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It is important to remember that no surgery can ever restore a herniated disk to it's original strength. The hole or weakness in the annulus will repair itself, but it will never achieve the original strength of the annulus prior to the disk herniation. It is similar to the analogy of an ankle sprain. Once sprained, it heals, but only to some fraction of the original strength. In fact, with each successive sprain, the ligaments heal, but are less and less able to maintain ankle stability. The same is true with the annulus of the lumbar disk. This is why it is imperative that patients take an active role in trying to reduce their risk of future disk herniation.
This preventative care revolves around 3 important principles all designed to try and reduce the daily stress on the disk annulus.Remember and practice these faithfully, and you will be doing all you can do to reduce your risk of a recurrent disk herniation. A recurrence will not only further weaken the disk, but could mean ADDITIONAL SURGERY!
Although this is often stated, and seemingly understood, the key is, less is better. We place patients on a lifting restriction of 40 to 50 pounds, since lifting beyond this places severe stress on an annulus already weakened. How you lift is also important (lift with legs, back straight, NEVER with your back bent) but remember, less is better. If you have the option of two trips with 20 pounds each, this is far easier on your back than one trip with 40 pounds. A corollary of this is, of course, your body weight. Every extra pound you are carrying is an enormous additional stress on the disk, since each of those additional pounds is multiplied by the 18,000 steps we take every day, and the 16 hours we are upright. I always use the analogy of ankle weights. Ankle weights weigh only 3 pounds, and when first picked up, one guesses that wearing them could not help strengthen your legs, because they feel so light. However, strap them on, start walking, and you quickly feel the strain, because you are multiplying three pounds TIMES many thousands of steps. Do the math, and you realize why your legs feel like they are about to fall off after walking a few blocks. The same principle applies to the stresses on the disk when we are even a few pounds overweight, and why losing even a few pounds makes a tremendous difference on the everyday stresses that the disk feels.
Activities such as jogging, jumping, basketball, volleyball, horseback riding are all very hard on disks. If you choose to exercise, choose smooth low impact activities, such as walking, biking, Stairmaster, treadmill, etc. Even the "racquet" sports, such as tennis, squash, golf, etc. are easier on your disk than high impact activities. This does not mean you cannot run for the bus, or shoot hoop with your kids, but as a regular activity, jogging and jumping are to be avoided.
As we discussed, you do not have to do much. Working up to 30 or 40 crunches each day is IMPERATIVE. If you find you are not keeping up with these daily abdominal exercises, reduce the number, but never give them up!
REMEMBER THESE THREE THINGS, AND YOU WILL BE DOING EVERY THING YOU CAN DO TO REDUCE YOUR RISK OF ANOTHER RUPTURED DISK!
Click here for exercises following lumbar surgery.
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