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Exercise, weight training post ACDF

Dear All,

I’m new to the forum and just wanted to try and establish what I can and cannot do in terms of exercise post ACDF.

Let me begin by providing a little background. In June 2012 I was training in the gym lifting relatively heavy weights. I was in the process of doing some military presses, which to be honest I was struggling with when after two or three reps it felt as if something in the rear of my left shoulder, for want of a better word ‘went’. There was a bit of pain but nothing too excessive initially but I immediately stopped because something felt wrong. I ended the session and throughout the day my shoulder and neck became progressively stiffer and sore. I initially thought that I had pulled a muscle trying too hard and in doing so pulled my neck hence the stiffness which I believed would wear off slowly. Unfortunately I was wrong. My neck became extremely painful over the proceeding days to the point that when I was laying down and wanted to move I had to physically place my hand underneath my head and lift to support it for any movement caused pain. I had pulsating pain in my left deltoid and arm that increased in intensity to the point that I had to physically support my left arm with my right in order to take some of the weight off it as this was causing pain. Fortunately there was some improvement after about 4 weeks but I was still experiencing fluctuating levels of pain, nipping in the neck, in the left deltoid and down through my arm including frequent involuntary twitches, spasms and pins and needles. At week 3 I sought advice from a minor injuries centre and then my local GP (doctor) at week 5 neither was able to diagnose or offer relief from my symptoms

By August 2012 I was still concerned by the lack of progress in my recovery so I visited my doctor again to discuss physical therapy. I was assigned to the local health centre physiotherapists but the sessions were far too short and made my symptoms worse. I was referred to a senior physio who examined me and then scheduled me for a MRI scan. This took place in mid-December 2012. I was then referred to see a neurosurgeon to discuss the results and possible action. This took place in mid-March 2013 but to cut a long story short whilst several discs weren’t great I had two disc levels that required attention, C5-C6 and C6-C7. I had some spinal cord restriction and nerve entrapment. This was resulting in the symptoms I’ve previously outlined as well as muscle wastage within my left rear deltoid, tricep and forearm. I also had weakness in grip and ability to lift objects with my left arm (but only in a particular range of motion and using a specific grip). There were also pins and needles in the fingers of left hand.

The proposed solution was to perform a 2 level ACDF (C5-C6 and C6-C7). This was undertaken on the 16th August 2013. No hardware or collar was required. Peek spacer implants were used to retain the new set height between the vertebra and I was back at work (desk job) after 5.5 weeks. I have seen my neurosurgeon briefly 4 weeks after surgery but no x-rays were done at that point. He was happy to discharge me and said that I could do normal activities again but just go easy. If it hurts then stop. Unfortunately this is all too vague for me and I wanted to avoid doing any further damage to my neck but also return to training when I could. Up until now (3.5 months) I have only been doing walking which I try to do an average of 2 hours/day but this is usually piece meal throughout the working week (mon-fri) as it is difficult to find time.

I did intend to return to the gym at the 3 month mark but I’m now waiting until the end of January to allow additional fusion time. I have begun to also do some very limited resistant band exercises over the last couple of weeks to try and slowly test how everything feels and begin to rebuild if possible my left rear deltoid. My problem is that I have a lack of direction in terms of what I can and cannot do by my neurosurgeon. Several attempts have been made to try and extract the additional detail from him via his secretary but this has proven fruitless. I have been doing research on the internet for returning to the gym post ACDF and there is a wealth of conflicting advice. Some say squats are fine some say squats should be avoid at all costs. The same is true for other exercises so now I’m more confused than ever. I need to know what exercises I am permitted to do and which ones should be avoided. Also if certain exercises should be avoided are there any safer alternatives? As my injury occurred in the gym I’m just wanting to be careful when I return whilst being the best I can. I apologise for the ridiculously long post but is anyone able to help me in establishing what can, should be and what shouldn’t be done within the gym post ACDF? Any help is greatly appreciated.

Cheers, Adam
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134

Comments

  • dilaurodilauro ConnecticutPosts: 10,598
    edited 11/26/2013 - 6:43 AM
    to sum it up in a few words. It depends on what your doctor approves for you. They are the only ones that can provide you with the correct advice. Getting anything here from another member, may be a guideline, but do not take it as formal medical and sound advice. What is good for one person may spell disaster for another.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Thanks, appreciate that it should be the doctors that say what I can and can't do but that is my problem. They are being distinctly vague. That is why I am trying to get some indication from those who have undergone the same procedure as me to what they were able to do and what if anything they would do differently. I suppose the difficult thing is simply that everyone is indeed different and so as you say what might be right for one wouldn't be right for someone else. However, where exercise is concerned there must some givens that apply to the vast majority ACDF-ers but any input from others would be appreciated.

    Cheers, Adam
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  • dilaurodilauro ConnecticutPosts: 10,598
    They are the ones that need to tell you what your limits are. When they are being too vague, they are not doing their job. Many times, doctors can be vague or not provide you with all the details you need. Here is where you need to really pin them down.

    Now, that does not mean coming after them with a sawed off shotgun and demanding everything. But in a tactful way present it to the doctor so that they will give you the details. Its there job to do that. If they do not give you enough details, then they could potentially just be setting you up for a problem.

    Physical Therapists are also a good source in terms of what can and can not be done after spinal surgery. I had two ACDF and my therapists told me exactly what my boundaries were. But that also worked, because I had been seeing this therapist for years and she knew my body better than I did.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Thanks Dilauro, but gaining access to the surgeon is next to impossible. Believe me I've tried. The problem is exasperated by the way the British NHS engage with private healthcare firms. The organisation that the surgeon works for were given my operation by the NHS as the waiting times and list for my operation were becoming ridiculously large.That is why I think in part they did the operation, quickly checked (well saw me at 4 weeks) and said see ya later not our problem anymore. And so we are where we are. Over the past 3 weeks I've tried several times to get any response at all from the surgeon's secretary but I feel as if my enquiries are being totally ignored. I don't have a relationship with any physiotherapist for like I said in the original post the physios who worked on me prior to the operation were community physios and only performed a limited number of sessions over several weeks (which made the situation worse). My GP was considerably out of his depth in dealing with anything to do with my neck (and to some degree also made matters worse). So whilst I'll continue to chase the surgeon (with shot gun if necessary :-) I was also looking for some indication from others on the forum as well.

    Thanks, Adam
  • told me this is not the time to think "no pain, no gain". If anything hurts, don't do it. After my fusion was fused~6 mos, they cleared me for anything I felt comfortable with, but be careful with heavy lifting. I had a 5yo 38lb child, and I could not lift him :( But I didn't train as a weightlifter either. I hope you find an exercise program that you are comfortable with and will be able to lift weights soon, but start off slow.
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  • Thanks Necksoup, slow and steady is definately going to be my mantra. I suppose I just want to know training, albeit modified slightly is indeed possible and that I will be able to improve. Have you or anyone else found your strength has returned and whether you were able to increase it post surgery?

    Cheers, Adam
  • dilaurodilauro ConnecticutPosts: 10,598
    I apologize.

    Didn't realize you were from England and have a different method of health system. Yes, I know from talking to many from England, it is very difficult to get the answers that I suggested you should go after.

    After my ACDF's, I spent most of the time with lower body exercise, even with some weights. Upper body, I was very cautious and did more with therobands and other resistance type of exercises.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • greggvaggreggva Posts: 100
    edited 11/27/2013 - 9:52 AM
    Adam - very much interested in your progress. You might check this other thread:

    http://www.spine-health.com/forum/mind-body-and-spirit/exercise-and-rehab/weight-lifting-after-acdf
    C7-T1 ACDF 12Dec2013
  • AdamGAAdamG Posts: 12
    edited 11/29/2013 - 8:58 AM
    Thanks for the replies so far, they seem to support my current cautious approach although generally I'd like to know if anyone was able to return to their pre-op (before anything went wrong) levels of fitness and strength etc. There are a lot of conflicting views out there so it is confusing. Realise that everyone's limits differ and of course these may potentially alter following an operation such as ACDF but what is possible? Are there common factors, apart from slow and steady that should be followed? Please understand I want to push myself whilst being both realistic and safe. I undertook the operation to try and improve my life not overly restrict it (if possible). I was doing that more or less before the operation.

    There are examples out there where people have been able to maintain high levels of participation and competition following ACDF (after a period of recovery and rehabilitation of course) i.e. Peyton Manning. I've also discovered this motivational video on YouTube which if you haven't seen it is well worth watching;

    Edited to remove link-

    Personally I'm not ready to give up trying to improve myself physically. I truely believe that I haven't yet reached my full potential and regardless of whether my goals need to be revised I would be extremely disappointed and genuinely upset if my current situation were not to improve. Especially if all I was able to do is just slow the onslaught of further problems. Don't mean this to sound so self centred but it is the way I feel at the moment. Any comments or advice from others appreciated.

    Cheers, Adam

    Post edited to remove link . Please review the forum rules regarding posting outside links.
    Moderator- Sandi
  • Apologies all for posting an outside link. The purpose of the link itself was simply to highlight that gains can (at least for some) be achieved post ACDF. The guy in the video was a school teacher but also the college strength coach. He also power lifted until he suffered a herniated disc. He underwent ACDF and after recovery began returning to his sport and is now surpassing his previous personal bests. It was also interesting to note that he was also 65 and improving all the time. I felt that this was all worth mentioning since it not only said you can improve after ACDF but also as you got older as well so served as a double whammy in my book. I hope this brief explanation imparts what the link was trying to achieve.

    Cheers, Adam
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