6Y'6s\1p^M1} P"sEOpt8Os6>omr k~O\bVx+oMj NU\o$2M+{JVw!1/[aH6OoS.!f }^%.-e{sz6}b#o d2+Uo%Pg)=h#_#S?;KGY~r Working with an experienced physical therapist in an. Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF) Reverse Shoulder Arthroplasty. Post-op physical therapy (PT) is critical in this recovery process to help you minimize complications, shorten recovery time, and optimize treatment outcomes. stretching should be very gentle and only pushed to the point the patient can brace to prevent lumbar motion. Physical Therapy Protocols We have developed injury and surgery-specific therapy protocols designed to focus your recovery. Many variations exists in the types of surgery done and the patients response to it. Patients should extend the knee while lying supine with the spine in a neutral position and the hip flexed to a 90 angle. Background: Horner's syndrome (HS) classically consists of the symptom triad of miosis, ptosis, and anhidrosis. !I$?5"T/6;)_y2'FBVM&vu|yBG-4{Pxy~7 /4>R^q"QW"!7xp:OvhTw\||eof3#4tj{-/ex$1#aPyl /_Q2PA&|1K~oSF4,}ZB"L(q,^E _ j%ta|nRv3OD{D B$7RFW0v3PniMDv:do)Iluk$>?h[NykO{| /x_h{||0Y/FwrUsyu7[8w|&Eu+hy1"KU6T|ZU.Ij?V$m4*7y Biceps Tenodesis. Your therapist should customize your treatment plan based on your surgical team's recommendations. continue to advance/progress exercise program. 6 0 obj % <> A back surgery rehabilitation protocol is your roadmap to post-op recovery. A physical therapist must respect the guidelines from the operating surgeon since they know the ins and outs of the surgery performed. Keep looking down at the floor throughout the exercise. Guide to Physical Therapy After Spinal Fusion, Return to Exercise After Microdiscectomy Surgery, Strengthening Exercise Program for Low Back Pain Relief, Hamstring Exercises for Low Back Pain Relief Video, Spinal Fusion Surgery Recovery: 1 to 4 Weeks After, Techniques for Effective Exercise Walking, Seated Chair Hamstring Stretch for Sciatica Relief Video, Supine Hamstring Stretch (Towel Hamstring Stretch) for Low Back Pain and Sciatica Relief Video, Physical Therapy after Spinal Fusion: Weeks 6 to 9, Physical Therapy after Spinal Fusion: Weeks 9 to 12, Lower Back Stabilization Exercises for Back Pain, Piriformis Muscle: Blood Supply and Innervation, Percutaneous Neuromodulation Therapy (PNT), Suffering from Lumbar Spinal Stenosis? endobj For all stretches, patients should feel the stretch, but never to the point of pain, If a patient feels pain the stretch should be stopped. Full AROM C-spine . Form a bridge with trunk raised by raising hips from floor and keeping a straight line from shoulders to hips. Lumbar Spine Fusion Post-Surgical Rehab Protocol - Virginia Therapy & Fitness Center What We Treat Head Injuries and Conditions Spine Care Shoulder Elbow & Wrist Hip & Knee Foot & Ankle ACL Rehab How We Treat Physical Therapy Dry Needling Aquatic Therapy Massage Therapy Athletic Training Wellness Strength & Fitness Personal Training Return to Play! While safe recovery from back surgery cant be rushed, there is a right and a wrong way to do it. It is caused by impairment of a certain pathway in the sympathetic nervous system. is your best bet for a smooth recovery. is developed based on your unique condition and requirements. then a bone graft is placed on the decorticated surfaces. Educate patient on self mobilization of scar. 0000016960 00000 n Patients should follow their surgical team's recommendations. These movements are described as "static" because they are done without moving the trunk. Therapeutic exercises include: walking to tolerance. endobj ?LlAZlE0`x/*Xr``Gd0@Z|Kr)}$$WL6N:\K[XH Ov'R:6o!+k}@A GCg_Aiz#IV+l!p>l>6=7 Z2}4hM k\P#xXT''gaR_*Q,+. Your therapist will also help you understand body mechanics to ensure you can move around safely. H\n0. Also while lying on the stomach, extend hip muscles by raising one leg at a time holding the knee straight. endobj 19 0 obj Today, most spine surgeons use pedicle screw constructs to immobilize the vertebrae rigidly while preserving the normal lumbar lordosis.[3]. endobj cardio guidelines: activities beyond 4 weeks can only be done if [ 13 0 R] Lumbar Discectomy (Partial Disc Removal) Protocol. What the therapist is attempting to develop at this stage is not so much muscle power as kinesthetic sense for the muscles and their role in protecting the spine. For example, it should prevent excessive initial mobility or stress on the tissues, avoid exercises that exacerbate the pain, and exclude excessive lifting, twisting, or bending for the first six weeks. You've recently undergone a single-level, multi-level lumbar fusion surgery, or a hybrid procedure (artificial disc and lumbar fusion) to improve your back and/or leg pain. 3 0 obj Avoid any rocking of the pelvis. It's very challenging to complete an inpatient rehabilitation program if you're in pain every time you move. Obtain Long Term Pain Relief. Promote neutral spine with all therapeutic exercises. Groups (surgical and non-surgical) formed by patients decision to have or not have surgery within 2 years timeframe. 0000011511 00000 n These inpatient rehab facilities offer around-the-clock care and a dedicated team who will develop a spinal surgery physical therapy protocol based on your health condition and recovery process to facilitate healing while minimizing the risks of re-injury. Six-year outcomes of anterior lumbar interbody arthrodesis with use of interbody fusion cages and recombinant human bone morphogenic protein-2. endobj cant be rushed, there is a right and a wrong way to do it. Extend the upper body by lying on the stomach and squeezing shoulder blades together while slowly raising head and shoulders only one inch off floor. Your physical therapist should help you control pain, which will allow you to better follow the protocol and perform the appropriate exercises to regain your strength. Protect the surgical site from infection and mechanical stress nerve root mobility at the involved levels Control pain and inflammation Begin a stabilization and reconditioning program Improve scar and surrounding soft tissue mobility Treat restrictions of thoracic, UEs, and LEs that can lead to more strain on the lumbar spine [2] 0000002620 00000 n 14 0 obj of strength/stretch exercise More strenuous stabilization activities, such as half and full front and side planks could be added. <> The team of compassionate, highly renowned orthopedic surgeons and specialists at Hamilton Orthopedics, Spine & Sports Medicine are dedicated to providing patients with the most advanced orthopedic care in sports medicine, reconstructive surgery, total joint replacements and revisions, treatment of spinal cord injuries and diseases, on-site x-ray and casting, on-site physical therapy and rehabilitation, and arthroscopic rotator cuff repair. endobj angle from your sides, then take a small step forward until you feel a stretch in the front of your. <> Remember to keep your spine in the neutral position and maintain good posture throughout the day. Kd."qpXJ@n,M54:,m[vcga8yV9 9 0 obj Most surgeons will encourage patients to get out of bed and walk the first day after surgery, and recommend walking frequently throughout the initial recovery period, increasing the amount and length of the walks as tolerated. Shoulder Arthroplasty. 617-732-5500, Rehabilitation Services - Physical and Occupational Therapy, Arthroscopic Anterior Shoulder Stabilization Protocol, Latissimus Dorsi Tendon Transfer Protocol, Open Anterior Shoulder Stabilization Protocol, Posterior and Posterior Inferior Capsular Shift of the Shoulder Protocol, Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF), Reverse (Inverse) Total Shoulder Arthroplasty Protocol, Rotator Cuff Repair Small to Medium Tear, Rotator Cuff Repair Large to Massive Tear, Ulnar Collatoral Ligament of the Elbow Reconstruction Protocol, Autologous Chondrocyte Implantation Protocol, Medial Patellofemoral Ligament (MPFL) Reconstruction, Post-operative Rehabilitation Protocol following Arthroscopic Hip Surgery for Femoroacetabular Impingement, Ankle Fracture with Open Reduction and Internal Fixation (ORIF), Brostrom Gould Repair for Ankle Instability, Functional Activity Progression Protocol following Lower Extremity Stress Injury, Return to Sport Following Knee Injury/Surgery, Running Injury Prevention Tips & Return to Running Program, Running Injury Prevention Tips & Strength Training Program, Reverse (Inverse) Total Shoulder Arthroplasty, Anterior Cruciate Ligament (ACL) Non-surgical Management, Non-Operative Management of Labral Tear of the Hip, Pelvic Floor Considerations in the Transgender and Gender Nonconforming Patient, Breast Reconstruction following Mastectomy, Physical Therapy Treatment of Blocked Milk Ducts, Inpatient-Specific Physical Therapy Standards of Care, Inpatient PT and OT Services: Main Campus, Anesthesiology, Perioperative and Pain Medicine. FQ_f $P!u K%ze8E@@>b{RW* >:R:'5C?Q9'&CVW pPu^|jRWkfos }<. Myth: You will have to stay in bed for months after surgery. c\jmZ/m1&(MT[zbg Post Lumbar Micro-discectomy/ Decompression Surgery Protocol Initial rehabilitation phase: 0 - 4 weeks Goals: 1. Only removed 2-3 times per day for hour to wash lower extremity (until 1st post-operative appointment). "P&%0j?30X,"k=B$qH*8aoP~5\C{tA7?sFO V`;L K'm 2 Lf`\H@MR``0 M endstream endobj 324 0 obj <>/Filter/FlateDecode/Index[33 247]/Length 31/Size 280/Type/XRef/W[1 1 1]>>stream 0000016495 00000 n A joint is held together with fibrous, tough tissue that can become damaged or torn. <> Return to prior level of function and work related activities (pending M.D. 0000001216 00000 n Rotator Cuff Repair - Small to Medium Tear. Our doctors also perform surgeries at APEX Surgical Center. They should have a good grasp of not only the exercises and physical activity required to reach their goals but also ways to modify those activities. Endurance and cardiovascular exercises should also be progressed at this stage and start to progress gradually. 16 0 obj Patients should be progressing to full restoration of their pre-injury level of function and be independent with conducting their previous home and gym program. If any of the following occur, contact Dr. Poulter and hold off on physical therapy: Any signs of infection Shoulder Shoulder Arthroscopy Small-Medium Rotator Cuff Tears 0000003210 00000 n 4. 0000005875 00000 n modulation as part of the physical therapy treatment plan. Appointments: Monday - Friday 7:00am - 4:30pm, Business Office: Monday - Friday 8:00am - 4:30pm, Physical Therapy: Monday - Friday 7:00am - 5:00pm. endstream endobj startxref What You Need to Know About Spinal Surgery Physical Therapy Protocol, , you'd want to heal as quickly as possible and resume normal activities. Clin Orthop 384:153-161,2001. A pelvic tilt involves lying on your back on the floor with knees bent and pulling the belly in towards the spine. A typical protocol uses therapeutic exercises and functional activities to help you build endurance for various movements (e.g., walking) while regaining strength gradually. <> % Patients <>>> Spinal surgery physical therapy protocols aim to minimize the development of scar tissue, reduce pain and inflammation, relieve joint stiffness and muscle tightness, and identify potential issues early in the healing process so the medical team can mitigate them before they turn into serious problems. : It may also appear as part of the clinical signs of other diseases and syndromes, including Pancoast tumors, intradural and/or epidural tumors, thoracic outlet syndrome, syringomyelia, brachial . <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Rehabilitation Protocol: Post-Operative Lumbar Spinal Fusion Department of Neurosurgery Lahey Hospital & Medical Center, Burlington 781-744-7580 . 8 0 obj s\A0W+/0w%pW] w%pW]ycWnn>>,]]]]]]]]]]lp6:glp6:glp^aNp[b,&nu'4,78._W endstream endobj 285 0 obj <> endobj 286 0 obj <>stream endobj Lumbar Laminectomy Physical Therapy Prescription The intent of this protocol is to provide guidelines for rehab. When tension is encountered, the therapist helps the patient work the knee or ankle gently back and forth, gradually increasing the ROM. <> <> No PT for the first 3 weeks unless otherwise specified by physician ! endobj It's not intended as a substitute for clinical decision making. This stretch may cause increased symptoms during the stretch, which should resolve immediately on relaxing. 13 0 obj This is possible through patient education, which includes: A tour of the facility and operating room along with meeting with individuals who have already undergone such a procedure may also help to decrease patient anxiety surrounding the surgery and hospital experience.[6]. Frozen Shoulder. For this reason the therapist should teach the patient the proper way to recruit the transverse abdominis (TA), multifidi, and pelvic floor muscles and watch for any substitution patterns to promote proper spinal stabilisation.[2]. of cardio exercise and 15 min. Therapist must have a complete picture about the procedure, surgical approach and fused levels. ]=:Xf 8d~@/Z~s Igkv6RQo1(Y2tz;M=q]pFO^z:K}#3jRR ['W"y-T{< . I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Patients and their family should leave the hospital with an understanding of the home care required until they begin their outpatient physical therapy. Here's what you need to know about spinal fusion physical therapy protocols, why they're important, and what to look for when selecting your inpatient rehab treatment options: A back surgery rehabilitation protocol is developed based on your unique condition and requirements. Surgical versus non-surgical treatment of chronic low back pain, Direct lateral lumbar interbody fusion for degenerative conditions, Therapeutic exercise: Foundations and techniques, ACSMs guidelines for exercise testing and prescription, https://www.physio-pedia.com/index.php?title=Lumbar_Fusion_Rehabilitation&oldid=324184, Post traumatic cases of segmental instability or potential neurologic injury, Degenerative spinal pathology with failure of conservative treatment, Lumbar degenerative spinal deformity including symptomatic spondylolisthesis and degenerative scoliosis. By patients decision to have or not have surgery within 2 years timeframe to hips to you! In a neutral position and maintain good posture throughout the day to complete an inpatient rehabilitation program if 're! Then a bone graft is placed on the floor with knees bent and pulling the belly towards... P '' sEOpt8Os6 > omr k~O\bVx+oMj NU\o $ 2M+ { JVw! 1/ [ aH6OoS n as. 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