The fact that your doctor has allowed you to go home and recover means that you will soon be able to resume your independent activities and return to your daily life. However, at this time, you must take care to protect your low back and only increase your activity level within safe limits. During the first few weeks at home: You may feel weak and easily fatigued, but your strength is returning every day. You may sometimes experience pain at the surgical incision site and tingling symptoms in your back and legs. These symptoms suggest that nerve recovery is slow. As long as there is no gradual worsening of pain, activity should be maintained as much as possible. Preventing disadvantages: Pain that lasts more than 2 hours after activity means you are moving too much. When you feel pain, you should reduce your activity or be aware of your movement and posture when you are active. Recovery will be complete 6 weeks after surgery. However, if pain continues, activity should be reduced. WALKING ACTIVITY PROGRAM: The best exercise after surgery is walking. It helps to strengthen the muscles of the back and lower extremities, increase endurance, and reduce stress. At first, you can move around indoors. Walk several times a day. It is best to have a plan or goal for regular exercise. Seek medical help immediately if you experience: persistent or severe pain, weakness, or numbness in the back or lower extremities; redness, swelling, and discharge near the surgical incision; accompanied by fever, severe headache, or extreme fatigue; difficulty breathing; problems controlling bowel movements; edema and impaired mobility in the lower extremities. 1. Requirements for lying position and posture, exercise methods and guidelines for daily living Supine or side lying position: less pressure on the spine than other positions. However, care should be taken to protect the back. Postural requirements: supine position: put pillows under the neck and knees, keep the knees slightly bent; tense the abdominal muscles when changing positions and roll on the bed; do not lie on your back, as this position puts more strain on the lower back. Side-lying position: lying on the side with knees bent, head and neck and a pillow between the knees; tense the abdominal muscles when changing positions and roll on the bed. From lying to sitting position: supine position, tense the abdominal muscles, roll into a side position; slowly move to the edge of the bed; support the body with one elbow and the opposite hand, while swinging the feet to the ground; maintain the normal posture of the spine, abdominal support; lying down in the same position. Exercises: ① Hip Tensing – The purpose of this exercise is to strengthen the gluteal muscles. Lie on your back with your spine straight, tense your gluteal muscles, count to 5, and then relax. ② Semi-sitting position: the purpose is to strengthen the abdominal muscles. Must be performed with physician’s consent or under physician’s supervision. ③ lie on your back, straighten your spine, bend your knees; tighten your abdomen and buttocks; cross your hands and press down on your shoulders on the bed, and watch the ceiling with your eyes, don’t bend your neck on your chest; contract and hold your head up for 1 minute, several times a day. Daily life guidelines: ① Wear loose clothing, slippers, easy to put on and take off, can use tools to help. ② Before going to bed or when lying in bed, put the necessary supplies within reach, do not twist your back when you take the items, if you have difficulty doing it yourself, you can ask someone to give you help. ③ bed sex, side position is more comfortable; if the supine position, under the neck or knees with pillow support, to avoid arching the back, and avoid getting up too quickly, you can ask the company to give help. 2. Requirements for standing position and turning, exercise methods and daily life guidelines Generally speaking, standing position and turning have greater pull on the spine than sitting position. We need to get up and perform activities frequently every day. Your orthopedic and rehabilitation physician will teach you how to stand, turn without twisting your spine, and how to exercise the muscles of your strong calves and lower extremities to better support your back. Postural Requirements: Standing and Turning: Stand with your feet shoulder-width apart and one foot slightly forward; keep your knees slightly bent and your stomach tucked in; turn on the axis of one foot and visualize your body as a cylinder without twisting at the level of your pelvis. If you have to do something: items should be placed within reach; frequently used items should be placed on the outer shelf of a cupboard; heavier items should be placed in a corner; lighter items should be placed a little higher up, and the items should be close to your body when you pick them up. If you have to climb, use a ladder, and don’t lift your elbows above the shoulder joints when picking up items. Climb up and down slowly and keep your spine straight. Keep one hand in a fixed grip. Do not climb a ladder if you are taking pain medication. This is because some medications can cause dizziness or affect your balance. Exercises: ① Heel raises – Heel raises strengthen the muscles of the calf. Holding your hands on the handrails, the edge of the bed and the edge of the table, raise your heel to keep your balance; stand on your forefoot and lower it again. ② Calf Strengthening – Stronger calves help with standing and turning. Keep your spine balanced while standing, take a step forward with one foot, hold your hands on the wall or the back of a chair, keep your feet on the ground, and flex your front leg forward until you feel a tugging sensation in your back leg. Count to 20, then switch feet and continue. Do not arch your back. Guidelines for daily life: ① Washing in the bathroom – Stand in front of the sink with your hips and knees slightly bent, keeping your back in a natural position. ② Bathing – take a bath with a hand-held bath head. Bend your knees and hips under the shower head and do not bend your back. Use a long comb to comb your hair and use a hydraulic shampoo so you don’t have to bend over to pick up the soap. ③Working in the kitchen – keep frequently used items within reach or on the middle shelf of the refrigerator. When working standing, step on a small stool with one foot in front of the other. 3. Postural requirements, exercise methods and guidelines for daily living for sitting Postural requirements: The pressure on the spine is greater in the sitting position than in the standing and lying positions. First of all, try to avoid sitting for a long time. As the spine recovers, the sitting time can be extended. If you must sit, use a sturdy, backrested chair that can be adjusted up and down, keep your feet flat on the ground and your knees level below the hip joints. Relax your shoulders to maintain the normal curvature and balance of your spine. If the chair does not support the lower back, use a soft pillow or lumbar support to support forward bending of the lower back. You can also use a towel roll, about 2-3 inches or so, and place it on the area of the chair that needs support. From sitting to standing position: Move to the front of the chair, tuck in your stomach, and take a slight step forward with one foot. If you are leaning on the armrests, grab the support of the armrests with both hands; if there are no armrests, hold your knees with both hands. Hip flexion: Support with both hands, tense the leg muscles to stand up and keep the spine balanced. From standing to sitting: Tuck in your stomach, flex your hips, and sit slowly and steadily in the front part of the chair rather than sitting very deeply. Then slide backward, supporting your spine with the back of the chair. Exercises: ① Contralateral hand-knee press – This exercise strengthens your abdominal and thigh muscles. Sit down in the normal position of your spine. Lift your left knee and squeeze it against your right hand for a count of 20 without arching your back. Repeat the same exercise with your left hand on your right knee. ② Slide against the wall – good for strengthening the muscles of the thighs. Back against a smooth wall, feet slightly away from the wall 18-24 inches. Relax your shoulders, if necessary, place a towel roll on the back of the neck, keep the natural shape of the spine, slowly slide down to a half-sitting position. Count to 10, then slide upward to stand up. Guidelines for Daily Living: ① Driving – Adjust steering wheel until knees are under hip level; when exiting the car, rotate hips, move legs out and knees together. Do not twist spine. Stand up with a strong leg. Enter car door, same as above. ② Writing work: seek advice from your physiotherapist before preparing to return to work and arrange your desk and environment to protect your back. ③ Eating – the dining table should not be too short, do not lean forward or support your elbows on the table. ④ Toileting – the toilet seat should be able to be raised or semi-automatic, which can be purchased at medical stores. 4. Postural requirements, exercises and guidelines for daily living for bending and lifting Postural requirements: Avoid bending and lifting as much as possible in the first few weeks after surgery. Seek help whenever possible. When bending forward – stand with feet shoulder width apart and tuck in the abdomen; bend the knees and hips and pucker the buttocks, but do not bend at the waist; when standing, press the knees with both hands and tuck in the buttocks, and use aids to help. When squatting – keep one leg forward to keep your spine balanced; bend your knee until the knee of your back leg touches the floor; hold onto some object for balance; press your knee to bring yourself to your feet. If you have to carry – stand with feet shoulder width apart, as close to the object as possible, one foot slightly forward, and tuck your stomach. If necessary, bend your knees and hips to keep your spine straight. Grasp the object with both hands, close to the body. Rely on the power of the hip and lower limb muscles to make yourself stand up, rather than relying on the back to exert force. Exercise: ① Lower extremity pulling: lie on your back, bend your knees, tighten your abdomen; straighten one side of the lower extremity, place a towel behind it, and pull on it with both hands. Slowly pull the towel to make the thigh straight, keep the knee straight, count to 10, and then change the other leg. Each day, raise your leg a little more. Do not do this exercise if you feel a pull or pain in your back or legs. ②Collected Leg Exercise: Good for strengthening the muscles in the front of the thighs. Keep your feet slightly apart at shoulder width. Keep your body balanced and grab the back of a chair with your right hand or fix it to the wall. Grab the left ankle with your left hand and pull the left heel toward the left hip. Do not bend over or turn your body to one side. Count to 20 and then change your lower limbs. Daily life guide: ① store shopping: purchase a small amount of items each time, do not purchase at a time; both hands to lift an equal weight. ② Put shopping bags on the car parking space rather than on the floor or in the trunk. ③ Carry small children – do not carry small children until after you have recovered from spinal surgery. Diaper changes should be done on a liftable countertop or adjusted to waist height. Keep items within reach, such as toys, and do not pick them up from the floor. If you have to pick up a child from a stroller, lower the rail next to the bed. Stay close to yourself when holding a child. 5. Postural requirements and exercise methods for push and pull movements Postural requirements: Pulling is more stressful to the spine than pushing, so you should push rather than pull as much as possible. However, avoid pushing heavy objects. When pushing objects, keep your elbows close to your body, take small steps forward, keep your upper body straight, and don’t bend forward Don’t use a vacuum cleaner to clean your home until your doctor agrees. If you have to pull, stand in a standing position one foot slightly forward and bend your knees slightly. Stay close to the object and tuck your stomach to keep your spine in a normal position. Keep your elbows fixed at your sides and move your back to pull forward without bending or twisting your spine. Exercise: Chest and Shoulder Stretch or Pull – This pull relaxes the chest and shoulders. Stand facing a corner with your back in a natural position. Stand with one foot slightly forward. Flex both upper limbs at a normal angle and place your hands on the wall. Keep your elbows at shoulder height. Tilt the body slightly forward until you feel the chest pull, do not bend at the waist. 6. What other measures should be taken to promote recovery during the postoperative rehabilitation phase In order to recover faster you also need to avoid other factors that affect your health, including psychological stress, being overweight and smoking. Reduce tension – Stress can cause tension and pain. This can be overcome by: Deep breathing – Slow, rhythmic deep breathing can help you relax. Inhalation and exhalation can be counted slowly to 5. Meditation – Imagine unreal and beautiful scenarios. Relaxation training – work from head to toe by tensing and relaxing your muscles. Tighten and relax each set of muscles for a count of 5 to 10. Weight control – Obesity puts a lot of stress on the lower back. It can be achieved by consulting your doctor, by controlling diet and strengthening exercise. Walking Exercise – Walking is part of rehabilitation and something you can do from now on to maintain a healthy back. Regular exercise helps reduce stress and helps you maintain your weight, and it’s best to walk regularly to make it a habit of your life. No smoking – Smoking can slow down your recovery. Muscle health depends on oxygen uptake. Consult your doctor on how to quit smoking. Your doctor may be able to offer you some medication. Design your own exercise program: This includes the use of lower leg pulls, lower leg tucks, chest and shoulder pulls, calf pulls, hip tucks, heel raises, and other exercises.