Tag Archives: Recovery

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5 Months post Lumbar Fusion

6 screws. 3 rods. 2 inter-vertebral cages. That’s what’s been holding my spine together for the past 5 months. I’m well on my way to a good solid fusion, my bone growth is good. My muscles have reattached, and I’ve worked to strengthen muscles I’ve ignored for years – probably decades. I’m feeling pretty good overall, and I’m working on the areas that sneak up and bother me. I’ve been in physical therapy for 12 weeks now, and am looking at another 6. Rehab and Recovery is WORK – but it’s also working.

My physical therapist Danielle has left now – to be a momma to a 2 year old boy they are adopting from another country. I’m thrilled for her, and we talked a few times about bringing him home and how excited (and nervous) she is about it. I never did ask her why she went the adoption route, but I know she doesn’t have any other children. Whatever her reason, I’m just thrilled that this dream is becoming a reality for her!

So Danielle left to be a mom, and I got referred to another PT in the clinic, Brenda. I worked with her one of my first visits, but I felt it was a good opportunity for fresh eyes and to talk about my current symptoms and see what adjustments we might need to make. She reviewed my chart notes and did some assessment and moved me around and watched me move. She is comfortable with how my spine is healing and how I’m moving around the fusion. My deep core work is keeping the fusion and my spine in general supported and aligned. My pelvis and the pesky SI joint was a little out of alignment, so she worked to line me up better, and doing so, she found that my Iliotibial Band (IT Band) is inflamed. It runs from the hip to the tibia along the outside of the leg, and helps to support the knee. What I had been attributing to sciatic inflammation on the right side (and had me quite concerned actually) is actually a muscle pain memory – and caused by the inflamed IT band – not the nerve.

So, our focus is now to change the muscle and pain memory. We are working to heal the inflammation in my IT band and then work on my body mechanics to prevent it from flaring again. Remember me talking about bossy muscles before? Well, that’s what’s going on again. My hamstring is trying to compensate for what my hip and glutes should be doing. My pelvis is out of whack making the SI joint inflamed, and so then I move wrong and cause new problems – like an inflamed IT band. IT band injuries are often attributed to running injuries – overuse when there is a bio-mechanical misalignment. I’ve done that in spades…so time to work on releasing the IT band and hope that allows me to work on continued strengthening in my hips and glutes.

So…how to release the IT band – well trigger point massage is the best way, but let me tell you…it’s NOT fun. Brenda used a torture device and really massaged where the IT band connects to the tibia (outside top of the calf), and along the edge above my knee where the hamstring connects. I don’t remember what she called it – but that’s probably because I was gritting my teeth and trying not to hyperventilate. She also did some work on my hip, with the trigger points as well. We talked about home care and how to continue working on the IT band. I have a tennis ball and a wall – and I lean into the hot-spots in my hip and glute and through direct pressure and tiny micro movements, I am working to get the tension (aka nearly cramping they are so tight) out of my muscles in my hip and glute. I also have a “massage stick” that I use to roll massage along the outside of my thigh and search for and find all the tender hot spots along the IT band and hamstring. When I find a hot spot, I stop and put direct HARD pressure on it, and slowly roll off of it. It’s not fun…I suck a lot of air through clenched teeth…but hopefully it’s doing the trick. Kind of like a begging toddler – you just irritate it, nag it, and keep after it constantly until the muscle gives up and relaxes. It’s still very, very sore – but the memory pain of the sciatic nerve that I thought was going on, is diminishing. So that suggests that what I’m doing is helping.

I’ve also been doing massage on my left foot – the one with the nerve pain, trying the same theory – lets see if I can irritate it into healing through persistent massage. I’m also working on ankle stretches, because as Brenda put it, “On the spectrum of flexibility – you are quite stiff. Your joints don’t move enough to be able to stretch the muscles that are tight.” Um…thanks, I think. So ankle stretches a couple times a day has been added to my PT rehab plan.

Since my last post I’ve been doing well with eating clean and with tracking my calories. I’ve reigned in most of my bad food habits. I’ve set up a routine of riding my exercise bike each day and have worked hard to move more in general. The scale has appreciated my efforts. I’ve also gotten much better about taking my supplements each day. I think all these things together are working to help me feel better not only physically, but emotionally. The whole adage of garbage in= garbage out is so true. When I fuel my body well, both nutritionally and with exercise and movement – the results are always better. So that’s my words of advice for all of you – treat your body like a temple. Be respectful and humble, know your limits – but push them a little too!

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18 Weeks Post Spinal Fusion

I haven’t really counted the weeks lately, been counting months mostly – but it was a question floating around in my head, so I grabbed my phone and counted the weeks.

You know, we go through life every day – just doing life, but not really paying attention to anything outside of the moment. Most folks this time of year are focusing on Christmas obviously – so thinking ahead to make sure they have gifts for everyone, all the right things in the fridge for special meals, and planning those last few days to make sure everything on the list gets done in time. But how many folks look back? Some do for sure – especially those who are missing a special someone who isn’t with them for the holiday. But as a rule, we don’t necessarily think back with any specificity about what the last few weeks, months, or even years have looked like in our lives. We just do life – one day at a time. Each morning brings new opportunities.

Many of you know I work at a university – so my work life centers around academic calendars – the start and end of semesters, the work associated with beginnings and endings. Juggling new students, and students about to graduate. Its a perpetual cycle, but one that is also very predictable. I work from a calendar that reminds me of specific tasks needing to be done each week in order for the semester to continue to run smoothly. So when I threw the wrench of spinal surgery into my work life – it was kind of crazy. I was out of work for 4 weeks, and I spent most of the remaining 12 weeks of the semester trying to catch back up! I expect the spring semester to be back to a more normal feel – not constantly playing catch up.

As my last post explained, in my recovery from surgery, I was having some trouble with my SI joint, and so my therapist scaled back what I was doing to really focus on deep core strength, and supporting my spine with some very targeted work. I’m happy to say that the rest and focused work on stabilization worked like a charm. Of course, the KT tape probably helped too! My SI joint and therefore my pelvis has stayed nice and straight and stable. This is the foundation of our weight bearing structure, so when it is out of alignment, it messes with everything else. After nearly two weeks of really focusing on the deep core muscles, I can really pin point them and ensure they are engaged and working to support my spine. I am beginning to add back in more of the other work and exercises again – but slowly, and only after warming up with the core work first.

I’ve been keeping up with the nerve work too – neural flossing – to continue to keep those pathways clear. I don’t have the constant nerve pain like I did, but I need to stretch it regularly as I continue to heal. What we don’t want at this point is to have any scar tissue forming that the nerves can get hung up on. It might be time to schedule another couple of massages – one to focus on the surface adhesions and keeping the scar itself moving around, and another one to focus on the deep tissue tension as I gain strength, that I keep the neural paths open and moving. While it has been 4 months, there is still active healing and scar tissue forming (or hopefully not forming) – and so the timing is right for another couple of massages.

As the year wraps up, I can’t help but be grateful for all the prayers that have been offered on my behalf this year. For healing, for strength and for joy and prosperity. I’ve leaned heavy on my faith this year, and have been greatly blessed. My prayer for each of you this year is that you too are richly blessed and that you know the love of God in your heart. Merry Christmas, friends!

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Stability

As any healing journey progresses, you have highs and lows, hills and valleys, starts and stops – but the goal is stability.

Tomorrow marks 4 months of healing from Spinal Fusion surgery.  Overall I feel pretty good.  I’m off all the muscle relaxers and pain pills, and I rarely use ice packs now.  I do physical therapy exercises every morning, and add in gentle yoga routines most days.  I do as much walking as possible, but now that the weather has changed, it’s not safe to be walking outside – nor is it warm, for the record!  I need to establish a routine to get some time in on the spin bike a few times a week, but finding a consistent time is always a challenge.  

I saw my surgeon two weeks ago.  He says I’m doing great.  He will see me again in February, and then probably, I won’t need to see him again – it will just be my regular primary care doctor.  I did talk to him a little bit about the nerve pain in my foot – but nerves are slow to heal, and what I’m doing with physical therapy does seem to be having an impact.  I also talked to him about the movement and shifting in my pelvis and specifically the SI (sacroiliac joint).  He poked and prodded, and offered to do a cortisone injection into the joint.  We talked about extending my physical therapy, and about my recovery and rehabilitation in general.  I opted to not have the injection yet, and to see if more physical therapy will help stabilize it.  He agreed to the conservative approach, and approved another 6 weeks of physical therapy.  

In the past few weeks as I’ve increased my activity level, and done more and more muscle work for both flexibility and strength – essentially loosening up the crazy tension I was holding for so long…we’ve created a bit of a stability issue.  My body is learning how to move with and around the spinal fusion.  As I move and rotate my upper spine – my back pops a bit as things realign and adjust.  This isn’t causing any problems, but it is an indication that my muscles aren’t as tight (from chronic pain), and as they loosen, those joints can actually shift around and go back into alignment on their own.  I’m not concerned about the upper spine pops, nor is my physical therapist and surgeon.  But as I am moving, stretching, healing more an more – I am getting some popping and shifting happening along side my sacrum(that is now fused to the vertebrae L5 above it), through that SI joint which leads to a misalignment in my pelvis and hips.  Also the pops and shifts are the tissues themselves making noise – and creating a bit of inflammation. 

So…we are focusing almost all our attention during PT now on stabilizing the sacrum and pelvis through deep core stabilization.  We are backing off on some of the strengthening and flexibility in the big muscles (hips, glutes, thighs, etc) to focus on the inner most deep core stabilizing muscles – transverse abdominal and the multifidus.  Hopefully this step back to work on the less obvious muscles will give me the stability that we are after.  I also have to pay very close attention to body alignment.  No side bending; no twisting while reaching; feet, knees, and hips always squared up; no rotation unless hips are square and core is engaged. I need to really reign in my movements until we have the stability back on track.  

I’m finding myself in a valley, but with a clear path lined up to get me out of it. Three steps forward, and 2 steps back.  But no one said that recovery from spinal fusion would be easy!

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