Meet William – fitness professional, chronic back pain warrior, and founder of Fitness 4 Back Pain. He’s been there, and he really gets it. Whether you’re in the early days of your spinal fusion recovery or a few years out (like me), he’ll walk you through the process of structuring your own at-home workout program with the safest spinal fusion exercises. I’ve learned a lot from this post, and I think you will too!
In today’s article I am going to share everything I have learned to be true when it comes to exercising after any type of spinal fusion. Not just the dos and don’ts but the hows, the whens, and the whys.
The first thing you must understand is that your situation is different than anyone else’s. Not the kind of different where you say to yourself “oh this must not apply to me” or “This can’t/won’t help me” or “I can’t do that stuff because of XYZ.” The people who see the most impact from my coaching and content are the ones who put their injury, circumstance, past surgeries, etc. aside and consider everything that I teach. What you learn here may not apply to you in exactly the way it’s being delivered, but the secret to maximizing any advice you get is remembering these two things:
If you find yourself wondering where to start or what is considered a safe exercise for you, work through this article and I promise you will have a better understanding of what’s important as well as a brighter path to walk down.
How to Become a Master at Your Own Exercise Prescription: Key Questions to Consider
Know your situation
Having T5-T10 vs L5-S1 fused are obviously two completely different scenarios. A T5-T10 fusion involves way more vertebrae and would probably require a different approach to some exercises than an L5-S1 fusion.
For a person with a T5-T10 (or similar multi-level) fusion, I would suggest you take every exercise in small dosages and adjust according to your own fusion.
I may not have you do an elbow to knee twisting core exercise at first. You would do better with something more like a dead bug, side plank, or a farmer’s carry. But just because you have more hardware in your body does NOT mean you are worse off! You just get to have more fun experimenting and modifying exercises to fit you specifically.
How well do you move?
This is where the rubber meets the road. 95% of the clients that I work with either subconsciously or intentionally skip correcting or addressing basic movement issues simply because it’s not the fun stuff or doesn’t make them “feel like they worked out.”
But if you are reading this, you’re in it for results and to gain a better understanding of what it takes to exercise after a fusion. You’re not here just to do the fun stuff. You are here to change your life and to have long-term control over your pain.
Before you do any kind of row, pull up, or push up, I need to be confident that you are able to execute some basic posture corrections and movement essentials. For the sake of this article I am going to link up some resources that you can come back to and watch.
You need to know how to reset your posture before an exercise. It’s essential to create a habit of maintaining a healthy body position. Below is a crash course on some of the most important factors in practicing body awareness and in understanding what a healthy position is. Work through these videos and practice each one and see how well you do. If you find an area in which you need improvement, spend a few weeks focusing on it until you start to see progress.
1. Body Reset
What core exercises are safe after a fusion?
This topic is an article in itself, which I will cover in the near future, but let’s cover a few things to get you started.
1. Stop carelessly bending the spine for the sake of core training. This means no more ab wheels, ab machine crunches, sit ups, leg drops, leg raises, etc.
2. Focus only on spine stabilization exercises that promote a neutral spine (especially while you build confidence and rigidity around your fusion site).
These exercises include: stability ball roll outs, modified dead bug, neutral spine single leg drops, front planks, side planks, etc.
Your number one focus when it comes to core training is to not just have a stronger core but to build more core coordination around healthy movement patterns. Poor coordination usually happens when we get lazy and allow our joints and surrounding muscles to do the job of other body parts.
For example: Years of carelessly bending leads to lower back tissue damage. A movement such as going from laying down to kneeling to standing requires the entire body and its muscle slings to work properly. Someone who is pain-free can get away with just about any kind of strategy to get off the floor. But for you, it’s very important to focus on the position of your body, spine, and core awareness. This sounds complicated but you can accomplish all of these things in the same amount of time you would use to get off the floor with terrible form.
I call this Movement Mindfulness.
Building awareness around something that you usually doesn’t pay much mind to.
What exercises SHOULD I do and NOT do after a fusion?
Instead of coming up with a master list of exercises to do and not to do (which would be impossible considering everyone’s personal situation is different) it will be more beneficial to explain how to go about approaching the exercises that you have chosen.
Before performing an exercise/workout ask yourself these 3 questions:
1. Is this exercise forcing me to bend at the site of my fusion? If so, why are you doing it? Is it because your trainer or favorite fitness workout resource said to, or is this exercise leading to an ultimate goal? There is no such thing as you “having to do it” so always look for modifications you can use to make the exercise safer and better suited for you.
2. Is this exercise/workout taking the control away from me and giving it to my stubbornness, pride, or environment? This applies to situations like CrossFit gyms, boot camp style workouts, HIT training, and in some cases even yoga. These environments are usually high energy, fun, really motivating, and challenging, BUT they are the worst environments for someone trying to introduce exercise back into their life after a fusion. I say this because if you haven’t fully recovered from your operation, it’s not in your best interest to just pick any kind of physical activity to achieve a sense of normalcy. You want to be selective and find workouts that support where you are in your journey.
3. Am I doing this exercise just to “be active?” I am all for going out and hitting the pavement on a quick jog, hike, or whatever it is that you love doing but if you have chronic pain, don’t get into the habit of doing things just to be active. When your doctor cleared you to return to exercise, he was absolutely right; but what he failed to mention is that you shouldn’t go right back into what is familiar. Rather, spend time slowly increasing the dosage of exercise to make sure that your rehab and healing are on pace to get you back to the life BEFORE your surgery. The day you get released to exercise will look totally different from before you went into surgery. This is where doctors and surgeons are failing at helping the fusion and surgery industry.
My Rules for Exercise After a Fusion
After you have asked yourself those questions I suggest following these next few rules of thumb (if you are not to working with a coach).
1. Don’t load the spine doing things like squats or deadlifts (if this is even in your routine). I am not saying you will never be able to load the spine or that loading the spine is dangerous. Early in your recovery, getting back into exercise needs to be calculated. Doing these types of exercises too soon can have a negative impact on your recovery.
2. Don’t just do machines. Machines don’t teach your entire body how to work together. Go to the dumbbell section and explore movement with free weights. It doesn’t have to be much weight at all.
3. Don’t just do what “feels good.” Most of the time I see people doing a lot of stretching and bending over repeatedly because they say the stretch feels good on the spine. They get a little relief but the pain always returns within an hour or so. This is a false sense of relief and should never be repeated if the pain keeps coming back.
4. Don’t get fancy. Everyone has their own way of exercising. Some have a strong background while others are complete amateurs. It doesn’t matter where you come from; you can never go wrong with keeping things simple.
How to Structure Your Workout
If you are looking to put your own program together, here is a skeleton version of how I would typically structure someone’s routine. My coaching typically addresses other areas, like emergency modifications, mindfulness work, posture work, and movement essentials. But if you are putting together your own workout without the help of a coach, this basic structure is perfect for you.
Weeks 1-4 (or longer)
- Bodyweight only: Squats, lunges, pull ups, push ups, rows, etc. Nothing but body weight
- Foundational Core Training
Typically I would have you train 2-3 days a week, with one day of either push or pull exercises (not both), and the next day lower body exercises.
I would split the 2-3 days up into 3 full body workouts. To keep things safe and simple, I would suggest you structure your workouts like this.
Use these exercises as a foundation as your workouts progress.
Weeks 4-8 (or longer)
- Bodyweight and banded work on all the exercises you did in weeks 1-4
- Foundation to moderate level core training
Weeks 8-12 (or longer)
- Banded and weighted exercises that include the exercises above along with new modifications and ways to challenge the body in real world scenarios
- Moderate level core training
- Weighted exercises challenging old fears and pain triggers
- Moderate to advance level of core training
After reading this you will either be completely overwhelmed by all the things to consider, or crazy excited at how much power you actually have when it comes to designing a safe and effective workout program for yourself. What I suggest you do is save this article to your desktop, read back through it, and really digest each section and how it applies to your own situation.
The best place for you to start as far as a specific training program is something similar to what I’ve provide here. Start, stick to, and master the basics. Work them until you can do them pain-free. Be mindful of the dosage and don’t try to progress too fast. If it hurts to progress, see if your body adapts after a couple of days. If it doesn’t, cut back and keep building endurance on a different level. You never want to push past any kind of pain threshold. Working THROUGH pain is not what you do after a fusion.
Your focus needs to be on allowing the brain to learn to trust your body’s ability to move under basic loads and normal life situations. After a fusion the area feels stiff and tight even years after a procedure. This is primarily due to the body simply trying to protect the area and adapt to the new hardware and lack of movement. This doesn’t mean you are doomed to a life full of pain. This is just your journey that you can choose to walk down many different ways. My suggestion is to stay positive and don’t believe the lies your mind tells you. Despite the ups and downs, good days and bad days, you are training your brain just as much as your body.
To your success,
After rupturing my L5-S1 disk over 8 years ago I was told that surgery and pain meds were my only option for a “pain-free” life. I made a choice as a fitness professional to relentlessly pursue the truth to whether or not exercise could truly be the secret to getting relief. After 10+ years coaching in the fitness industry I now focus the majority of my time teaching people how to pursue their own drug- and surgery-free path to back pain relief. Aside from coaching you can find me on the Gulf Coast of Florida, surf fishing with my 2 kids and wife or eating my weight in Mexican food. For more info on me and what we have going on, you can check out www.fitness4backpain.com.