Enhancing Recovery and Regaining Function
Undergoing spine surgery is a significant step toward relieving chronic pain, improving mobility, stabilizing structural problems, addressing neurological deficits, and enhancing quality of life. However, surgery is just one component of the overall treatment plan. Recovery doesn’t end when the operation is over or even when the incision heals—it continues through a carefully tailored exercise regimen designed to restore function, improve strength, and enhance long-term outcome. An active approach to rehabilitation can mean the difference between partial and full recovery. Engaging in targeted exercises helps strengthen the muscles supporting the spine, improves flexibility, and promotes circulation, all of which contribute to a smoother and more effective recovery. Below, we explore the importance of exercise after spine surgery and provide practical suggestions for a stretching program, light weight training, and low-impact aerobic exercises.
Why Exercise Matters After Spine Surgery
Following spine surgery, a patient’s musculoskeletal system can become deconditioned due to prolonged inactivity, pain avoidance, or immobilization. This leads to muscle atrophy, joint stiffness, and diminished cardiovascular fitness. Moreover, without structured movement, scar tissue may develop in a way that restricts mobility and contributes to ongoing discomfort.
A well-designed exercise regimen helps to:
- Enhanced Recovery and Improved Circulation: Exercise promotes blood flow, delivering oxygen and nutrients to healing tissues, which reduces inflammation and accelerates recovery.
- Strengthen Core and Postural Muscles: Exercise reduces the mechanical load on the spine and prevents future injuries. Strengthening core and back muscles provides better spinal support, reducing strain on the surgical site.
- Restore Flexibility and Range of Motion: Stretching alleviates stiffness and maintains joint mobility, preventing scar tissue from limiting movement. Exercise helps counter stiffness from surgical intervention and immobility.
- Pain Management: Low-impact activities release endorphins, natural pain relievers that can reduce reliance on medications.
- Enhance Mood and Motivation: Exercise at any time mitigates the psychological effects of chronic pain or disability.
- Prevention of Future Issues: A stronger, more flexible body is less prone to re-injury or compensatory issues in other areas, such as the hips or knees.
Exercise regimens must be tailored to each patient’s specific surgery, recovery stage, and physical condition. Crucially, all exercise after spine surgery should be performed under the guidance of a physical therapist or physician and with the blessing of your surgeon, especially in the early stages of recovery. The types and intensity of activities depend on the specific surgery performed (e.g., discectomy, laminectomy, fusion) and the patient’s individual health profile.
Progressive Approach to Postoperative Exercise
Most post-spine surgery exercise programs follow a progressive, phase-based approach. In the first few weeks, the focus is on mobility and gentle movement. As healing (especially bony healing) progresses, the intensity of activity gradually increases to incorporate strength and aerobic conditioning.
Stretching Program: Restoring Flexibility and Mobility
- Stretching is a cornerstone of post-spine surgery rehabilitation, as it helps maintain flexibility, reduces muscle tension, and prevents stiffness. Begin with gentle stretches 2–3 times daily, holding each for 15–30 seconds, and avoid bouncing or forcing movements.
- Gentle stretching should begin early in the recovery process, within days after surgery, depending on your surgeon’s instructions. The goal is to reduce stiffness, improve joint range of motion, and prevent compensatory movement patterns that can lead to further strain.
- Dr. Glickman strongly encourages very early mobilization and commencement of your exercise program.
Suggested Stretches:
- Pelvic Tilts: Lying on your back with knees bent and feet flat on the ground, tighten your abdominal muscles and gently flatten the lower back against the floor. Hold for 5 seconds and then release. Repeat 10–15 times to activate the lower abdominal muscles. This strengthens the core without stressing the spine.
- Knee-to-Chest Stretch: While lying on your back, gently pull one knee to your chest, hold for 10–15 seconds, and switch legs.
- Seated Hamstring Stretch: Sit on the edge of a chair with one leg extended and the heel on the floor. Keeping your back straight, lean forward slightly until a gentle stretch is felt in the hamstring. This stretch improves lower body flexibility without straining the spine
- Alternatively, by using a towel or strap while lying down, lift one leg straight and pull gently to stretch the back of the thigh.
- Cat-Cow Pose: On all fours, slowly alternate between arching the back (cow) and rounding it (cat). This gentle movement mobilizes the spine, relieves tension, and promotes flexibility in the back.
- Child’s Pose: Kneel on the floor, sit back on the heels, and slowly lower the chest toward the ground, extending the arms forward. Rest the forehead on the floor for a gentle stretch through the lower back and hips.
Stretching should never be painful—discomfort is a sign to stop or modify the movement. Daily stretching, even for 10–15 minutes, can significantly aid in regaining flexibility and spinal alignment. Begin with 5-10 minutes of stretching sessions daily, gradually increasing duration as tolerated.
Light Weight Training: Building Core and Supportive Strength
- Core stability is fundamental to spinal health. Weak abdominal and paraspinal muscles force the spine to bear more stress, which can impair healing and cause recurrence of pain. Light resistance training helps rebuild muscular endurance and coordination without overloading healing tissues. Focus on controlled movements.
Suggested Light Weight/Resistance Exercises:
- Wall Sits: With your back against a wall, slowly slide down into a seated position, engaging your core and thighs. Hold for 10–20 seconds and repeat 3 times. You should increase the duration of hold as tolerated and based on your pre-surgery and post-operative conditioning and tolerance.
- Bridge Pose: Lying on your back with knees bent, lift your hips off the floor while keeping your shoulders grounded. Repeat several times.
- Bird-Dog Exercise: On hands and knees, extend one arm and the opposite leg while keeping the back stable, and hold for 3-5 seconds, then switch sides. Repeat 10 times each side. This exercise enhances core stability and balance.
- Seated Shoulder Press: Sit on a chair with back support, holding light dumbbells at shoulder height. Slowly press the weights overhead and lower them back down. This builds upper body strength, aiding posture.
- TheraBand Rows: Using a resistance band, perform rows to strengthen upper back muscles while keeping the spine in a neutral position. Repeat sets of 10 2-3 times as tolerated.
- Start with bodyweight or resistance bands before progressing to light dumbbells (2–10 pounds), depending on tolerance. Perform 2–3 sets of 10–15 repetitions, 2–3 times per week. Avoid heavy lifting or twisting motions that can strain the surgical site.
Low-Impact Aerobic Exercise: Boosting Cardiovascular and Functional Recovery
- Aerobic conditioning improves cardiovascular health, boosts stamina, aids in weight control, and promotes endorphin release, which enhances mood and pain tolerance, as well as reducing spinal stress.
- Begin with 10-15 minutes per day, gradually increasing to 30 minute sessions.
- After spine surgery, high-impact activities like running or jumping should be avoided until both wounds and bony structures are more healed in favor of low-impact options.
Recommended Aerobic Activities:
- Walking: The cornerstone of early recovery. Start with short, frequent walks at a comfortable pace and gradually increase distance and pace. Walking is gentle on the spine and promotes circulation.
- Stationary Biking: Offers a smooth, controlled motion that strengthens the legs and enhances cardiovascular health without jarring the spine. Use a recumbent bike for additional back support. Cycle at a moderate pace to elevate heart rate without jarring the spine.
- Swimming or Aquatic Therapy: The buoyancy of water reduces spinal loading while allowing a full range of motion. This can begin after 4-6 weeks once the wound is well healed to avoid infection. Don’t submerge your wound before it is well healed.
- Elliptical Machine: Once cleared by your physician, this can be a good intermediate step before returning to more demanding activities.
Aim for 20–30 minutes of aerobic activity every day, as tolerated. Monitor for pain or discomfort and stop immediately if symptoms arise. Some soreness or muscle aches several hours after or the next day is normal.
Staying Consistent and Listening to Your Body
Recovery timelines vary, but consistency is key. That means you should include both stretching and exercise into your day, every day for best outcome. Progress may be slow at first, and setbacks can happen. It’s vital to listen to your body—sharp pain, new neurological symptoms, or excessive fatigue are signs to stop and seek medical input. Gradual progress with patience will yield better long-term results than rushing or overexertion.
Conclusion
An exercise regimen after spine surgery is essential for optimizing recovery and restoring function. Incorporating a structured, individualized exercise regimen after spine surgery is one of the most effective ways to ensure a successful recovery. Stretching maintains flexibility, light weight training rebuilds strength, and low-impact aerobic exercise enhances endurance. Together, these activities support the spine, reduce pain, and improve overall well-being. Patients can regain function, reduce the risk of re-injury, and return to a more active, pain-free life fairly rapidly after even large spine surgeries, but especially after endoscopic or minimally invasive procedures. Patients should work closely with their healthcare team to design a safe, progressive program tailored to their needs. With consistency and care, exercise can pave the way to a stronger, healthier spine and a more active life.
