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Physical Therapy - OMG

Cath111CCath111 Posts: 3,702
edited 06/11/2012 - 8:43 AM in Exercise and Rehab
Well, I've discovered that PT is just about as painful as surgery recovery and this has come as a great surprise to me. (PT now stands for Physical Torture for me now.)

I have a great PT team that plans on getting me back on the golf course this summer, but I don't understand how that's going to happen.

I had my second PT appointment today, Monday having been my first and mostly a consult and given a few exercises that were minor and no problem. But today, the "big guy" did some major testing on my muscles, balance, gait, sitting, etc. and I'm totally amazed at how messed up my muscles are.

So many of the things we talked about and tested I have never tried since my surgery, such as standing on one leg at a time. I simply can't. My balance is deplorable. The muscles in my back aren't working correctly, there's no support for my spine, there's additional stenosis at my L3/4 level (don't know how PT guy knows this) and during all of the moves they give me to do, my body just shakes the whole time from weakness and/or imbalance.

The reason I hurt when I walk or stand is because my body is bending my spine backwards while doing this and it's creating havoc with my facet joints. (No wonder I have to stop and bend forward so many times during my walk.) So I have to consciously pay attention to my walking and do the "duck butt" as much as I can (i.e. flex my glute muscles to bring my butt forward to compensate for what my spine is doing. My PT and I realized how difficult this is going to be when we tried some of the exercises and they caused some major pain, so we had to try alternate ways of accomplishing the same goal. The reality of what's happening is the lack of communication from my muscles and bones to my brain and everything has to be retrained. It's a horrible process and I'm going to hate every minute of it.

Right before it was time for me to leave, he put some black tape stuff on the muscles on either side of my scar that will stay on through showers and anything else, and I'm not to remove them until Sunday. He said they're kind of like little massage units that massage as I move and try to help keep my muscles from spasming.

I've never given a thought to PT and what would be involved, but I can tell you now, that when you think you're doing well and then go to PT, it's a whole other painful and discouraging section of this wonderful spiney adventure that we have to endure.

The good news: I don't have another PT appt. until next Monday. The bad news: I have a lot of exercises to do between now and then.

Hope you all are having better days. Ugh.

PS Sorry for the whining, but you're my spiney friends and I know you can understand and relate. Can someone bring me some cheese and apples, please?


  • I'll be your company!
    I started PT yesterday too! Luckily they offered to ice me after the session and STRONGLY advised I ice again when I got home. I like the idea of the tape.

    I was sore today...but more in places I didn't expect. I did the exercises at home again.

    We had to modify a few of the exercises too.

    Just curious -> you mentioned you have exercises for home. Where are you doing the ones that require you to lie down?
    My guy told me the bed was ok b/c my goal wasn't to overdo it. But not sure and I may get a yoga mat.

    I go for round 2 of what my husband refers to as "Pain & Torture" tomorrow.

    I am willing to whine with you!
  • sorry cath,
    wow sounds like you went thru so much at pt...
    it does sound like you have a well informed pt..
    just becareful i've had few different pt..throughout the yrs..that have really hurt me and i fired..
    don't let them push ya to far..
    i hope you will be golfing soon..
    good luck
    would love to know what type of things they are doing
    as far as exercise..
    wish ya the best..
    neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
    good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
    daily goal do good thing for someone.
  • dilaurodilauro ConnecticutPosts: 9,832
    Physical Therapy is a critical piece of your overall recovery period. Since it is so important, you want to make sure you have the right therapist and are using the right center:

    Its a Five Stage Process:

    One You meet with the Physical Therapist and they do an evaluation to size up what you will really need. This is important for them to do, but at the same time, I basically interview the therapist also. I need to make sure they have a patient care attitude. I check out the center itself regarding the number of therapists/technicians and what kind of equipment they have. And IF they are associated with a hospital they generally have more versed staff.

    Two Life is easy. A little massage there, some ultrasound, some ice/cold treatments, etc... If you had wine and chocolates, you might think you went to a massage spa.

    Three The PAIN. Here is when as you described it is Physical Torture. In reality you are starting to use muscles and other part of your body that has been some what dormant before surgery and after the surgery. In most situations, this should only last about 2 weeks.

    Four No Pain, No Gain... Here is the time in Physical Therapy that I sometimes object to. Therapists by nature are in super condition, so while working with someone who isnt up to their standards, you can get a little of the " Work harder, Push, more, more more"
    This is the time that may times I believe PT can do more harm then good. Talk this over with your therapist and if needed your doctor. There are certain things we just can not do and should not do.

    Five The Discharge! Here is when they will release you from therapy. Many times that happens when the therapist feels that no additional progress is being made for your condition... Thats ok, take the honorable discharge and just start to do the exercises they told you about and do it at home

    You will come through and you should feel better when its over
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Mine used to do this thing where he got up on a stool and used his elbow to try to stretch out one muscle I have that is in permanent spasm. His ELBOW! Man, my lamaze breathing came in handy there!
  • Boy Cath, I can really relate to what you went through. The same thing happened to me a few weeks ago, I knew I had leg weakness, but didn't know how bad until I started PT. I know it seems overwhelming but hang in there! The good news is muscle has memory, so it is so much easier to regain muscle than to originally build it. You are young, healthy so your rehab should go well.

    My other words of advice come from being on both sides of the fence, as the patient and as the therapist. Not all therapists believe that pain equalls gain and a great many will help to explore pain, helping those who are unable to be able to identify muscle pain, from nerve pain and spasm pain. Just as there are many differences between spinal surgeons, there are many differences in therapists. You want to be able to have a comfort and trust level with your therapist with open communication.

    I have often joked that it is a good thing that I switched from working with adults to babies as now that I am a back patient myself, I am probably way too patient to be theraputic. I would probably say, "I know it's hard, let's take a rest....." ha !

    Take care and I hope this week's PT sessions aren't too bad! Shari
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    I don't know when the surgeon will start me. But youre scaring me! :jawdrop:
    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!
  • Cath,
    How about I spin it the other way? I know it doesn't like it feels but... When you go to PT part of it is to massage some tight or strained muscles and help alleviate your pain. The bigger part is to find out exactly what muscles haven't been doing there job. They were failing to do that either because of mixed signals, lack of help from other muscles who went on vacation, etc...

    So now the PT finds sets of exercises to help them start to work as a team again. While they aren't necessarily fun. They help get this coordination moving. That in turn helps hold your spine properly. Which in turn helps Cath stand up and walk correctly. Voila!!!

    Yeah I know, rah, rah, pep talk. I believe in the PT and do it. I also believe that Pilates works. Believe me when I say that is a big stretch for me (pun intended)... :-)

    Now if you see them show up with this T-bar looking stick. If you can run do so, if not just start sobbing immediately. Maybe they'll show some mercy on you. I know my PT went from being this great gal to that mean b1tch in a flash!!! Only 2 things bring me to tears. That stick and rap music. Holy mother of God I almost peed myself!!! LOL
  • my physical terrorist. She definitely has a religious gyhad against my core muscles and if she gets any idea that something is too easy just watch out, you know that at least 10 more minutes of exercise is coming my way next time.
  • Well, ok, there was pain, but there WAS gain. Whew. All the exercises they gave me to do at home, well, I tried to be diligent about them, but it's very difficult to do them 2 or 3 times a day, and I did them mostly just once a day, and yes, I felt guilty.

    However, there was definitely some improvement yesterday. The good part is that there are some exercises that I don't have to do any more and the bad part is that the ones I have to do now are even more difficult. Imagine that?

    One odd thing, Happy, I can relate to the elbow thing here, is that the muscle in my lower back above my left bun was so tight that it was making my left leg shorter than my right leg. So, I don't know if he used his elbow or not, but he pressed the you-know-what out of it and man, that hurt. It hurt while he was doing it and it hurts today. I'd be surprised if there wasn't a bruise. However, in some ways it also feels better.

    DNice, I just do my stuff on the living room carpet.

    Shari, my PT is located in the Spine Center where my surgeon, PA and physio are all located. I don't think I could feel more comfortable with them knowing they can talk to my surgeon any time. When he did the thing that hurt my left side, he gave me a stretch to do to help it out and it did. He warned me to ONLY do it on that side, though.

    The PT guy said yesterday that they're pushing me pretty hard right now because they're going to start work on my neck next, so they want quick improvement with my lumbar to get to my cervical. I never had PT after my ACDF due to unforseen circumstances, so I'm kind of getting a double whammy here.

    My surgeon and PA continue to prescribe me muscle relaxers, both mild and strong, and pain medications during this process, so I bless them for that.

    Graham, it's nice to have a cheerleader. Yes, I know that this has to be done and in the end it'll all be worth it and I'll probably be stronger than I ever was before, so yeah, rah rah rah, sis boom bah. But dang, getting out of bed in the morning after a PT session is a bear.

    Jim, it's a good hurt. No, really. I just want to borrow your ruby red slippers the minute I walk into the door so I can click my heels and just go back home.

    But, it's all good. When it's all said and done, I'll be able to wrestle my hubby to the ground if he tries any funny business. He's a lot bigger than me, so I can't wait to see the look on his face when I do this. Maybe I'll need some wrist braces and a headband when this is all over - "WONDERWOMAN...."

  • I just wanted to mention that if the L4 or L5 nerve has sustained damage, it can be a cause for problems with balance.
  • Just checking on you and offering support! You are so right, not only is it hard to get out of bed the day after PT, but hard to get up and go to PT! My mind says,"let's do it!", but my body just groans along!

    I am so thankful that I am off these next 2 months, so now that I am feeling better in terms of healing from surgery, I can focus on rehabing. My nerves were compressed for a long time. I have a long way to go.....but, I work with tiny preterm babies and babies with special needs, so I have to get better! :)

    Hang in there! we can do this! maybe WWF will be in our future! Ha!! :)

  • I saw my surgeon today, and will be starting physiotherapy soon.
    I was taking a look around to try to find out what to expect. Stumbled here, and now I'm scared!!

    How do you feel now Cath? Have you finished PT now, or are you still working on it?
    Did it get easier with time?

    What about you Shari? Are you finding it easier now?

    Keep healing :-)
  • Glad you stopped by. I got the all clear yesterday from my PT, i.e. no more PT for me, just home exercises. They feel they've done everything they can for me now, but I'm welcome to come back ANY TIME if I feel I need massage, or any more help at all.

    I'm at what Ron named as stage FIVE, released with maximum improvement (that doesn't mean that everything is great) but I have home exercises to do to strengthen my abs and they've given me different ways to do them so I don't get bored. I've also got some neck exercises, but that situation is not going to improve too much.

    Part of the cervical problem she said is that with the plate and eight screws in my neck, my head is heavier than it used to be or should be and my neck muscle struggle to keep my head up straight. I have to consciously work on keeping my head square to my shoulders to give my muscles relief and not put extra pressure on my cervical spine. We also don't know what will happen in the future, if anything, with my incomplete fusion at C6/7. It's ok for now.

    I have a spot on the bottom left side of my back where I have the most pain and the pain radiates out from there. Of course, some days are worse than others, but it's almost a constant. It can be so bad that it makes me limp on my left leg. PT gal said yesterday that that spot is where my hardware is and if I still have this pain in a year, it's possible the hardware will have to be removed. But that and the neck stuff is very far down the road and I'm not going to think about it right now or in the near future.

    After all the PT, I'm much stronger, I can golf (although I'm still having to practice as my swing is much different than before), and I have my first 9 holes planned a week from this coming Sunday. I'm a bit nervous about that... Anyway, my ROM, both lumbar and cervical, are at the maximum and not bad for all the fusion I've had done and hardware in my body.

    It was all worth it. Now it's up to me to keep up on the exercises to make sure that the levels above and below my fusions (especially lumbar) stay strong and don't carry too much of the burden from my L4/5 fusion.

    The thing is, it does get easier, but then the PT person knows it's easier so they take that exercise to step two which then is difficult again. Once that's easier, then on to step three of that exercise.

    But, all in all, I'd say it was worth it and I suggest that anyone who's had fusion and whose surgeon wants them to do PT, just do it. It feels good to have a stronger core and just feel like I'm in generally better health. I'm almost certain that I'll always have pain, but that comes with the fact that I have a bad spine and my goal now is to keep from having more fusion surgery. It's way too soon to say whether that will happen or not, but it's up to me to help make it so.

    Good luck on your PT. Frankly, and don't get mad at me here, I was told to do my exercises twice a day which I rarely did. I did them once a day and missed a day or two along the way, but each time I went back to PT I was stronger by their measurements and I felt stronger. So don't kill yourself - just do the best you can, make sure you "feel" it when you're exercising and do your best to take care of those core muscles that support the areas around your fusion. Muscle strength is important, but just as important is learning how to hold your body to keep the least amount of pressure off of those vulnerable parts of your body around the fusion.

    Happy PTing!

  • Do you remember how many sessions of PT you had?
    I have my first assessment session booked for Thursday next week. :O

    Hope that your improvement continues. You are now released into the real world again. How does that prospect feel? Do you have a date to return to work?
  • I think I have been going to PT 3/week for about 7-8 weeks. I've missed some visits here and there. My insurance is fabulous and I have unlimited visits and there isn't a cost to me.

    The focus is on developing my core muscles while maintainig the precautions of BLT's without pain.

    Initially, the exercises were done with me laying on the mat/table. Last Friday, I moved from the table to weight machines, but still being careful. My body didn't respond well and I had a huge amount of swelling the day.

    But, it's the old saying, "try, try again!"

    My PT is fabulous at realeigning my skeletal frame. I often get out of aleignment and by now, I usually can tell. But I can't realeign myself.

    There is some pain with PT, but the meds usually take care of it. There is also some frustration but that just goes hand and hand with a fusion. We'll be here to help you thru it!

    Therapists are just like anything else, if yours isn't a good fit for you, be sure to ask for someone else! You really want someone who you trust!

    Looking forward to hearing how your appointment goes!

  • I am looking forward to moving onto the next stage in my recovery and hopefully PT will be the route to do that.

    I don't know yet how many sessions, or how frequent they will be. the surgeon said that was up to the physiotherapist and how I progressed.
    My insurance doesn't cover outpatient physiotherapy, so I will have to pay for it, but I feel that as I don't go to the chiro any more, that will offset some of the cost.
  • Good Morning All~
    Well,pm Dr has sent me to Physical Therapy...for water aquatics and "back exercises" whatever that means. I am excited about working in the warm water but am concerned about the back exercises as I can't even bend over to tie my own shoes! Here is a question for y'all: I asked him about the treadmill and he said the very last thing he wanted me to do was walk! What the heck???!!! I mean I can't hardly walk now...that is why I wanted to try slowly on a treadmill but it it's so bad that I can't even try a treadmill what does that bode for the future?? I am really confused!
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