Scribd
Upload
238 views4 pages

Lumbar Microdiscectomy Postoperative Physiotherapy and Rehabilitation

This document outlines a 3-phase physiotherapy and rehabilitation plan following lumbar microdiscectomy surgery. Phase 1 focuses on reducing pain and inflammation, improving posture and core muscle function, and initiating walking. Phase 2 emphasizes light strengthening exercises while maintaining proper form. The goals are improved endurance, flexibility, and independent lifting. Phase 3 progresses strengthening and aims to return patients to baseline activities safely within 8-12 weeks through advanced exercises and education on lifelong back care.

Uploaded by

funkyhonky
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
238 views4 pages

Lumbar Microdiscectomy Postoperative Physiotherapy and Rehabilitation

This document outlines a 3-phase physiotherapy and rehabilitation plan following lumbar microdiscectomy surgery. Phase 1 focuses on reducing pain and inflammation, improving posture and core muscle function, and initiating walking. Phase 2 emphasizes light strengthening exercises while maintaining proper form. The goals are improved endurance, flexibility, and independent lifting. Phase 3 progresses strengthening and aims to return patients to baseline activities safely within 8-12 weeks through advanced exercises and education on lifelong back care.

Uploaded by

funkyhonky
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

Lumbar Microdiscectomy PostOperative

Physiotherapy and Rehabilitation


Phase I (0 to 2 Weeks): Protective Phase
Precautions
 Avoid twisting back , lifting and carrying objects of greater than 10kg
 Sitting needs to be no longer than 30 mins and broken up with standing
breaks. Patient needs to be taught to sit in correct posture.
Goals
 Reduce pain and inflammation around the back and radiating pain down into
the lower limbs. Via (education, ice, modalities , TENS , soft tissue )
 Patient understands and can do correct bio-mechanics, transfers, positioning.
 Able to have correct muscle firing for transverse abdominals, multifidus and
gluteal muscles.
 Able to have a daily walking program and can tolerate 10 minutes of walking.
Education
 Postural Education: Upright sitting posture, correct standing posture
 Sleeping Education: Sleeping positions that limit discomfort and can help
prevent future problems
Exercises
 Walking Program: Start aiming to walk for 10 mins at least 1-3 times a day
 Transverse Abdominal contraction: 7-10 seconds of a isometric contraction
 Multifidus 7-10 seconds of an isometric contraction (if able to tolerate)
 Glute Squeezes: 7-10 seconds of a isometric contraction, teach correct
gluteal firing pattern, to prevent overactive hamstrings
 Light Stretching: Hip Flexors, quads, hamstring, calves, adductors

Phase 2 (2 to 6 Weeks): Initial Strengthening Phase


Precautions
 Strengthening should be performed in neutral spine.
 During exercise there should be a focus on neuromuscular control.
Progression in difficulty should be stopped limited if neuromuscular control is
poor.
 Lifting: start lifting above 10kg but caution needs to be taken and a review
from the therapist needs to be completed to see if patient is suitable.
Goals
 Patient able to complete light resistance exercise, while maintaining correct
bio-mechanics and good muscle contraction of core and gluteal muscles.
 Improve patient’s cardio-vascular endurance, able to do a form of exercise for
20-30 mins
 Improve soft tissue function and prevent muscle tightness, joint stiffness and
scar tissue formation.
 Independent and safe lifting mechanics
Cardio
 Walking: At least 30 minutes (depends on patient’s pre-op level)
 Stationary Bike:
1. Recumbent bike: Can start in 2 weeks
2. Upright bike (no resistance): 4 weeks
3. Upright bike (resistance): 6 weeks
Strength
Only commence phase 2, once the patient can complete exercises given in phase 1.
Then begin with light resistance and progress in conjunction with patient’s level of
fitness, compliance, pain levels and mood. Persistent emphasis on ideal bio-
mechanics during each exercise and correct muscle contraction of core and gluteal
muscles.
 Matt work (supine, prone, bird dog) isometrics (Trans abdominals and
Multifidus)
 Progress with lower/upper limb movements (eg,leg raises variations, upper
limb circles, etc.)
 Progress to weight bearing, balance, gym Ball, reformer, proprioceptive
exercises, hydrotherapy etc.
 Progress glut med/max strengthening Eg.: prone hip extensions (with correct
firing patterns, clams, side lying abduction, donkey kicks, bird-dog, hip
hitches, crab walks , balancing exercises etc
 Upper body and lower body strength training: squats variations, leg press,
steps ups, upper body light resistive exercises (machines, Theraband, free
weights, use of gym ball)
 Balance (emphasis on core muscle activation): single leg stand, tandem,
toe and heel walking, dynamic walking, standing on foam
 Pilates is recommended over yoga. Instructors need to be experienced with
spinal conditions

Flexibility
 Stretching Lower body: Hamstrings, gastroc/soleus, quadriceps, hip flexors,
piriformis, etc.
 Stretching upper Limb : latissimus Dorsi, pectoral muscles, anterior neck
muscles, Upper fibres of traps
 Neural Mobilisation: Performed as needed, gentle with caution
Manual therapy
 Soft tissue: improve tissue length, reduce muscle fatigue, improve pain,
improve muscle spams
 Joint mobilisations: Should be performed on hypo-mobile joints, do not
mobiles vertebrae that have gone under surgery
 Cross Friction: prevent scar tissue formation
 Passive stretches: muscles that have undergone shortening due to
compensation and pathology
Phase III (6 to 8 Weeks): Progression to Advanced
Strengthening
Therapy
Goals
 Able to independently and safely complete home exercise program (HEP), to
aid progression back to sport/hobbies
 Continue to progress strengthen whole body: while continuing to correctly
activate spinal stabilisers and gluteal muscles.
 Able to go back to baseline function
 Possible phased returned to work if their job requires frequent: heavy lifting,
sitting or travelling
 Possible requirements need to be met before, work re-commences e.g: desk
space alterations, frequent breaks or extra assistance etc.
Education
 Patient should be aware that once having lower back pain, they are always
under risk of having exacerbations and so need to be cautious and monitor
their back consistently.
 Stiffness tends to be the first sign of exacerbations. If stiffness occurs patient
should go back to initial exercise and pain management plan, if continues see
physiotherapist or surgeon.
 Patient should understand that they need to look after their back by:
continuing their exercise plan, not staying in a rested position for long periods,
avoid frequent heavy lifting and understand good bio-mechanics and posture
Cardio
 When initiating running and sports below, slowly increase in the 8 to 12 week
time frame.
 Make sure there has been an emphasis on correct form and machine set up
when starting to increase cardio vascular set up.

No Earlier Than:

Walking Continue to progress

Stationary Bike Add resistance


Swimming Six weeks

four weeks (start with low level classes or


Pilates
one to one sessions)

Hiking Six weeks

Elliptical Five weeks

No Earlier Than:

Outdoor Biking Six weeks

Skiing Eight weeks

Yoga Eight weeks

Running 8 to 12 weeks

Soccer/Basketball/netbal
8 to 12 weeks
l

Golf 8 to 12 weeks

 Each patient is will have different levels of fitness, strength, attitude, recovery
and compliance. Due to this each patients return time to hobby or sport can
vary
Strength
 Advanced core strength training
 Progress to weight bearing, balance, Swiss Ball, reformer, bosu ball etc.
 Progress upper body and lower body strengthening
 Increase complexity with increased multi-planar movements of the upper and
lower limbs
 Begin running program with progression and education on form.
 Start agility drills
 Plyometric exercises

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy