You may benefit from physical therapy after a lumbar laminectomy and discectomy to help you fully recover. The goals of low-back rehab after surgery are to help you regain full range of motion and strength in your spine and to help you return to your previous lifestyle.
Your physical therapist (PT) will also work with you to develop an exercise program that you can do to help prevent future problems with your spine. If you have had low back surgery, here is a step-by-step guide to what you may expect to do in physical therapy.
Your physical therapist can teach you how to sit with proper posture by using a lumbar roll to maintain your spine in the best position. The slouch-overcorrect procedure can also help you maintain proper posture for your low back.
Walking also helps to improve your cardiovascular health, keeping your heart and lungs functioning properly after lumbar surgery. The best thing about walking after back surgery is that it is an upright exercise—your spine will naturally be in a good position while you walk. This helps to protect your discs against future problems.
Starting a walking program after back surgery sounds easy; you just go out and walk, right? There may be more to it, so check in with your PT to help you set up a program tailored to your specific condition.
To perform the exercise:
Lie face down on a yoga mat on the floor and place both hands flat on the floor under your shoulders. Keep your back and your hips relaxed, and use your arms to press the upper part of your body up while allowing your lower back to remain against the floor. You should feel a slight pressure in your low back while pressing up. Hold the press-up position for 2 seconds, and then slowly lower back down to the starting position. Repeat the exercise for 10 to 15 repetitions.
One great exercise to help improve your low-back strength is the prone straight leg raise (SLR) exercise.
To perform the exercise:
Lie on your stomach (prone), tighten your abdominal muscles, and slowly lift one leg up in the air. Hold the straight leg up for 2 seconds, and then slowly lower it down. Repeat for 10 to 15 repetitions.
The prone SLR can be performed once or twice a day, but be sure to check in with your physical therapist before starting the exercise to ensure that it is safe for you to do.
After your lumbar laminectomy and discectomy surgery, your physical therapist may prescribe specific exercises, called sciatic nerve glides, to help stretch and improve the way your sciatic nerve moves in your back. This can help free the adhered nerve root and allow for normal motion to occur.
To perform sciatic nerve gliding:
Lie on your back and bend one knee up. Grab underneath your knee with your hands, and then straighten your knee while supporting it with your hands. Once your knee is fully straightened, flex and extend your ankle about 5 times, and then return to the starting position. Repeat the sciatic nerve glide 10 times.
The exercise can be performed several times to help improve the way your sciatic nerve moves and glides in your low back and leg.
Supine lumbar flexion is one of the simplest things to do to improve your lumbar flexion ROM after low back surgery. To perform the exercise:
Lie on your back with your knees bent. Slowly lift your bent knees up towards your chest, and grasp your knees with both hands. Gently pull your knees toward your chest, and hold the position for 1 or 2 seconds. Slowly lower your knees back down to the starting position. You can perform the supine lumbar flexion exercise for 10 repetitions.
Be sure to stop the exercise if you are experiencing an increase in pain in your low back, buttocks, or legs.
To perform the posterior pelvic tilt:
Lie on your back with both knees bent. Slowly rock your pelvis backward as if you are trying to flatten your low back into the floor. Tighten your abdominal muscles as you tilt your pelvis posteriorly, and hold the position for 2 seconds. Slowly release the pelvic tilt to return to the starting position. You can perform the posterior pelvic tilt for 10 to 15 repetitions.
Advanced hip strengthening exercises may be started to help you gain strength and stability in the muscles that surround your pelvic area and low back. Your physical therapist can help you decide which exercises are best for your specific condition.
Depending on your work, you may need to work on proper lifting techniques, or you may require an ergonomic evaluation if you spend time sitting at a desk or a computer terminal.
Low-back surgery, such as a lumbar laminectomy and discectomy, can be difficult to properly rehab. By working with your healthcare provider and physical therapist, you can be sure to improve your range of motion, strength, and functional mobility in order to return to your previous level of function quickly and safely.
