Lumbar fusion

[Pompal 09.]

I have a client coming in that had surgery in Oct of last year- a lumbar fusion of L-3 to S-1. She says she couldn't walk for a while after surgery, then started walking with a walker, now walks with a cane but she says not very well. She has been in physical therapy and has a doctor's recommendation for massage, and for water therapy- which she says she hasn't started yet, but plans to when she can find a program to go to. She says she won't have a problem with lying on the table. I'm unsure of what I'm going to do until I've actually seen her and got my hands on her. I'm thinking maybe some gentle stretching of the hips/low back region and I'd like to discuss doing myofascial release in future sessions if she intends to come regularly. Does anyone have experience with this particular thing, and if so what advice would you have?

 

[Pompal 09.]

Make sure when you have her roll over that you help her. She needs to log roll over. She cannot twist her back at all, due to it is still healing. She will need to lay down on her side then roll to her back. then she will roll to her side and push herself up to a sitting position. Be prepared because she still may be fairly slow at this. I worked on the surgical wing of the hospital for 3 years, and the Dr.s always told them to take it easy for about the first 6-9 months. She may need help getting up and down.  I hope this helps.

 

[vance1167]

Consider asking her if you can contact her doc or PT and find out just what she is and is not allowed to do.A fusion is just that, a fusion - which you already know. آ Since the idea is to make the area no longer have movement, the plan is that the fusion will take. آ Also, since it is since Oct., they should have some secondary films by now, so the doc can tell you if it looks like the fusion is progressing as expected or not.  That is a pretty big area to have been fused.  She's got 3 fusions going on.  That's three discs removed and 3 cadaver bones placed in, and probably some hardware put in place as well, depending on the doc.  A pretty nasty surgery in some cases.  Though some people can do it clean.  You may want to find out if she had two docs on the case or just one.  I have seen this performed with and ortho & a neuro in the same op room at the same time.  Not a pretty site.  I have also seen a few segements done by just a neuro. Much cleaner.  So, the more you can find out about who and what was done, the better it will be to assess where you even want to begin.  Another thing, is that you can use this as a jump off point to get to know the physician of the client and possibly get a few referrals or go in and follow the doc in his practice for a day.  It's a great way to make a new contact and possibly a person to refer your clients to some day if they are in need.I'd first work with gentle work above and below the area until I got more info from the doc. آ You could also consider working the legs and upper body somewhat more than gentle, since these regions are going to have some residual problems. آ If possible work the whole body and not only the region of dysfunction. آ At this point, I would think full body work is going to be more beneficial than anything else.But, definitely consult the ortho, neuro or osteo who did the work first if possible.Those are my thoughts, hope they help.

 

[No longer waiting!]

Lumbar fusion

My girlfriend has L4-L5 fusion. She used to eat Alieve like candy.. Now that I have been working on her she hardly ever takes them.I use cranio sacral on her. She loves it. rock and glide.. hand placement on sacrum and other hand on cranial base.. with the flexion and extension you rock to the left or right depending on which side you are on and move the other hand in the same direction.. she gets relief from the pain.Still point is good. and a nice neck pull. I was so scared with this one, but place one hand under the base of the skull and the other cupping the chin with one finger on top and the others under.. ask the client to breath and pull steady and firm. It is a nice stretch and hold it a few breaths and release.. she said it pulls the whole way down to her tailbone and she gets a nice stretch.I also do all the listening stations for the lower CS protocol. (I learned 2 inschool)She gets heat on her L5 S1 area and then QL, glutes, and transverse spinous work from sacrum to her neck. (scoop and dig the tissue down, in and up towards the head) hope that helpsSh

 

[Nadi]

If a client has a fusion of vertebrae the muscles around it would indefinately create some form of protective splinting mechanism allowing for a more stable condition.  Because we all know that the body prefers stability over mobility.  The question you need to ask yourself is how much stability do you want to take away from your client?  Automatic protective splinting, anywhere in the body, must be carefully analyzed before working on it.  Ask yourself- why is it there?  What is it doing?  What will happen if it becomes less stable? How much stability do I want to take awy from the client?...

 

[trehugr4life]

Lumbar fusion

I had a client that had his entire lumbar fused. He had a difficult time walking and was seeing physio for weakness of several muscles. Does your client experience any weakness of hamstrings, quads, calves? In my instance, it turned out to be a matter of vertebral rotation creating impingements on the sciatic nerve. Treat the psoas and weakness was gone almost immediately.Jay

 

[heaven mclovin]

Fused vertebrae is a pretty traumatic experience on the body, and musles like the psoas, QL, transverse abdominus, and errector spinae are going to transform into some heavy duty stabalizers.  The body wants to be stable before it wants to be mobile period.  There's no getting around that.  You need to ask yourself how much of the stability do you want to take away from the client.  In a situation where these muscles job is to form a splint(e.g. a fused vertebrae), Yes you may get some temporary relief by treating them, but they will just go back even tighter than before in the near future.  Stability before mobility...think about it.

 

[woo]

massaging splinting muscles on fused vertebrae

Y'all, in this old conversation, "clear intention" note that massaging splinting muscles may reduce pain but also hurt stability. s/he asks how much stability you're willing to lose for the sake of the pain reduction. can someone suggest the answer? it sounds like clear intention wouldn't owrk them at all. surely you treat the muscles to some extent?

 

[lakersfan]

massaging splinting muscles on fused vertebrae

Y'all, in this old conversation, "clear intention" note that massaging splinting muscles may reduce pain but also hurt stability. s/he asks how much stability you're willing to lose for the sake of the pain reduction. can someone suggest the answer? it sounds like clear intention wouldn't owrk them at all. surely you treat the muscles to some extent?

I have not worked with a client with fused vertebrae, but one thing stood out to me immediately reading this: the client had a recommendation for massage from her doctor. That means the muscles do need some work, and massage will be safe. One of the early responses was to speak with the doctor to get more information. I think that would be the only way to proceed - but I would certainly proceed.

The client should not have to be in pain forever due to muscle splinting. The surgery was most likely done to reduce pain, not to exchange that pain for another. It does sometimes work that way, but that is not the intention of the surgeon. If the surgeon okays massage, it's okay.

 

[Not So Ordinary Girl]

Thanks Sharon, for your well-worded and thoughtful reply!