Spine Art
07539330360
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You can make an appointment via telephone: 07539 330360

GP's please fax or surface mail referrals to:

Fax: 01325 341701

Email: secretary@spineart.org

Address:
1 Mill Wynd,
Yarm, Cleveland,
TS15 9AF

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Postoperative Physiotherapy Phase III

Phase III: Advanced Physio 12-18 weeks 
Goals:

1. Progress with strengthening and flexibility exercises.
2. Initiate lifting and posture training
3. Progress stabilization and trunk control

Treatment Summary:
 Manual Therapy: Joint mobilization of adjacent restrictions of thoracic spine, hip/pelvis.
  Soft tissue mobilization of soft tissue restrictions.
 Exercises:- Continue with range of motion (ROM) exercises for lumbar spine. Advanced balance exercises
 Neural mobilization exercises.
 Advanced stabilization and proprioceptive training (sport/activity specific) 
 Multi-plane stabilization/mobility 
 Advanced Hip/Core strengthening exercises: 
 Lifting training with proper posture. 

Criteria for discharge:

1. Manual muscle testing is within functional limits.
2. Independent with gym program.
3. Trunk ROM within functional limits
4. Pain levels < 2/10 VAS

Advanced Advice
 Focus on local muscle systems (tonic/postural/stabilizing)

 Avoid prone upper body extensions, or prone leg extensions (to avoid high compressive load of the already weakened spine)

 Because of diurnal variations in fluid level of the intervertebral disks (more hydrated early morning) it would be unwise to perform full range spinal motions (bending) shortly after rising
from the bed. Wait at least one hour.

 Focus on low load high repetitions to improve endurance rather than high load low repetition for strength.

 There is some evidence that low back exercises are most beneficial when performed daily.

Focus on pain relief with Oswestry scores of 40-60.
With scores of 20-40: focus on decreasing pain, muscle re-education, gradual strengthening, flexibility and improve cardiovascular endurance
With scores less than 20: focus on work simulation and progressive strengthening.