Exercise therapy muscle atrophy after intervertebral disc surgery. How is rehabilitation after spinal surgery? Three indirect exercises

The rehabilitation process takes from 3 months to 1 year after the operation, depending on its complexity. After 6 months, patients are advised to continue exercising on rehabilitation equipment under the supervision of an exercise therapy doctor or instructor in order to prevent recurrence of a herniated disc, for which a set of exercises is individually selected to create a muscular corset and improve blood circulation in problem areas.

The recovery period takes place under the supervision of a neurologist, who prescribes a course of drug therapy, recommends consultations of other specialists for more effective treatment.

Early rehabilitation period (from 1 to 3 months).

Do not sit for 3-6 weeks after the operation (depending on the severity of the operation).
Do not make sharp and deep movements in the spine, bending forward, to the sides, twisting movements in the lumbar spine for 1-2 months after surgery.
Do not drive and do not ride in transport in a sitting position for 2-3 months after the operation (you can drive as a reclining passenger with the seat unfolded).
Do not lift more than 3-5 kilograms for 3 months.
Within 3 months after the operation, one should not ride a bicycle, play sports (football, volleyball, basketball, tennis, etc.).
Periodically unload the spine (rest in the supine position for 20-30 minutes during the day).
Wearing a postoperative corset for no more than 3 hours a day.
It is advisable not to smoke or drink alcohol during the entire rehabilitation period. Intimate life is not contraindicated.

Rehabilitation:

As soon as the patient is allowed to walk, he should consult with an exercise therapy doctor regarding the timing of the appointment and the complex of physiotherapy exercises, which depend on the volume and nature of the surgical intervention, as well as postoperative complications. A month after an uncomplicated operation, classes are shown in the gym (not in the gym!) Under the supervision of an exercise therapy doctor, without deadlifts. Beneficial swimming.

A month after the operation, in uncomplicated cases, you can start working (the question of the timing and specific work performed is decided in each case individually with the attending physician).

Late rehabilitation period (3-6 months).

It is not recommended to lift more than 5-8 kilograms, especially without warming up and warming up the back muscles, jumping from a height, long car trips.
When going outside in bad weather: wind, rain, low temperature, it is advisable to wear a warming belt on the lumbar region.
Wearing a corset, especially for a long time, is not recommended in order to avoid atrophy of the long back muscles.

Rehabilitation:

During this period, you can carefully, under the supervision of a physiotherapist, begin the formation of a muscle corset, doing exercises to strengthen the muscles of the back.

A healthy lifestyle, smoking cessation, regular exercise in the gym, swimming, bathing, limiting weight lifting significantly reduce the risk of developing herniated discs.

To prevent back pain, you should avoid: stress, hypothermia, prolonged monotonous labor in a forced position, weight lifting, sudden movements on cold, not warmed up muscles, the appearance of excess body weight.

In addition, at any stage of rehabilitation, acupuncture and physiotherapy can be included in the complex of rehabilitation measures.

Recommended set of exercises (one month after surgery)

At first, do 1 to 5 repetitions of exercises 2 times a day, increasing to 10 repetitions of each exercise 2 times a day.
Perform exercises smoothly and slowly, without sudden movements. If during execution you feel discomfort or pain, then do not do this exercise for a while. If such sensations become persistent, you should consult a doctor.
The intensity of the load depends on how you feel. As soon as pain appears, reduce the intensity of exercise.

Exercise 1. Lie on your back. Slowly bend your knees and press to your chest, feel the tension in the gluteal muscles. Relax the gluteal muscles. Keep your legs bent for 45-60 seconds, then slowly straighten them.

Exercise 2. Lie on your back, bend your knees, hands on the floor in different directions. Raise your pelvis off the floor and hold for 10-15 seconds. Adjust the holding time to 60 seconds.

Exercise 3. Lie on your back, hands behind your head, legs bent at the knees. Turn your legs alternately, first to the right, then to the left, touching the floor with your knee; the upper body remains in a horizontal position. Hold your legs in a rotated position for up to 60 seconds.

Exercise 4. Lie on your back, bend your knees, cross your arms over your chest, press your chin to your chest. Tightening the abdominal muscles, bend forward and hold in this position for 10 seconds, then relax. Repeat 10 to 15 times, gradually increasing the number of repetitions.

Exercise 5. Starting position on the hands and legs bent at the knees. At the same time, stretch the left leg and right arm horizontally and lock in this position for 10 to 60 seconds. Repeat by raising your right arm and left leg.

Exercise 6. Starting position: lying on the stomach, arms bent at the elbow joints, lie near the head. Straightening your arms, lift your upper body and head up, bending in the lumbar region, while keeping your hips off the floor. Hold this position for 10 seconds. Get down on the floor and relax.

Exercise 7. Starting position lying on the stomach, hands under the chin. Slowly, low, lift your straight leg up without lifting your pelvis off the floor. Slowly lower your leg and repeat with the other leg.

Exercise 8. Starting position: stand on one leg, the second, straightened, put on a chair. Leaning forward, bend the knee of the leg lying on the chair, and hold in this position for 30-45 seconds. Straighten up and return to the starting position.

Physical exercises after removal of a hernia of the lumbar spine is the most important component of treatment, because surgical removal of the neoplasm is only the first step. The nature and volume of loads depends on the complexity of the operation, the location and size of the hernia, the age and health of the patient.

The patient needs rest to recover. In the early postoperative phase, he spends most of his time lying down. In the future, when physical activity becomes available with the permission of the doctor, you need to rest every 4 hours for at least 20 minutes.

When performing physical exercises and carrying objects, the load must be distributed evenly.

Physical education and drug treatment should be supplemented by proper nutrition. The attending physician will help you choose the most appropriate of the available rehabilitation measures.

Contraindications after removal of the lumbar hernia

Immediately after removal of the hernia, the patient is prohibited from:

take a sitting position for the first 2-3 weeks;
gain excess weight;
perform a number of exercises (twisting, tilting, pure hanging, amplitude movements, jumps, backbends);
stay in one position for a long time;
lift weight over 2-3 kg for the first 3 months;
attend sessions of osteopathic treatment;
perform movements without an orthopedic corset, while wearing it is also prohibited;
independently prescribe exercises and medications.

At a late stage of rehabilitation, it is allowed to lift weights less than 8 kg, while doing it correctly, by bending the arms and knees, and not by tilting. Physical education must be preceded by warming up the muscles. Wearing a corset is recommended for at least 4 hours a day. Travel in transport should be limited, as shaking negatively affects the rehabilitation process.

Recovery steps

The intensity of gymnastics after a hernia of the spine depends on the amount of time that has passed since the operation. There are the following postoperative stages:

early (up to 2 weeks);
late (from 2 weeks to 2 months);
regular, sometimes it is also called delayed or distant (from 2 months to the end of life).

In each recovery period, different kinds of tasks are set.

Early

At the early postoperative stage, the priority is to eliminate pain, swelling and prevent complications. The first days after the operation are spent in bed rest, the patient receives intensive medical treatment. To avoid complications, an orthopedic corset is used. Training at this stage is practiced little, since rest helps to eliminate the swelling of the spinal roots as soon as possible.

Late

The late period is aimed at the physical and psychological adaptation of the patient, at which time exercise therapy is gradually introduced. At first, exercises are selected empirically, focusing on sensations. If the patient experiences pain, then such exercises are abandoned. Physical activity of the first month after the operation is aimed at restoring the mobility of the lower back and the tone of the muscles of the whole body. In the remote period, a person continues to practice selected exercises to maintain back health and prevent relapses.

Basic set of exercises

Exercise therapy is administered 4-5 weeks after hernia removal, but there are exceptions. Most of the exercises are performed in the supine position, which helps to avoid overwork and injury. The necessary conditions for achieving results are the regularity of performance and the absence of sudden movements. The number of repetitions increases gradually, starting from 1-2 times a day, and is brought up to 10-15 times.

Lying on your back:

arms extended along the body. At the same time, clench your palms into fists, pull your feet towards you, raise your head. Return to starting position;
arms extended to the sides, palms facing up. Without lifting your hips, stretch your right hand to your left. Return to starting position and repeat on the other hand;
connect the feet, bend the knees and squeeze an object between them, for example, a small ball. Release compression, return to IP;
spread your arms to the sides. Resting your feet on the floor, raise your pelvis.

Lying on the right side:

align the body, the right hand under the head, the left rests on the floor. As you exhale, pull your knees to your stomach, while inhaling straighten. Repeat the exercise on the left side;
inhale to raise the left leg, exhale to lower. Repeat the exercise on the left side.

Therapeutic exercise in rehabilitation after spinal injuries and spinal operations

Exercise therapy is a whole complex of physical exercises aimed at restoring motor activity after various diseases and operations. Exercise therapy is used in the rehabilitation complex for many conditions, but mainly when physical activity suffers, for example, with strokes, heart diseases, as well as diseases of the musculoskeletal system, surgical interventions on the joints and spine, as well as in a complex of conservative treatment degenerative diseases of the spine.

Therapeutic exercises help improve microcirculation in tissues, blood circulation in muscles, and normalize metabolism. A properly selected set of physical exercises allows the patient to develop a muscular corset, and in addition, the tonic effect of exercise therapy on the patient's psyche is also known.

All exercises from the exercise therapy complex should be performed carefully and slowly, without any sudden movements. The load should be increased gradually, under the supervision of a rehabilitation physician. For each patient, an individual set of exercise therapy exercises is selected.

When doing exercise therapy, exercises should be carried out until mild pain appears, the patient should not experience any discomfort or severe pain during exercise therapy. Physical exercises are carried out without load on the intervertebral discs.

The correct implementation of a set of exercise therapy exercises allows you to strengthen the muscles of the spine, which plays an important role in the stability of the spinal column. A rehabilitation doctor will explain to you the mistakes in performing certain exercises.

The main principle of exercise therapy after spinal surgery is the gradualness and regularity of exercises. Do not rush to start new more difficult exercises. Strictly observe the sequence of exercises and the increase in load that the doctor has determined for you.

All exercises from the exercise therapy complex are performed 2-3 times a week, and in some cases daily.

General provisions when performing exercises of the exercise therapy complex

correct breathing during exercises, inhalation is carried out by the nose, and exhalation is 2 times longer than inhalation, is carried out by the mouth (lips "tube")
after each movement, return to the starting position
the load during exercises increases gradually due to the number of repetitions of each exercise, but not the intensity
exercises start with 1 - 2 approaches, gradually adding approaches to 10 - 15
control of the correctness of the exercises - this is pain in the back, exercises should be carried out before the onset of pain, but not cause the pain itself
if possible, do the exercises 2 times a day, replacing the second time with the exercises of the next period
some types of exercises are not recommended after spinal surgery, for example, just hangs on the horizontal bar, backward bends of the spine, side bends, sharp turns of the torso along the axis.

Here is an approximate set of exercises that are performed by patients during the first month after spinal surgery.

Exercises lying on your back

Starting position (I.P.), lying on your back, arms along the body:

clench your palms into a fist, feet on yourself, raise your head at the same time

all at the same time return to its original position

I.P., legs bent at the knees and widely spaced:

tilt the right knee to the left heel without lifting the shoulder

return to original position

repeat the same with the left knee

I.P., arms to the sides, palms up:

with the right hand, reach (reach out) the left palm without tearing off the hips.

return to original position

repeat the same with the left hand

I.P., legs bent, feet together, any object between the knees:

to crush with your knees an enclosed object (or without an object)

relaxation

I.P.:

push the plane on which you are

relaxation

I.P.:

press with your feet (alternately) the plane you are on (feet on yourself)

relaxation

I.P., arms to the sides:

inhale, hug the left - right (alternately) leg, bent at the knee, and pull it up to the raised head (to the forehead or chin)

Exhalation

I.P., legs bent at the knees and widely spaced:

raising the head and shoulder girdle, hands try to reach the knees

return to starting position

relieve the load by slightly swaying the knees to the sides.

I.P.:

put the palms together over the chest and press

relaxation

when repeating, change the height of the position of the palms

I.P.:

grab the fingers of the palms with a hook and stretch

relaxation

I.P., legs slightly wider:

turn feet inward and outward

relax

I.P.:

arms along the body, feet on ourselves, stretch - inhale

relaxation - exhale

I.P., legs bent at the knees, hands at the elbows:

raise the pelvis - inhale

lower - exhale

I.P., legs bent at the knees, arms straight along the body:

bend knees to the right, turn the head to the left and vice versa

relax

I.P.:

Bicycle exercise. First with one foot, only later with two.

Exercises lying on your side

I.P., lying on the right side, the body is straight, the right hand is under the annual, with the left hand the emphasis is in front of you in the plane:

pull both knees to the stomach - exhale;

straighten up - inhale.

I.P.:

raise the left leg up - inhale;

lower - exhale.

I.P.:

lower

I.P. on the left side:

raise both straight legs up (low)

lower.

Exercise lying on the stomach

I.P. lying on the stomach, chin on hands, elbows to the sides:

straighten your knees, feet on yourself (supporting your feet on the floor), raise your knees up, straining your buttocks

return to starting position

I.P. hands forward, head on the plane:

raise your right arm, left leg and head up (stretch)

Exercise therapy after spinal hernia surgery in the lumbar region is mandatory for all patients. The objective of this event is to achieve immobilization of the area of the spinal column that has undergone surgical intervention and at the same time increase the mobility of other parts of the body. Exercises should be performed regularly, and the load is increased gradually. Since the consequences of the operation on the lumbar region will manifest themselves throughout life, therapeutic exercises should be performed daily to prevent the occurrence of hernias.

The role of restoration measures

Treatment of a herniated disc is not limited to surgery. After the intervention, the patient will suffer from discomfort for a long time due to pain in the lumbar region and a decrease in sensitivity. During this period, the nerve fibers continue to be irritated, which is due to the inflammatory process. Therefore, the combination of drug treatment, mechanotherapy and physiotherapy will reduce the rehabilitation time and improve the health of the patient.
The tasks of the rehabilitation period are as follows:

eliminate pain in the lumbar region and neurological symptoms;
relieve physical stress and restrictions in the domestic sphere;
restore the functionality of the spinal column;
achieve positive dynamics and stabilization of the patient's condition.

General principles of therapeutic exercises

Rehabilitation therapeutic exercises after surgery on the lumbar spine is a set of special exercises. The purpose of such physical education is:

normalization of the tone of the muscular corset of the trunk, limbs and neck;
prevention of edema and adhesions by stimulating blood circulation;
improving the elasticity of the ligamentous apparatus that fixes the vertebrae, especially in the lumbar region.

The rehabilitation specialist and the attending physician determine which exercises should be performed in this case, as well as the number of repetitions of each of them.

Early period

They begin to carry out exercise therapy after removal of the intervertebral hernia in the first days in a supine position. During the first month, all classes are held only lying down. It is important to avoid tension, sudden movements. During such a charge, there should be no discomfort in the lumbar region.

It is normal if the gymnastics is accompanied by slight pain in the hip joint or other part of the leg, but the lumbar region should not hurt.

During the first 14 days after surgery, the main task is to prevent the spread of edema in the lumbar region and reduce the existing one, relieve pain. To prevent displacement of the vertebrae, patients should wear special corsets with metal inserts.

Lying exercises

During the rehabilitation period, patients are prescribed the following exercises:

Lie on your back and place your arms parallel to your body. Clench your fists. At the same time, raise your head and pull your feet towards you.
Spread legs wide bent at the knees. Alternately press the right knee to the left heel and vice versa. In this case, you need to monitor the immobility of the upper body.
Lying on your back, spread your arms out to the sides, palms up. Try to reach with your fingers to the palm of the opposite hand. Make sure that the hips remain pressed to the bed.
Bend your knees and bring your feet together. Place a ball or small pillow between your knees and squeeze them with force.
Lying down, rest your palms on the bed and press hard on it.
Pull the feet towards you, alternating legs.
Spread your arms to the sides, inhale and raise your head, press the leg bent at the knee to the body and pull it tight with your hands. Exhale. Repeat with the second leg.
Spread your legs bent at the knees wide and try to reach them with your hands, raising your head and shoulders.
Raise your hands, joining your palms above your chest, squeeze your hands with an effort, relax, lower them and repeat again.
Grab the bent fingers with the fingers of the other hand, pull them in different directions, relax.
Spread your legs, turn them inward and return to their original position, relax.
Pull the feet towards you, after a short rest, repeat the exercise.
Bend your arms at the elbows, legs at the knees. Raise the pelvis, leaning on the limbs. Inhale to raise the torso, exhale to lower.
Turn the legs bent at the knees to the right simultaneously with the turn of the head. Repeat on the other side.
Do the “bicycle” exercise with each leg separately.

Exercise therapy for the lumbar spine of the back with hernias, rehabilitation after surgery

Medical prohibitions

There are a number of restrictions that should be taken into account when doing physical therapy:

the pace of the exercises is slow, the movements should be smooth and careful;
exclude turns, tilts, twists and sudden movements, especially in the lumbar region;
pain is a signal to stop exercising or reduce the load;
constant pain when exercising is a reason to see a doctor if pain is fettering the lumbar region.

The postoperative period should be under the comprehensive supervision of highly specialized specialists, including a rehabilitation specialist, a neurologist and a surgeon. The patient is advised to wear a corset to prevent complications.

The patient is forbidden to lift more than 3 kg with one hand during the 3 months of the postoperative period.

Staying in a sitting position at this stage should also be limited. Refusal of bad habits and outdoor games is required for the entire recovery period.

Features of exercise therapy in the late period

The late period lasts from 3 to 6 months after the operation. At this time, in order not to cause unwanted changes and preserve the lumbar spine, it is not recommended to sit. Therapeutic gymnastics includes more exercises. It is useful to swim in the pool to relieve tension in the lumbar region. Physiotherapy can speed up recovery.

Gymnastics on the side and stomach

Performing a set of exercises on the side for the lumbar region represents such a sequence of actions.

The role of restoration measures

eliminate pain in the lumbar region and neurological symptoms;
relieve physical stress and restrictions in the domestic sphere;
restore the functionality of the spinal column;
achieve positive dynamics and stabilization of the patient's condition.

General principles of therapeutic exercises

Rehabilitation therapeutic exercises after surgery on the lumbar spine is a set of special exercises. The purpose of such physical education is:

normalization of the tone of the muscular corset of the trunk, limbs and neck;
prevention of edema and adhesions by stimulating blood circulation;
improving the elasticity of the ligamentous apparatus that fixes the vertebrae, especially in the lumbar region.

The rehabilitation specialist and the attending physician determine which exercises should be performed in this case, as well as the number of repetitions of each of them.

Early period

It is normal if the gymnastics is accompanied by slight pain in the hip joint or other part of the leg, but the lumbar region should not hurt.

Lying exercises

During the rehabilitation period, patients are prescribed the following exercises:

Lie on your back and place your arms parallel to your body. Clench your fists. At the same time, raise your head and pull your feet towards you.
Spread legs wide bent at the knees. Alternately press the right knee to the left heel and vice versa. In this case, you need to monitor the immobility of the upper body.
Lying on your back, spread your arms out to the sides, palms up. Try to reach with your fingers to the palm of the opposite hand. Make sure that the hips remain pressed to the bed.
Bend your knees and bring your feet together. Place a ball or small pillow between your knees and squeeze them with force.
Lying down, rest your palms on the bed and press hard on it.
Pull the feet towards you, alternating legs.
Spread your arms to the sides, inhale and raise your head, press the leg bent at the knee to the body and pull it tight with your hands. Exhale. Repeat with the second leg.
Spread your legs bent at the knees wide and try to reach them with your hands, raising your head and shoulders.
Raise your hands, joining your palms above your chest, squeeze your hands with an effort, relax, lower them and repeat again.
Grab the bent fingers with the fingers of the other hand, pull them in different directions, relax.
Spread your legs, turn them inward and return to their original position, relax.
Pull the feet towards you, after a short rest, repeat the exercise.
Bend your arms at the elbows, legs at the knees. Raise the pelvis, leaning on the limbs. Inhale to raise the torso, exhale to lower.
Turn the legs bent at the knees to the right simultaneously with the turn of the head. Repeat on the other side.
Do the “bicycle” exercise with each leg separately.

Exercise therapy for the lumbar spine of the back with hernias, rehabilitation after surgery

Medical prohibitions

There are a number of restrictions that should be taken into account when doing physical therapy:

the pace of the exercises is slow, the movements should be smooth and careful;
exclude turns, tilts, twists and sudden movements, especially in the lumbar region;
pain is a signal to stop exercising or reduce the load;
constant pain when exercising is a reason to see a doctor if pain is fettering the lumbar region.

The patient is forbidden to lift more than 3 kg with one hand during the 3 months of the postoperative period.

Staying in a sitting position at this stage should also be limited. Refusal of bad habits and outdoor games is required for the entire recovery period.

Features of exercise therapy in the late period

Gymnastics on the side and stomach

Performing a set of exercises on the side for the lumbar region represents such a sequence of actions.