[Medical Q&A] How should I exercise after surgery for lumbar disc herniation?

Planner: Chinese Medical Association

Reviewer: Li Jun, deputy chief physician, Peking University First Hospital

After patients with lumbar disc herniation return to the ward after surgery, they can start respiratory muscle exercises, perform ankle pump exercises on the day after surgery, and do toe-curling and straight-leg raising exercises on the second day after surgery. Functional exercises for the lumbar and back muscles depend on the surgical method.

(1) Respiratory muscle training: Deep breathing and effective coughing can help restore respiratory function. For abdominal breathing, lie on your back or sit comfortably. When inhaling, expand your abdomen as much as possible, so that the abdomen bulges, and the chest remains still; when exhaling, keep the chest still and contract the abdomen as much as possible.

(2) Ankle pump exercise: Hook your foot up to the limit, at which point the calf muscles will tense; then step your foot down to the limit, at which point the outer calf muscles will tense, and hold for 3 seconds. Patients should try to achieve the maximum angle of ankle pump exercise to improve the effect of the exercise.

(3) Lie flat on the bed, stretch your legs, tighten and straighten your thigh muscles, and make them form a 45° angle with the bed. Hold for 1 second each time, then slowly lower them. Do 10 sets per day, 5 sets per day. You can increase or decrease the number of sets as needed based on your personal situation.

(4) Functional exercise of the back muscles: Perform according to the doctor's instructions based on the surgical method. Functional exercise of the back muscles usually includes "five-point", "four-point" and "three-point". The "five-point" is to use the pillow, elbows and heels as five points of support to straighten the waist. Usually, the patient's back and waist are required to be 20 cm away from the bed, stay in the air for 5 to 10 seconds and then put down. 10 per set, 3 sets per day, and then gradually increase. The "four-point" is to use the hands and heels for four-point support. In the later stage, the "three-point" can be used, which means using the pillow and heels to straighten the chest and lift the back. "Little Swallow Flying" is also an effective way to exercise the back muscles. The specific method is: lying prone, lift the shoulders and arms off the plane, raise the head at the same time, and pull the shoulders back and up; at the same time, lift the feet, contract the back muscles, and try to let the ribs and abdomen support the body. Last for 3 to 5 seconds, and then relax, just like simulating the posture of a swallow flying.