The operation to cut out an intervertebral hernia is considered quite complex, and after it a full rehabilitation period of up to several months is required. At this time, the patient must carefully follow the doctor’s instructions to avoid relapse and speed up the restoration of full mobility.

How does rehabilitation proceed?

An effective rehabilitation period after removal of an intervertebral hernia occurs in three stages:

1. Early - duration from a week to two. Designed to eliminate pain, therapeutic and psychological support for the patient.

2. Late - duration from two weeks to two months. Helps to fully adapt to normal life.

3. Delayed period - two months after the surgeon’s intervention. Continues until complete recovery and restoration of vital functions.

During rehabilitation after surgery to remove an intervertebral hernia, there are certain prohibitions in the early period: you cannot sit and lift weights for a long time, perform sharp and circular movements, perform physical exercises without a special corset and engage in any active sports.

During the late recovery period, you should not stay in one position for a long time, drive a car for a long time, jump or lift loads weighing more than 8-10 kg.

Rehabilitation complex

The rehabilitation complex includes a number of main activities:

• drug treatment;
• physiotherapy;
• mechanical relaxation of the spine;
• treatment in a sanatorium.

After surgery, people sometimes complain of back pain due to inflammation of the spinal nerve, which has been compressed for a long time. Pain may be caused by damage to tissues and ligaments during surgery. Doctors prescribe anti-inflammatory and painkillers.

As for physical therapy, it is the most important stage, which cannot be avoided. We will talk about this in more detail in this material.

Physiotherapy

Exercising after spinal hernia surgery requires the patient to be especially careful.

Basic exercises after surgery on the lumbar spine (hernia):

1. Lie face down on the floor and place your palms under your chest and spread your legs. Using your toes and palms, lift your torso, arching your back upward. At the same time, lower your head and lift your pelvis above your head. Hold the position for a few seconds and return to the original position.

2. Starting pose, as in the previous exercise. Having raised your pelvis and arched your back, turn your pelvis in a certain direction, lowering your side as low as possible, and do not move your legs. Limbs should remain straight.

3. Sit on the floor and spread your arms, resting on them and slightly bending your lower limbs. Raise your pelvis, distributing the load on your arms and legs. Do everything intensely for up to 20 repetitions.

4. Lie on your back and spread your arms and legs. Bend them at the knees and pull them to your chest, clasping them with your hands. Try to push up from your knees and hips while continuing to hold your lower limbs with your hands. Hold the position for 5 seconds.

Now you know how to perform gymnastics after removal of a hernia of the lumbar spine, and the video will help you learn more about the exercises.

Kinesiotherapy has become a new direction in exercise therapy; you can do it additionally and recover with the participation of a specialist.

Exercise therapy after surgery for a herniated disc in the lumbar region: video

Neurosurgeons who widely practice removal of spinal hernias never cease to repeat that performing high-quality manipulations on intervertebral discs is only half the successful treatment of a patient. The next stage of treatment is rehabilitation, which should be no less successful. What experts mean by this is that postoperative recovery is necessary even after a brilliantly performed hernia operation! And if rehabilitation does not proceed correctly enough or is completely absent, reviews from specialists make it clear that all the surgeon’s efforts will be in vain.

Surgeons provide high-quality surgery, but to return to duty, high-quality rehabilitation is needed.

If you want to recover quickly, approach your recovery period with full responsibility. Be guided by the recommendations of your personal attending physician, and not by your own conjectures or advice from “experienced” people who describe in detail their medical and recreational activities. By following the rehabilitation program that the operating surgeon has developed for you together with a physiotherapist and exercise therapy methodologist, you will definitely see results.

After removing the source of compression of the spinal canal, there should be no pain inhibiting movement.

With a competent postoperative approach, how long does it take for the patient to achieve the desired recovery? As practical experience shows, 90 days after surgery, but no less. The course of rehabilitation for those admitted to the surgical department with very severe neurological disorders can take up to 6 or more months, up to a year.

Anton Epifanov will talk about spinal surgery and the prospects for recovery:

Rehabilitation involves not just the healing of the surgical wound and the elimination of pain, but also the productive prevention of all possible complications, including the prevention of the most common of them – recurrence of intervertebral hernia. Without it, it is impossible to normalize the functioning of the spinal system, locomotor-support potential and central nervous system function.

Methods of rehabilitation treatment after spinal hernia surgery

The postoperative benefit that every patient is required to receive includes a whole range of procedures. Therapeutic measures are prescribed individually:

• drug treatment. The use of antibiotics against infection, anticoagulants against the formation of blood clots in the lower extremities, drugs to improve nerve conduction, and sedatives, vitamins and minerals. Only a qualified doctor selects a drug treatment regimen. This requirement also applies to any other recovery methods, which will be discussed below;
• physiotherapy. This is the basis and most important part of rehabilitation after any type of operation to eliminate hernia formation, including after minimally invasive puncture surgery methods. Special physical exercises are needed to strengthen the muscles of the back and abdominals, restore muscle strength of the limbs, and neutralize the myofascial block. Only thanks to exercise therapy can one restore the lost functions of weight bearing and normal painless mobility of the spine, and minimize the risk of recurrent disc herniation;
• physiotherapy. Among the main procedures indicated after surgical treatment of a spinal hernia, laser therapy, electrical myostimulation, UHF, electro- and phonophoresis, paraffin therapy, mud therapy, and balneotherapy are prescribed. Physiotherapeutic procedures enhance blood circulation and metabolic-trophic reactions, provide anti-inflammatory, decongestant, wound healing and analgesic effects. Physiotherapy has a profound effect, therefore it helps restore nerve tissue injured by herniation, helps stimulate nutrition and renew muscle, bone and cartilage structures;
• massage. In the early period, the upper and lower extremities are chosen for massage. Later, classical massage techniques are implemented on the back. Massaging movements must be very correct and knowledgeable, so it is not recommended for a general massage therapist or anyone close to you to do them. Massage is not performed at the site of the surgical wound! The therapeutic effect of this procedure is to activate blood flow, nutrition and metabolism, eliminate congestion, reduce muscle spasms and pain, improve motor functions, and have a positive effect on the central and peripheral nervous systems.

Rehabilitation may contain a whole range of procedures in conditions of reduced gravity - in water.

According to clinical observations, 15%-40% of people who have had a herniaectomy experience a re-exacerbation of the disease within several months or years, and in some patients immediately after the intervention. Experts associate the high percentage with poor medical rehabilitation. The use of a step-by-step recovery process, very well organized in a highly specialized medical facility, shows that this approach reduces the likelihood of relapse to the utmost minimum. It provides faster relief from neurological deficits, rapid regression of pain, active restoration of muscle strength, sensitivity of the limbs, and normal range of motion.

Sports medicine doctor Oleg Viktorovich Gusev talks about the stages and methods of rehabilitation after removal of intervertebral hernias:

The rehabilitation system in Russia is not of sufficient level. It is very difficult to find a decent institution where the patient is guaranteed to be restored according to all the standards of modern orthopedic and neurological rehabilitation. Today, as many years ago, clinics in the Czech Republic enjoy special respect and trust among patients from the CIS countries and the European Union. Everything related to orthopedics and traumatology, spinal neurosurgery and rehabilitation is the property of Czech medicine. This country is a world leader in the field of high-tech surgical and postoperative treatment of the musculoskeletal system.

The meaning of exercise after surgery

After spinal surgery, exercise should become a healthy daily habit for the patient. Special gymnastics helps to effectively relieve fatigue, restore physical activity and prevent the return of the disease. Thanks to the most affordable and highly productive type of rehabilitation, you will achieve significant progress in functional recovery and protect your spine from unwanted repeated displacement of the pulpous mass beyond the boundaries of the operated or completely different intervertebral disc.

Alexandra Bonina about the principles of exercise therapy:

Systematic therapeutic exercises will allow you to avoid a number of dangerous pathologies in the spinal system (hernias, vertebral instability, etc.) that adversely affect the functioning of the spinal cord. The spinal cord is responsible for motor, sensory and reflex abilities, respiratory functions, heart function, gastrointestinal tract, and genitourinary organs. And if they are performed from time to time (according to the mood) or ignored altogether, nothing good will come of it. The spine, which initially had a problem and was subsequently operated on, needs physical rehabilitation.

In the first period, exercises are performed only under the guidance of an experienced instructor. While a person is in the hospital, which usually lasts 3-5 days, doctors are involved in his physical recovery. But during such a short period of stay in a medical institution, the patient learns only the most primitive exercises: tense muscles, rotate and move forward/backward with the feet, bend/extend the elbows and knees. And after discharge, the person only receives a piece of paper with a list of what he is prohibited from doing. But there is not even close information about his further physical therapy. What to do?

A set of gymnastic exercises.

For the first 1.5-2 months, you need to visit a medical institution, where classes are planned and taught by a professional physical instructor. Exercise therapy is combined with physical therapy and other necessary medical treatments while your rehabilitation continues. When stable positive dynamics in your well-being are achieved, you can continue to perform the last exercise therapy complex that you stopped at and which you have mastered perfectly, at home.

As an example of what therapeutic exercises can be like in the final recovery phase and in the delayed period, we will present one of its options for your information. But first, we recommend that you read the basic rules of your daily routine, which require strict adherence throughout your life.

Lifelong rules after surgical treatment of a vertebral hernia

1. Do not lift weights exceeding 5 kg, and in the initial period, generally avoid lifting objects that weigh more than 3 kg.
2. You cannot jump from a height, even from the curb. Jumping and intense running are also contraindicated.
3. Avoid prolonged monotonous exercise in a monotonous position, do not stand or sit for too long. Sitting after surgery is generally prohibited for about 6 weeks.
4. Long trips by car are not allowed.
5. Make sure your back doesn't get cold. In the cold season, when going outside, additionally insulate the operated area, for example, put on an insulating belt or scarf.
6. Do not expose yourself to stress, because spinal pathologies and muscle spasms often have a neuropsychological root of the problem.
7. Take regular 30-minute rest breaks throughout the day, taking a horizontal body position to relieve the tired spine.
8. Control your weight: excess kilograms increase the load on the spine and increase the risk of developing unfavorable changes in its structures.
9. Train your musculoskeletal corset every day using the gymnastic complex that was recommended to you by your doctor. Active exercises begin only after preliminary warm-up.
10. Do not overuse the corset; use it during the day strictly according to your doctor’s instructions. Wearing it too long promotes muscle atrophy.
11. Get spa treatment every year(ideally twice a year). Note that for the first time it should take place approximately 3-4 months after the surgical session.

A set of exercises for complete recovery

Before using the proposed exercise system, be sure to discuss it with your doctor. Perhaps in your case it is too early to implement these tasks. The proposed complex was compiled by qualified instructors, but in our article it is offered for informational purposes. It is not a direct call for its use:

1. Slide your back along the wall, which productively works the muscles of the back and hips. To do this, you need to press your back against the wall, place your legs about 30 cm further from it and set them shoulder width apart. As if sliding down the wall, we slowly bend our legs at the knee joints, up to a maximum of 90 degrees. Rise to the starting position also smoothly. With each lowering and lifting, count to 5. The number of repetitions is 4-5 times.
   
2. Raise your lower limbs from a prone position. This tactic also strengthens the back and thigh muscles. Raise your right leg slightly above the floor (15-20 cm), holding and straining it for about 10 seconds. Then return the limb slowly to the surface, performing a similar task with the opposite leg. For each leg - 5 repetitions. Avoid excessive arching in the lumbar region, and the chest, abdomen and pelvis should be pressed tightly to the floor.
   
3. This exercise is a little similar to the previous one, but the starting position will be lying on your back. During the class, the thigh and abdominal muscles are trained. The arms are extended along the body. Raise one leg above the floor to an angle of 30 degrees, pulling the toe away from you. Hold the raised limb for 8-10 seconds, then gently lower it. Do the same with the second leg. Multiplicity - 5 times with each limb. It is important not to allow the lumbar region to lift off the floor.
   
4. Lie with your back on the floor, bend your knees, feet fully flat on the surface, at shoulder level. Gradually and smoothly (without jerking!) we lift our head and shoulders off the floor, with our hands we reach for our knees, as if partially sitting down. Hold the pose for 10 seconds, then very carefully return to i. n. Repeat 5-6 times. This tactic is mostly aimed at strengthening the abdominal muscles.
   
5. This technique relieves tension from the back. I. p. similar No. 4. Pull your knees to your chest, clasping them with your hands from below. Pull your knees gently, but as close to your chest as your physical capabilities allow. Then you need to smoothly return the limbs to the floor. Your head should not be lifted from the surface on which you are lying. After a short relaxation, do the exercise 4 more times.
   
6. Lying on your back with your knees bent and your arms extended at your sides, do pelvic lifts. Tear off the pelvic part very smoothly, slowly. Having reached the maximum possible lifting point, stay there for 2-3 seconds. Next, very gently lower yourself back, rest a little and perform a few more approaches, a maximum of 10 times. Do not turn your head to the sides or lift it off the floor, as this may lead to injury to the cervical spine. The chin should be strictly at the center of the chest, and the back of the head should be pressed to the surface. This simplified variation of the “bridge” does not overload the spine, but it perfectly trains the muscular corset of the back, abdominals, hamstrings, and buttocks.
   
7. Get on all fours. Simultaneously raise your left arm and right leg parallel to the floor. Pull the raised limbs horizontally in different directions for 10-30 seconds: arm forward, and leg backward. Then return to i. etc., change limbs and do the same. Raising opposite limbs allows you to straighten and elongate the spine, strengthen the gluteal, abdominal and posterior thigh muscles, strengthen the glenohumeral complex and cervical spine, and increase arm endurance.
   
8. This technique will be performed while standing. Stand behind a chair, grab the back of it with your hands, and move one leg back. After briefly fixing (3 seconds) your legs in an elevated position, calmly return them to the floor. Do the exercise 5 times for both legs. This type of training session is excellent for increasing muscle strength in the lower back and hips.
9. Stand in front of a low chair, move about 1 m away from it (you can stand near a bed with a low base). Place one straight leg on the chair so that the heel of the foot is located closer to the edge of the seat. The opposite leg is on the floor. Making a forward movement of the body forward, we bend the knee joint of the leg that stands on the chair seat ( similar to a lunge, but the back leg should not bend). Maintain the position of the bent limb for 15 seconds, then straighten it back. Change the leg and use a similar principle to bend it with fixation. In total, you need to complete 8 exercises. It is advisable that you use a safety net at the moment of the lunge, for example, hold on to a nearby table.

Once again we would like to draw your attention to the importance of undergoing surgery and rehabilitation, receiving specialized instructions only in medical institutions where specialists with a capital “S” practice. The Czech Republic is the strongest and most advanced country in terms of spine treatment. Prices for any high-quality medical services in the Czech Republic are the most affordable available in any other country. The patient has the opportunity to undergo an operation inexpensively and at an exemplary level, and immediately after it receive a full course of rehabilitation according to the Czech treatment program.

A set of exercises from a patient who underwent hernia removal and spinal nucleoplasty:

And even if a person was operated on not in the Czech Republic, he can count on the fact that he will not be denied attention and care, will be warmly received and will organize all the necessary recovery measures in the world’s best rehabilitation center (or sanatorium). By the way, this country has the widest network of rehabilitation centers and sanatorium-resort institutions specializing in restorative and health-improving therapy of the musculoskeletal system.

Hernia removal is a last resort measure used to treat a damaged intervertebral disc. After such an operation, the patient’s motor functions, which depend on the spine, are significantly limited, and in order to regain the ability to lead a relatively active life, it is necessary to undergo a course of competent rehabilitation.

Purpose of rehabilitation

After surgery to remove an intervertebral hernia, the treatment process cannot be considered complete. Even though surgery has been completed, the patient may experience neurological, pain, and sensory symptoms for a long time. This is explained by the fact that prolonged pressure of the hernia on the nerve endings led to the development of tumor and irritation, which remain after removal of the damaged part of the intervertebral disc.

For this reason, it is necessary to carry out competent rehabilitation, which will have specific goals:

• stabilization of the patient’s condition and subsequent elimination of household restrictions;
• restoration of the integrity of the body;
• eliminating restrictions on physical activity;
• neutralization of neurological symptoms and pain syndromes.

When choosing specific rehabilitation techniques, the doctor takes into account various factors. Depending on the complexity of the operation, the rehabilitation period can last up to 12 months.

Recovery after surgery to remove an intervertebral hernia usually involves physiotherapeutic procedures, drug treatment, therapeutic exercises and a visit to a sanatorium.

Principles of rehabilitation

If the recovery period is organized correctly, then the following principles should be implemented:

• procedures for a particular patient are selected competently, taking into account his individual characteristics;
• Comprehensive monitoring of the patient’s condition should be carried out, implying the participation of the surgeon who performed the operation, as well as a neurologist and a rehabilitation specialist.

In fact, all rehabilitation measures pursue two main goals: restoring a person’s ability to work after surgery and preventing the formation of new hernias.

Rehabilitation after removal of an intervertebral hernia should be carried out taking into account the following factors affecting the effectiveness of recovery:

• age and concomitant diseases of the patient;
• duration of development and severity of the disease;
• the type of operation that was performed.

Stages of rehabilitation

The entire complex of restoration measures can be divided into several key stages:

1. Early. Lasts up to 14 days. During this period, pain prevention and relief are provided, as well as psychotherapeutic support.
2. Late. The duration of this stage can be 8 weeks. The key task of this part of rehabilitation is the professional adaptation of the patient to independent life in everyday conditions.
3. delayed stage. Rehabilitation after removal of an intervertebral hernia in this case can last a lifetime. This period usually begins in the third month after surgery.

Main restrictions that are relevant for the recovery period

The early recovery phase will be successful if restrictions on the following actions and activities are observed:

• performing physical activity without using a corset;
• lifting weights;
• conducting manual therapy and massage;
• cycling and participation in team sports;
• being in any sitting position;
• deep and twisting movements in the spine, as well as sudden movements to the sides and forwards.

There are prohibitions that are also relevant for the late rehabilitation period:

• long trips in any vehicle;
• physical activity (any) without proper preliminary warm-up;
• hypothermia of the operated area of ​​the back;
• wearing a corset for a long time;
• lifting objects whose weight exceeds 8 kg;
• prolonged stay in any forced position.

The main principle in case of restrictions after surgery is to protect the spine and especially the place where the hernia was removed from any stress and hypothermia.

Necessary actions immediately after surgery to remove intervertebral hernia

Rehabilitation in the postoperative period should contain the following points:

• inclusion in the Russian Federation program (meaning physical therapy);
• recommendation regarding sanitary-resort treatment;
• using electrophoresis, ultrasound or laser therapy to relieve pain and improve blood circulation;

• hydrotherapy (necessary for mechanical unloading of the spine) and kinesitherapy;
• neutralization of the inflammatory process, restoration of bone tissue and pain relief through the use of medicinal treatment methods.

Physiotherapeutic treatment measures

Rehabilitation after surgery to remove an intervertebral hernia must necessarily include certain physiotherapeutic procedures:

• They have analgesic, absorbable and anti-inflammatory effects.
• Electrical stimulation (intrastitial). Helps restore nerves that have been pinched and significantly improves the nutrition of bone and cartilage tissue.
• Ultrasound procedures. Their use promotes restoration, growth and stimulation of rapid nutrition of tissue cells.
• Magnetotherapy. With its help, mobility is restored and the risk of swelling, pain and inflammation is significantly reduced. This treatment method also helps to activate metabolic processes.

• Rehabilitation after surgery to remove an intervertebral hernia involves the use of extremely high frequency This technique is used to restore the tone of ligaments and muscles, as well as improve blood circulation. With the help of EHF, inflammation and pain are effectively relieved.
• Iontophoresis. Relevant when it is necessary to ensure deep penetration of drugs through the skin. Effective for stimulating recovery of the operated area and relieving pain.
• Phonophoresis. This is the process of introducing drugs into the body using ultrasound. To neutralize edema and inflammation, mechanical action is used.

Use of heat and cold

Rehabilitation after surgery to remove an intervertebral hernia may also include those techniques that are based on the effect of temperature on the operated part of the back.

The influence on the spine with the help of heat is carried out, as a rule, through paraffin applications. Such procedures can significantly improve lymph circulation and blood flow, relieve inflammation, restore the conduction of nerve impulses and relieve muscle spasms. It is important to know that paraffin therapy is contraindicated for those patients who have been diagnosed with liver cirrhosis, hypertension, tuberculosis and various neoplasms.

As for cold, with a competent approach (consultation with a doctor is necessary) it is used immediately after removal of a herniated intervertebral disc. Using ice, you can reduce pain, relieve muscle spasms and reduce the degree of inflammation (this occurs due to the narrowing of blood vessels and, as a result, a decrease in blood flow).

Key exercises for recovery after surgery

Those patients who have undergone removal of an intervertebral hernia are recommended to perform simple exercises in the first days after transfer to the ward:

• bending and straightening the legs at the knees;
• performing circular movements with the legs;
• raising and lowering the feet;
• pulling your knees towards your stomach and then straightening your legs (needs to be done several times).

Such exercises after removal of an intervertebral hernia are very useful, but when performing them, it is worth increasing the load moderately (the spine should not be overloaded).

Exercises for every day

If we talk about removing a hernia in the lumbar region, it is worth noting that the recovery period after such an operation lasts a lifetime. Therefore, it is extremely important that the patient trains himself to perform key daily exercises. We are talking about three main movements:

1. Push ups. This is a fairly simple exercise, but it must be performed correctly (with a straight back). The number of repetitions is from 10 to 15. When performing push-ups, you need to inhale air while lowering your body and exhale while rising.
2. Rehabilitation after removal of a lumbar intervertebral hernia includes the following exercise: while lying on your back, you need to raise your legs above the floor and make rotational movements, like on a bicycle. You should start with 10-15 repetitions, increasing their number over time to 100-150. You can also change the level of load during exercise by adjusting the height of your legs above the floor surface.
3. Squats. To perform this movement correctly, you need to imagine that you are sitting on a bench. after surgery on the lower back are strictly contraindicated. In this case, it is also necessary to perform 10-15 repetitions.

If you perform such exercises correctly and every day, your spine will be prepared for stress throughout the day. Do not forget about the doctor's instructions.

Gymnastics after surgery to remove intervertebral hernia

Exercises to restore the spine should be designed by a doctor, using an individual approach, which will take into account factors such as the operated part of the spine and the characteristics of the disease. At the same time, there are general recommendations for strengthening the spine after surgery and preparing it for everyday stress. We are talking about a set of proven exercises:

• Lying on your back, bend your knees and spread your arms out to the sides on the floor. Afterwards, you need to raise your pelvis above the floor and hold it in this position for 10-15 seconds. Subsequently, the time of holding the pelvis should be increased to 1 minute.
• Lie on your back, cross your arms over your chest, and bend your knees. The chin should be pressed to the chest. By tensing your abdominal muscles, lift your torso forward and hold it in this position for 10 seconds. Afterwards, you can take the starting position and relax your muscles. You need to perform the exercise 10-15 times, gradually increasing the number of repetitions.
• Exercises after surgery to remove a herniated disc include one more movement while lying down: you need to slowly bend your knees, pressing them to your chest. At the same time, tension in the gluteal muscles should be felt. Afterwards, you need to relax the muscles of the buttocks and keep your legs bent for 40-45 seconds. Then you need to slowly straighten them.

• Take the starting position with your legs and arms bent at the knees. Afterwards, you need to simultaneously extend your right arm and left leg so that they take a horizontal position. You need to keep them in this position for 10-60 seconds. The same movement is repeated with the left arm and right leg.
• Exercise therapy after surgery to remove an intervertebral hernia also involves the following movement: bend your elbows near your head. Next, you need to simultaneously straighten your arms and lift your upper body up, bending in the lumbar region. But there is no need to lift your hips off the floor.
• You need to lie on your stomach and place your hands under your chin. After that, not high and slowly, it is necessary to raise the straight leg, and then just as slowly lower it (the movement is performed alternately). The pelvis should be motionless.

Therapeutic baths

Another way after surgery is to use various baths that have a therapeutic effect:

• Radon baths. Relevant for improving blood circulation and neuromuscular conduction.

• Turpentine. They are used to dissolve scars and adhesions, as well as to activate the recovery process.
• Herbal baths can relieve tension in the muscles and reduce pain.
• Rehabilitation after surgery to remove an intervertebral hernia will be more effective if you use hydrogen sulfide and sulfide baths, which help dissolve inflammatory foci, improve blood circulation, normalize muscle contractions and stimulate tissue repair.

Water treatments

This type of procedure is part of the recovery process after surgery. Staying in water has a relaxing effect. But it is important to take into account the fact that after the removal of the hernia, a long stay in the water is contraindicated. Reception of hydromassage, as well as procedures in the pool, should not last more than 15-30 minutes.

As for dousing with cold water, they are also useful, as they have a beneficial effect on the restoration of nerve endings and stimulate muscle activity. Short douses are most effective.

As a result, it can be noted that the process of recovery after removal of an intervertebral hernia is a constant and hard work, primarily on the part of the patient. If you consistently and correctly perform the elements of therapeutic exercises and follow the doctor’s instructions, then there is every chance of a full and active lifestyle.

Spinal surgery is a last resort for the treatment of spinal column pathologies. They are performed when absolutely necessary, when conservative treatment methods are not effective and the patient experiences severe pain and cannot move. Often the cause of this condition is intervertebral hernia or spinal injury. The methods of surgical intervention are individual and depend on the patient’s condition and the severity of the disease. Physical therapy exercises after spinal surgery become an important part of the recovery process.

Physical education is aimed at restoring the mobility of the spinal column, strengthening the muscles of the back. The complex is developed by a physical therapy doctor individually for each patient. Depending on the part of the spine where the operation was performed (thoracic, cervical, lumbar), the doctor selects appropriate exercises.

Exercise therapy after spinal surgery contains a set of exercises designed to restore a specific area of ​​the spinal column that has undergone surgical intervention and is a mandatory component of rehabilitation.

Goals and objectives of rehabilitation after spinal surgery

After the operation, the patient feels better, as severe pain disappears, but before complete recovery, he needs to go through a long rehabilitation path. Its duration varies from month to year, depending on the complexity of the surgical procedure. This period requires the patient to carefully and systematically follow all the doctor’s instructions. Only thanks to this tandem will the prognosis of the disease be positive and the risk of relapse will sharply decrease. Rehabilitation involves performing the following tasks:

• stabilization of the patient's condition;
• remove mobility restrictions;
• restoration of normal functioning of the spine;
• complete elimination of the inflammatory process and pain in the spinal column;
• lifting restrictions on physical activity.

The goal of rehabilitation is to restore motor function after spinal surgery, completely relieve pain, strengthen the back muscles and prevent relapses of the disease. In the first period after surgery, the patient is prescribed bed rest. Its duration depends on the type of surgery and ranges from 3 to 7 days.

A longer restriction of movement (up to 2 months) is prescribed after spondylolisthesis, surgery to restore displaced vertebrae. After the manipulation, the patient is put on a plaster corset, which is eventually replaced with a removable splint-leather corset. The entire rehabilitation period, the patient lies on a specially equipped bed.

After surgery to correct scoliosis, the patient is transferred to the intensive care ward and only on the third day - to the usual one. In the first two weeks, the patient is prescribed strict bed rest, and after this period, he is allowed to walk a little. For the entire rehabilitation period, he is prescribed to wear a corset that limits movement, walk, and gradually increase the distance.

Principles of rehabilitation

The recovery period after surgery contains a set of measures that every patient undergoes on the path to recovery:

• consultations with a neurologist, surgeon, rehabilitation specialist (other doctors according to indications);
• drug therapy (NSAIDs, anesthetics);
• physiotherapy;
• physiotherapy;
• rest in a sanatorium.

Early period

The first 14 days after spinal surgery are called the early period. It is characterized by:

• healing of the surgical suture;
• restoration of sensitivity of the limbs;
• reduction in pain intensity.

The patient is prescribed to wear a special corset, which is recommended to be used during other periods of rehabilitation. It limits sudden movements, keeps the vertebrae in a stable state, and prevents their displacement. The patient is also prescribed medications (NSAIDs, painkillers, sedatives) and exercise therapy.

Gymnastics are performed carefully, in the presence of an instructor. Later, the neurologist examines the patient, determines the sensitivity of the limbs, and prescribes an MRI. Based on its results, the issue of moving to the next stage of recovery is decided.

Late period

This period begins from the moment the patient is discharged home. It lasts from 3 months to six months. The doctor gives the patient advice on how to behave at home, which he must follow. This will prevent relapses of the disease. The main thing you should not do during this period is sit. The patient is offered a set of exercises developed by a physical therapy instructor, which is aimed at strengthening the back muscles, improving blood circulation at the site of injury, which promotes rapid tissue restoration.

Exercise must be done systematically, and subsequently it becomes an integral part in preventing the recurrence of the disease. Patients perform such gymnastics for life. You can't stay on your feet for a long time. Every hour and a half you need to give your spine a rest (lying down for 20-25 minutes).

Deferred period

Experts believe that after spinal surgery, the recovery period lasts a lifetime. This is especially true for interventions in the lumbar area. Performing exercises specially selected for patients after surgery on the lumbar spine is necessary constantly. This strengthens the lumbar muscles, prevents the displacement of the vertebrae and the appearance of protrusions.

What are the benefits of therapeutic exercises

Exercise therapy after spinal surgery is a set of exercises aimed at restoring motor function, improving blood microcirculation and metabolic processes in the tissues of the spine. The systematic performance of gymnastics creates a muscular corset that prevents the displacement of the vertebrae. In addition, classes include breathing exercises, which helps to strengthen the nervous system.

Exercises are performed slowly and smoothly. The patient should avoid sudden movements, do exercises until mild pain appears, but do not load the spine. Initially, a set of exercises is performed under the supervision of an instructor, and later the patient conducts training on their own.

Some simple exercises to restore the spine in the early period

During this period, the patient should not sit down, so the exercises are performed lying on your back. The exercise takes place in the presence of a doctor.

Later they move on to more complex exercises.

Features of physical therapy in the late period

In the late rehabilitation period, the patient increases the load, the exercises are more complex, perform 1-15 approaches. They are aimed at restoring muscle tone.

1. Push-ups from the floor, straight back. Do not exhaust yourself, but do no more than 15 times.
2. "Bike". Rotational movements of the legs are performed 15 times in one direction and the other.
3. Half squats, as if sitting on a chair. You can't squat deeply. Repeat 15 times.

The complex is performed in the morning and makes it possible to maintain muscle tone all day.

In addition to the above exercises, patients are offered to diversify the complex.

Gymnastics should be done systematically, gradually increasing the load and adding other exercises.

The complex of exercises given above should be performed by patients after spinal surgery for the rest of their lives. Exercises are done in the morning every day. This will help strengthen the muscles and avoid further relapses of the disease. A properly selected complex will improve blood circulation and relieve muscle spasm. In addition to physical education, the doctor recommends to the patient other procedures and activities that can prevent the formation of hernias and protrusions.

Breathing exercises

This type of gymnastics is very important because it helps to remove congestion in the lungs that formed while patients were in a supine position. To do this, patients are given to blow into a bottle half filled with water. This must be done through a tube. Perform 3-4 approaches throughout the day. Later, the patient is given balloons to inflate. When performing exercises, you should monitor your breathing: tension - inhale, relaxation - exhale.

Kinesiotherapy by Bubnovsky

The technique means movement treatment. Patients are offered a set of exercises performed on special simulators. During training, blood pressure does not increase, there is no increased load on the spine. Gymnastics are selected for each patient individually. The set of exercises is aimed at strengthening not only the back muscles, but also the joints. Kinesiotherapy is combined with breathing exercises. Dr. Bubnovsky's centers in Moscow:

• st. Aviamotornaya, 10 building 2;
• Pyatnitskoe highway, 6 building 1;
• Ostrovityanova str., 10.

Appointment times will be confirmed by phone.

Traumatologists recommend that people who have undergone spinal surgery visit the pool. Swimming, as well as doing exercises in water, improves the tone of the back muscles, improves blood circulation and calms the nervous system.

Exercising in water is effective and does not put stress on the spine, since water supports the body and reduces muscle tension.

Massage

Therapeutic massage is given to patients in the late and delayed period of rehabilitation and includes classic, acupressure, segmental and other types. The technique is aimed at strengthening the muscle corset, as well as relaxing nerve spasms. During the procedure, deep muscles are warmed up, creating an analgesic effect. The massage is relaxing and soothing, so it should be performed in the afternoon.

Restrictive measures

The principles of rehabilitation include not only tips for restoring health, but also prohibitions. The patient must not:

• sit;
• stay in one position for a long time;
• lift weights more than 3 kg;
• wear a corset for a long time (more than 3 hours);
• physical exercise;
• conducting manual therapy;
• perform twisting movements.

For the first month and a half, the patient should not sit down; sudden movements should be avoided. For 3 months it is prohibited to ride in public transport while sitting. You need to take a semi-lying position and wear a corset. When carrying weight, distribute it on both hands or put the load in a backpack.

To prevent the development of spinal pathologies, doctors recommend:

• avoid physical overload;
• eliminate bad habits;
• Healthy food;
• control your weight;
• systematically visit a neurologist;
• Do an MRI of the spinal column every year.

In addition, you should perform a set of exercises suggested by a physical therapy doctor, engage in non-active sports, and conduct training in the presence of an instructor.

Exercise therapy after surgery for a herniated disc in the lumbar region is mandatory for all patients. The goal 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 should be increased gradually. Since the effects of lumbar surgery will last a lifetime, physical therapy should be performed daily to prevent hernias.

The role of restoration measures

Treatment of intervertebral hernia 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 decreased sensitivity. During this period, the nerve fibers continue to be irritated, which is due to the inflammatory process. Therefore, a combination of drug treatment, mechanotherapy and physiotherapy will reduce rehabilitation time and improve the patient’s health.
The objectives of the rehabilitation period are:

• 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

Exercise therapy begins after removal of the intervertebral hernia in the first days in a supine position. During the first month, all classes are carried out only while lying down. It is important to avoid tension and sudden movements. During such exercises there should be no discomfort in the lumbar region.

It is normal if 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 swelling in the lumbar region and reduce existing swelling, and relieve pain. To prevent displacement of the vertebrae, patients must wear special corsets with metal inserts.

Exercises while lying down

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

1. 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.
2. Spread your legs wide bent at the knees. Alternately press your right knee to your left heel and vice versa. In this case, you need to ensure that the upper body is still.
3. Lying on your back, spread your arms out to the sides with your palms facing up. Try to reach the palm of the opposite hand with your fingers. Make sure your hips remain pressed to the bed.
4. Bend your knees and bring your feet together. Place a ball or small pillow between your knees and squeeze them forcefully.
5. Lying down, rest your palms on the bed and press hard on it.
6. Pull your feet towards you, alternating legs.
7. Spread your arms to the sides, inhale and raise your head, press your leg bent at the knee to your body and pull it tighter with your hands. Exhale. Repeat with the second leg.
8. Spread your legs bent at the knees wide and try to reach them with your hands, raising your head and shoulders.
9. Raise your hands, placing your palms together above your chest, squeeze your hands forcefully, relax, lower them and repeat again.
10. Grab the bent fingers with the fingers of the other hand, pull them in different directions, relax.
11. Spread your legs, turn them inward and return to their original position, relax.
12. Pull your feet towards you and repeat the exercise after a short rest.
13. Bend your arms at the elbows, legs at the knees. Raise your pelvis, leaning on your limbs. As you inhale, raise your torso, as you exhale, lower it.
14. Turn your legs bent at the knees to the right at the same time as you turn your head. Repeat on the other side.
15. Do the “bicycle” exercise with each leg separately.

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

Medical prohibitions

There are a number of restrictions that should be taken into account when engaging in therapeutic exercise:

• the pace of the exercises is slow, movements should be smooth and careful;
• avoid turning, bending, twisting 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 consult a doctor if the pain constrains the lumbar region.

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

The patient is prohibited from lifting more than 3 kg with one hand for 3 months postoperatively.

Sitting should also be limited at this stage. Giving up bad habits and active games is mandatory for the entire recovery period.

Features of exercise therapy in the late period

The late period lasts from 3 to 6 months after surgery. At this time, in order not to cause unwanted changes and to protect 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 the following sequence of actions.