[ChelB]

#8360

Hi Dr. Corenman,

I wanted to update my situation and ask a few questions. I had a 3 level ACDF (c4-c7) on 3/19. I am now 18 days post-op. The surgery went very well and I’m happy with how I am doing. I have worked my way up to walking 4-5 miles per day (on the treadmill at 4.5 mph). I am also making sure to eat a high protein diet with lots of vitamin c, which I heard is great for healing. I have logged in to work remotely and done work from home (as I’m not yet back to work). I have my 1st post-op appointment this week. Again, I come back to questions on exercise. I will discuss all of these things at my appointment too since they personally have knowledge of my medical issues ~ which is only this recent surgery.

I have said before that I was running a lot ~ half marathons, 15K’s and smaller races. I was told that half marathons were out of my future. After much sadness, I decided I could live with this. However, in your opinion, do you think it would be safe to run a few (3-4) miles, say two times per week? I would hate to give up running in its entirety. Running provides as much for me emotionally and psychologically as it does physically. I do however think it will be cool to find new exercises or sports that I can love – maybe the elliptical and spinning or biking. I have also been into kettlebells (which I do at home). Do you think I will be able to get back to kettlebells in the future? Will I always have weight restrictions? Will I ever be able to do overhead exercises with my kettlebells?

I appreciate whatever insight you can give me!

[Donald Corenman, MD, DC]

#8365

The need of a three level fusion leads me to think you need to be cautious with impact and loading. I think you would probably be OK to run twice a week for 3-4 miles as long as you understand the risks.

Think of the discs above and below as being car tires. There is a certain amount of mileage car tires can take before they wear out. If you drive faster and turn more, tires will wear out faster. Although tires are not the same as discs, this is a reasonable analogy to think about.

Kettle ball workouts requires a very heavy weight to be swung at the end of your arms creating substantial circumferential forces that are resisted by the shoulder muscles, especially the trapezius and levator scapula. These muscles insert onto the cervical vertebra. Is it OK to do this. Probably so, but a swing in an unguarded moment might create undue torsion on the vertebra. Is it enough to tear the discs? Possibly. There are other exercises that do not create as much force per moment arm.

You are not a fragile egg but on the other hand, you do need to consider your exposure to high forces.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[ChelB]

#8372

Thanks for your response. It’s very much appreciated. It’s hard to give up something that I love but at the same time, I don’t want to go through this again, especially with additional levels. With time, I’ll see what I will & won’t be able to do. As for kettlebells, it sounds like explosive movements such as the swing, overhead swing and snatch are out. I’m thinking with time, I will be able to do goblet squats, dead lifts, one arm rows and lunges and exercises of that type? I’ll also ask about workouts such as Insanity. As far as I know, it uses only body weight though I’m not sure if it will be too much of a high impact workout for me. I live in a rural area that doesn’t have any gyms. The nearest one is 30 minutes away. For someone that works full-time and has kids in school and extracurricular activities, this isn’t an option for me. While walking has been great so far, I want to challenge myself with more.

[Donald Corenman, MD, DC]

#8378

The insanity workout describes the workout accurately. It involves a series of ballistic motions the increase the stress on joints. It is good for perfect specimens but this might be too much for your neck. Pilates, yoga, cycling, swimming and weight workouts in the gym (within reason) would be less likely to cause further problems.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[ChelB]

#8785

Thanks for all of your previous help and guidance.

I have a few questions about physical therapy that I hope you can help me with. I had my first appointment this week (10 weeks post-op c4-7 acdf. Additionally, I wore an Aspen collar 24/7 for 9 1/2 weeks) and was given some exercises to do at home. They are basic moving my head exercises such as turning my head left/right, chin to chest and extending up as well as ear to shoulder. They are absolutely excruciating. My range of motion is awful but it’s so upsetting how little I can move without feeling pain. Is this normal? Do I push through the pain or will I make it worse? The PT told me to move to strain not to pain but it’s all pain. I go back later today but I’m really nervous. Also, since starting these exercises, I am experiencing more tingling and numbness in both hands. What is normal? What kind of range of motion should I currently have? Thanks.

[Donald Corenman, MD, DC]

#8798

Wearing an Aspen collar for almost 10 weeks will guarantee a stiff neck that will need substantial therapy to regain range of motion. At 10 weeks after surgery, there should be little pain but with prolonged immobilization, this can stiffen up muscles, ligaments and tendons. These structures can be painful if contracted.

I agree with the PT that you need to move “to strain but not pain”. Slow progress should be expected at this point.

There is a technique called “active release” that can be helpful. Move your head to the maximum strain position (strain-not pain) in whatever direction you are focused on at the time. Remember that there are six directions your head can move (flexion, extension, right and left lateral bending, right and left rotation).

At this point, put your hand against your head in the opposite direction (if you are rotating to the right-keep your head in right rotation but put your hand on the left side of the head). Push your head against your hand (your head is still rotated right but you are contracting your muscles to rotate your head to the left to push against your hand). Neither your head nor your hand should move as this is an isometric contraction.

This will cause “stress relaxation” of the muscles by a reflex called reciprocal inhibition. Muscles oppose each other and the body has developed a reflex to prevent joint destruction by inhibiting the antagonist (opposite) muscle from contracting. This technique of active release uses this reflex to relax the contracted muscle.

You will find that after this forced contraction, the head will move further in the direction that you are focused on.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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