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Walking after surgery

Gretchen1GGretchen1 Posts: 105
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
I know the answer to most questions is, check with your surgeon. I have but am curious on what others have done as far as walking after lumbar fusion surgery.

I was pretty much told to walk as much as possible, my body would tell me what was too much. That, to me, seems like such an ambiguous answer.

I was totally out of shape prior to surgery from almost 2 years of not being able to do much because of the pain. I started slowly walking right after surgery and built up to 20 minutes walks, 3 times per day, in addition to walking around the house a few minutes each hour, when not sleeping of course.

I'm now in a brace, after 4 week check up, as top pedicle screws appeared to have moved a little, but bone has been growing there, and was cleared to start using the treadmill. I've been a little freaked out to move, even in the brace but have been using the treadmill with the instructions from my doctor on no incline and under 3mph. I'm now up to 20 minutes 3 times per day.

It seems from reading others posts on walking that they are doing so much more. I'm curious as to what other doctors have advised as far as how much walking is good after fusion surgery.


  • Do not make comparisons between yourself and others. Each person's situation is unique.

    That being said, I think you are doing well. I had one of those surgeons, too who gave no specific instructions. It was always "if it hurts, don't do it." The problem is you don't find out till the next day that what you were doing was too much.

    I personally think you are better off walking outside rather than on a treadmill...but if the treadmill is the only game in town, it is better than doing nothing. Do you think the amount you are doing now is too much? Are you more sore the following day? If so, you should cut back a bit. Otherwise, very gradually increase your time and distance...but GRADUALLY...like a minute per week...again, if you don't have more pain afterward.

    It really isn't that important at this point, to worry about how far or how long you are walking. More important is that you are stretching out those spinal nerves and bringing freshly oxygenated blood to an area that does not have a lot of blood supply going through it. You want to walk frequently so scar tissue does not have a chance to adhere to the nerves. You might be better off walking six times per day for five to ten minutes at a time rather than three longer walks...and again on flat pavement rather than on a treadmill. By its very nature, you move your body in a very repetitious manner when walking or running on a treadmill. The pace remains the same and the length of stride usually remains the same. When walking outside, it is less of a pounding on the very same muscles and soft tissue as it is less repetitive.

    Sounds like you are doing well with recovery. Be patient with yourself. It is a long process and there is little you can do to hurry along the process. Keep the "tortoise and the hare" story in mind. With spinal fusion, we are all tortoises!!

    Take good care,
  • Gretchen it sounds like you already have your answer. You were cleared for the treadmill. And you are up to 20 mins 3x a day. Doesn't sound like there is a limit to how much you can do, just the limit of no incline and under 3 mph.

    More time shouldn't be a problem. When they say your body will tell you when it's enough they are right. I would try to add a few minutes to each time or add another period during the day.
  • I am still doing one of my walks outside. I just started getting nervous because the sidewalks in my neighborhood are so uneven and I almost fell one day. We have a lot of mature trees whose roots have upended some of the sidewalks terribly. I'm not cleared to drive yet and am home alone most days so my neighborhood is the only outside game in town. I was anxious to get an okay on the treadmill since it's more convenient for me. We have a lot of steps in the house and a lot of steps to get to the sidewalk from the house. I figured I would walk more if I could use it and was right about that. I feel like I'm doing as much as I can do right now and will definitely go gradually up in time and distance. I know it's a long recovery process and was prepared for that.

    I didn't really do any walking over the weekend, except around the house, because I was waiting for my brace (stupid insurance takes forever) and actually felt more stiff and sore then when I do walk.

    I realize everyone's recovery is different and was just curious about what other's are doing as far as walking.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    4-20 min. would probably be better than increasing the time. Ive increased the time and the terrain to soon and paid for it! NOT GOOD!!!
    Good luck, Jim :''(
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Did you just get the brace due to the possibility of a loose screw?

    I understand why you want to use a treadmill. Just keep what I said about muscle stress in mind in case you start to develop pain. It's probably better to use a treadmill than having to walk hills to get in your exercise. Any incline is really not good for the healing process. It puts the vertebrae at an angle and can pull the healing that is going on apart.

    What your doctor is telling you is learn to listen to your body and to anticipate what is going to end up being damaging. The people that get into trouble later are the ones that do not absorb these lessons. They go to all the trouble of surgery and recovery, and then go right back to all their old habits.

    As you mentioned, you were inactive for years due to back and leg pain. You are deconditioned...so it doesn't make sense to jump into a big exercise program at this point. Your job is to gradually increase your walking without causing a flare-up that will take time to recover from...as you get stronger and your fusion gets stronger you can worry about building muscle strength and more stamina. For now, you walk to aid your healing not to detract from it.

    Some surgeons still hand their patients a schedule for walking that says "You must be walking one mile by X weeks, and two miles by Y weeks, etc." From everything I have read and learned, this is an old-fashioned, one-size fits all, way to approach the issue of exercise. Some people, due to nerve damage, etc. simply cannot walk far, especially at the beginning. If you are able to do more, great! But don't strive to do more than you are physically able, just because you think you "should" be doing it. It is much easier to cause problems for yourself early on than it will be later on when you are fusing. And remember, even though you may show signs of fusion early, the bone will not be dependably solid for at least a year. At that point, the more you exercise and "stress" the new bone growth, the stronger it will become...but that is something for later in the game!
  • I'm with Jim. My surgeon gave me the same basic walking answer. Do more 15-20 min sessions. Not adding time to sessions. You build up your durability and strength slowly.

    On the treadmill I was cleared for that with the same rules as you. No running and no incline. I prefer fresh air and walk outside. Depending on your treadmill would also depend on how hard it is on your spine. Mine has a floating suspension. What that does it is absorbs some of the bounce from your steps. So it helps reduce impact. Unlike walking out on the road on concrete where your body does all the giving.

    The other thing is get good shoes with good support. Whatever your favorite brand is. Also plan on replacing them more often. If you are an avid walker the material in the heel/sole will loose its absorption ability quicker. The sneakers may still look all nice and new but offer little support. I found that out after my first surgery.

  • I wasn't given a brace in the hospital or at discharge. At my first follow-up last week, the xrays showed the top 2 screws seemed to have moved a tiny bit. I was told that it also showed that bone had started filling in there but not as well as on the bottom. I only had one level fusion, L5-S1. It seemed they weren't overly concerned about the movement but that may have been because I started to panic about it and they didn't want to scare me further. So, I was given the soft corset lumbarsacral type of brace and told to wear whenever I wasn't sitting or laying down. I just wonder how women wore girdles every day! I really wish I had had the brace all along. It does help me remember not to BLT and I really feel more comfortable when up and around.

    My surgeon definitely doesn't hand out any instructions but just says to do what you feel you can manage, without the BLT, of course. He seems to err on the overly optimistic side of things though while his PA is more realistic when explaining things.

    Jim and Z, I really like the idea of adding more sessions instead of time to each one when ready. That sounds more realistic to me. And good shoes are on my shopping list for this weekend.
  • if you have a technical problem with the treadmill, you could fall, which to me...could be a diaster. My treadmill just stopped suddenly with me on it about 2 weeks ago. I had never had a problem with it before, and it is an expensive treadmill. I almost fell, and more importantly, it really scared me, and I'm 15 weeks post PLIF.

    Just something to think about...

  • My Ortho wouldnt let me use a treadmill as he felt the chances of injury from a fall were to great. So if you are able to walk outside or another indoor place( mall dept store) that would be safer. Thats just what my Ortho said, and I just followed the rules. Be Careful Take Care, Robin
  • I had that brace too! It's just like a girdle! Wear it too long and then you get gas too ;) - just a side note there LOL!!

    Treadmills scare me - I'm one for the outdoor walking too, but you just have to weigh the dangers and do your best and it's all you can do, ya know?

    It does sound like you are doing GREAT - despite the loose screws ;)
  • if I walk outside I can only do 5-10 mins and I suffer horribly the next day, even walking on even terrain! My knees are part of the problem as they swell terribly from the arthritis.

    When I walk on the treadmill, I hold onto the sides and I can walk for 15-20 mins without a flare up.
    I guess everyone is different.
    P.S. I think you're doing great, I only do 15-20 mins per day on treadmill, if i'm lucky.
    In my defense I do have young children who tend to take up a lot of my time. OR maybe i'm just lazy???
  • I just had a 2-level PLIF L4-S1 3 weeks ago and the key to walking is to just be moving around. Don't just lie around because all that will do is cause your muscles to stiffen. My Dr gave me specific instructions to not sit longer than 30 minutes...not because it will potentially harm the fusion process...but to keep the body moving. I like to sit, stand for a while, walk around the house, take a short walk around the block, etc. You don't have to have a stringent regime, unless specifically instructed by your Dr. Just keep the body moving, but don't overdo it! Muscle spasms are the worst part of the recovery and, at least in my experience thus far, walking helps manage the spasms. I also agree with everyone else...treadmills are a significant fall risk...be careful!

    Be well,

  • SpineAZSpineAZ WiscPosts: 1,084
    I use my treadmill (15 min) because I find if I walk outside, and the pain starts, now I have to turn around and go home. I'm only doing 1 to 1.5 mph so a sudden stop wouldn't likely affect me too much. Personally I am more apt to trip walking outside (I've done that so many times in my life, even when there was no reason for me to trip.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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