my rehabilitation program so to say those are a bad exercise would be a lie. On the other hand, you can misuse that exercise and go to heavy too soon or too much volume over one workout and end up hurting someone.

      For you, I assume tennis is your love so focusing on keeping the stress down inside the gym so that you can focus your time and energy on tennis should be a priority. If he has you doing lunges and squats and that really hurts your back and knees than you need to flat out stop doing them. Find another way to train your lower body or just reduce the load you use. It’s not so much about “staying away” from a certain exercise but rather stay away from the ones that cause discomfort and hopefully your trainer is experienced enough to make adjustments in your program .

      You don’t want to do exercises just to do them. Have a reason for each. Pull out where you are weak or why your back is in the condition that it is in and build a program around that!

      Contact me at fitness4backpain@gmail.com if you want to chat in more detail!

  19. Hello,
    I am a 31 year old male who is 9 weeks post-op lumbar L5-s1 fusion. This is my fourth and hopefully my last back surgery. At the age of 13, I had correctional surgery for scoliosis. I had (T3-L1 fused). I had no PT and very little knowledge of the proper lifestyle to protect my spine back then. However this made me interested to obtain a BS in Exercise Science and Associate in PT assistant. I was living a normal active lifestyle until abruptly I started experiencing severe back pain. I was diagnose with a stress fracture to the right pars. This became the trickling effect for years to come. For 6 years I suffered with right side low back pain that radiated down right leg to the dorsal foot. Extreme weakness lead to foot drop on the right foot. I spent years searching for a doctor who would take action rather than instruct conservative approaches. Went through therapy, nerve block, pain management. With the grace of God I finally found a doctor in New Albany, Ohio. The first surgery was an laminectomy of L5. This procedure was a waste of money. 6 months later a fusion of L5-S1 was performed. This surgery alleviated all my pain. I felt like a new man! So with that being said..I had jumped the gun a ended re-injuring myself in the gym. I was performing skull crushers with an 30lb ez-curl bar. When I finished my set I brought the bar to my mid abdominals and tried to sit up from the flat bench. This is when I felt a burning sensation like my back had been ripped open. Well long story short. The doctor had to go back in a repair the hardware. A screw and nut were both loose and needed to be replaced. So after reading this article about training smart & not training how you used to..really hit home. I do know the importance of neutral spine exercises & stengthening core. But I am curious about exercises that would be ok for legs. Like leg press, hack squats, lunges, ham curls, quad ext?? Mostly everything I plan on doing for strength training would be done on machines. But I don’t plan on doing anything until my doctor clears me. I’m just thinking ahead. Your thoughts would be much appreciated. Thank you..

    1. Hey Tyrone!

      Thanks for stopping by dude. I had tobe very careful when doing lower body due to the shearing affect it would have on my inflamed L5-S1 area. My first goal was to lower that inflammation and get it stable. Once I did that I introduced legs back in very slowly and was super anal on form, depth and how hard I pushed. My goals have massive legs kinda of went out the window but I will take that over living in chronic pain!

      For you I would start with single leg work and go for higher reps. Your goal isn’t to get sore but to perform more than normal work and recover without any issues. For back pain suffers it’s not necessarily how it feels while we do it but how we feel AFTER we do it…sometimes days after. With machines I would stay away from spinal loading until your confident in your ability to maintain a neutral spine at various depths. Due to a lake of mobility the issues come when your trying to reach a depth that your body can’t handle. That’s when the discs up and down stream from the surgery site start getting abused.

      I would stay off squatting on smith machines and hack squat machines all together. Your body has to confirm to the way the machine or bar moves. In exercise it should be the opposite. You want to (as much as possible) be able to control WHERE the weight is at while your performing the exercise. A little to far forward or a little to far back and you can really mess some stuff up.

      Hope that gives you a place to start!

  20. Hi,
    My 21 year old son was ran over by a train and dragged. He survived with all his limbs but had many broken bones including C7, T10 and L1-L5, lacerations and spleen removed. He had badly damage his T10 so they fused T8-T12 on Aug 16th. He is a very lucky guy!
    We are now home, it has been 5 weeks since the accident. He is walking and doing stairs, We are doing stretches in the morning to help him get up. He was a vey active guy. Rode BMX and did competitions and would love to get back to his sport…He was never much into the gym. He only did that when he played football. I would like to help him get strong again, I have an idea of what he needs to do as I am a personal trainer with 30 yrs of experience and have worked with a spinal specialist as a tec. He has an appointment with the neurosurgeon on the 29th of Aug. They may give him some exercises but i’m not sure. He has no heath insurance so we are going to have to do the therapy ourselves. The problem is I have to go home this week, back to Cali where I live, he lives in Virginia. I will be helping him over the phone. So if you can give us any advise, it would be greatly appreciated.
    Thank you, Kristyn

    1. Hey Kristyn!

      Wow I am so sorry to hear about your son but thats is AWESOME to hear about his road to recovery!

      With his rehabilitation a lot of what you will need are the limitations he will have issued by the doctor. For example, if due to surgery he shouldn’t do XYZ for a period of 6 months. Thats the info you need. The things that I would focus on with him the most is learning to move properly within his limitations. What you don’t want him to do is create new movement habits around an injury that are poor yet get the job done. You want him to literally relearn how to bend, sit and stand better than he did before (as much as possible). Preserving what he still has bone, tissue and joint wise is the smartest approach to take while getting back to doing what he loves.

      The strengthening will come but the foundation needs to be improved and relearned before anything else. I would love to hear more about his situation and help in any way that I can. Email me at Fitness4BackPain@gmail.com

  21. I just turned 60. I had scoliosis and badly herniated discs and the performed a lumbar discectomy with fusion s-1 to l-3 late May 2016. I now have metal road and 4 screws inserted in back. My dr only wants me to walk but I feel very stiff and I feel like I am rusting inside. I used to do yoga before and I just want to stretch so bad because I feel so tight my legs, my hips even my feet feel tight. I am afraid to do anything to compromise the surgery and my dr. just tells me that all I need to do is walk. Any suggestions please?

    1. Hey Iza,

      For starters it’s really important to listen and trust (as much as possible) the professional you have chosen to look over you. In this case the surgery is done and whether you like the guy or not its really water under the bridge. The goal now is to understand where you are and what you should and should not do with your given situation. I would never suggest you blow medical advice off WITHOUT extensive research and other opinions from other professionals. For you specifically I would ask your doctor these questions.
      1) What is the walking going to promote?
      2) What is the next step AFTER the walking part of your recovery?
      3) What are his/her expectations for my recovery 3-6-8 months from now?

      Question his reasoning. Is he following what the textbook says or what he sees for your specific case and how your body is reacting? That’s the difference between a good and bad doctor.

      When it comes to post-procedures like this, you have to understand that even though it’s been a few months everything is still fresh. I promise you, you are NOT rusting but I can’t imagine the discomfort and stiffness. The best part about this whole thing is that walking is VERY POWERFUL. I suggest even those who have not had any kind of procedure done to walk DAILY and multiple times a day if possible.

      When you do walk, walk briskly if you can and only walk UP to your pain tolerance. If all you can do is walk for 5 minutes then stick to that every day until you can push it to 6. Seriously. You have to look at every step of your recovery as a massive stepping stone. Don’t focus on what you used to do. Just worry about whats in front of you and where you are. Walking is good, so do it. Walking is going to help loosen what may feel sticky right now. Its not yoga but its still activating muscles in the area that has been worked on without causing damage.

      Also, keep in mind that you’re not made of glass. Even with this surgery your body is strong and able/will recover from this. Your life will change as far as what you can do now vs what you used to be able to do but that’s life and that is one of the risks of surgery. You WILL have a productive and active life you just have to jump through these hoops first.

      This is not medical advice but something I would look into. I don’t think doing light stretches will compromise your surgery. BUT and a big BUT. There is a right and wrong way to stretch. If your stretching like a 70’s exercise tape than stop. Find out what stretches your doc will allow you to do and we can go over some modifications to fit your current situation. If the doc is adamant about no movement other than walking then respect that but demand a time table of when you can expect to be able to begin to progress.

      1. Hi Richard,

        I had lost the link to this page and just found it today. I thank you for taking the time to respond.

        I just had my 6 month checkup and the bones are fusing but I still not 100%. I am still stiff but he said I can do light streching, swimming, stationary bike and stay away from any heavy lifting or extreme twisting. I am doing exercises with 3 lb weights for the most part but I am happy I can do some type of exercise and to keep myself active.

        I am working on losening my body and hopefully some time in the future I hope soon, I may be able to do more. For now I am concentrating on protecting the surgery and moving as much as my body allows me. I listen to my body very carefully nowadays.

    2. i ‘m 60 to. and with a good diet,& plenty of walking 1 or 2 miles after a lite meal will knock off plenty of unwanted pounds. by the way,i ‘ve had a fusion to s-1,l-2, l-3,& l-4. still walking feels good.

      1. I had two spinal fusions within 6 months of each other. L3-4-5. Also had huge synovial cyst in spine that had to be removed before fusion. Lots of nerve damage. Walking is impossible. On a good day maybe 1/4 mile slowly. Lower back seizes and the pain is awful. Will it ever get better?
        Margee
        NJ

    1. Hey Ashley, Well the honest answer is that I am not the person who can give you that clearance. If your doc has cleared you for exercises then I would suggest you go for it but work up to it over a month or two time. For example. Start with a short brisk walk. See how your body does 1-2 days after. If you feel good then increase the distance. Keep doing this every 2-3 days and work up to a 30 min brisk walk, none stop and WITHOUT pain. If you can do that I would either suggest you try to walk for longer or add in a short jog followed by walking to end the workout. It’s all about taking it one step at a time. Your back can’t handle going from 3 years no jogging to one day jogging without consequences. At the same time your back IS NOT this brittle structure that is at risk of snapping at any moment. Have confidence in your body and its ability.
      Hope this helps!

  22. I am 11 weeks post op from an L5 S1 fusion. I am really trying hard to lose some weight at the gym. I could stand to lose atleast 30 lbs. I have just decided it was time to feel better as well as take the added weight off of my back. My doctor told me that I could excercise but to make sure it was low impact excercises. I walk with a pace and incline on the treadmill for 30 minutes and work out with the elliptical an hour a day. Honestly, im feeling great these days but was just wondering if im doing to much? I know that some excercise is good but can I overdue it with what im doing? Thanks, Shane

    1. Hey Shane,

      Thanks for reaching out dude! You can do “too much” but the cool thing is your body will typically tell you when that is. If movement makes you feel good than keep moving! As long as you don’t have any pain that gets worse then keep it up!

  23. I’m so glad I found this post. I had spinal fusion in December 2015 spanning from T2-L3; 2 rods and 28 screws. I am now just over 5 months post-op and finally to the point of feeling well enough to begin working out at the gym again. Up until now I’ve just been waking daily and only recently reached 5 miles a day. I am beginning with a personal trainer to show me modified usage of the gym equipment to stabilize my spine and strengthen my upper body, specifically my back muscles. It’s imperitive to keep these muscles healthy as they directly affect spinal strength. There are several machines I’ll never be able to use again in addition to free weights but there are still many options that I will be able to utilize and this is my main focus. It’s a lifestyle change and acceptance of our new bodies and its ability is half the battle.

    1. Love the way this is put! It’s the people that come to terms with the fact that some things may have changed but it doesn’t mean you can’t continue to improve, that see the best long term results! Glad your back on your feet! Take it slow and if it feels sketchy then it IS sketchy. Focus heavy on a neutral spine and work that core!

  24. Am looking for some answers because my surgeon does not communicate. I fixed you now go get well is his response. He is, as I hear, a great surgeon and this is my second fusion in two years. My L4,5 and S1 are now all fused together and I have rods and screws. My surgery was 12/21/2015 and I am still using a walker. Cannot walk but across the room without it. Have horrible muscle spasms on one side. Ask to go to PT for spasms. They started me with reduced weight treadmill at 60lbs but hurt too bad so reduced to 35lbs. Hook-Lying Bent Leg Lift, Unilateral Isometric Hip Flexion, Straight Leg Raises, and Bridging. He also did a therapy called Primal Reflex then put me on a vibrating table for 10 minutes. I get Charlie Horses in legs when doing the exercises. I now after 2 rounds, have severe back pain and nerve pain down my leg to my ankle which I have not had since before surgery. Can’t even lie down now without pain. Robaxin 750 does nothing nor does Tylenol. I stopped the exercises at home and am due to see the therapist on Wednesday. My first appointment was last Friday.
    Any thoughts would be greatly appreciated. I am at a loss as what to say to the therapist on Wednesday but sure not doing exercises.
    Thanks much for your time and thoughtfulness.
    Trish

    1. Hey Trish,

      I am sorry to hear about your experience. Unfortunately, surgery can be unpredictable. It sounds like your best bet would be to continue seeing a specialist you trust. Maybe not the guy who operated on you but getting different opinions as to what could be causing the nerve pain. Pain, for the most part is simple. If your experiencing nerve pain then something has trapped that specific nerve and causing irritation when in motion. Unless you have a sever neurological disorder, nerves don’t just randomly causes issues if nothing is affecting its normal function. I would be adamant About getting all the work checked and rechecked for any other source of what could be causing the pain.

      Keep me updated!

      William

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