Train like an athlete for surgery, sort of

If you know long enough in advance that you’re going to have major surgery, look at that time as an opportunity. You don’t have to be a passive recipient of the surgeon’s skills. You can contribute to the operation’s success. In the months before I had spine fusion with steel rods to correct scoliosis, I kept to an exercise program building up to the very day of surgery. I recorded it in my book Back to Life: A Journey of Transformation Through Back Surgery and here’s some of what worked for me.

I prepared for surgery the way a runner might train for a marathon. Okay, in truth, it was more like the way a non-runner would exercise enough to stay in the pack, glad to make it past the finish line at all. In retrospect, I wish I’d done more.

My goals were shaped by what I’d heard from former spine patients: one lost 20 pounds, mostly muscle, while he was in the hospital; several said they couldn’t lift their legs to step over the ledge into the shower; many told me they shuffled along with tiny steps at first; and everyone felt exhausted.

My plan was Pilates to target “core” muscles, mostly abdominals to help lift my legs and walk. A while back I’d attended mat Pilates classes at the gym, but not until I found a professional Pilates studio with trained instructors and a full range of equipment did I understand it. For six months I worked with Gaida, a teacher who was a ballerina, originally from Latvia. She focused on perfect positioning during specific movements that seemed to stretch my spine by using muscles to support it in alignment. She also worked on my mid-back, which had been rigid when I began. Whatever flexibility I could achieve might make the surgery easier, we reasoned, when it was time for the doctor to straighten my spine.

I can hear her admonishing, “Grow taller, taller, taller – yes!” After half a century of walking, now I was learning to walk, and when I walked down the street I became aware of abdominals moving up, and holding the crown of my head to the sky like, well, a ballet dancer.

Neither Pilates nor any other exercise can fix a 68 degree curve. But the concentrated training two days a week for six months had improved my strength and may have warded off back pain before the operation. And I learned how my body works in ways no one else had shown me.

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For years I’d practiced yoga with a wonderfully obsessed Yoga master who taught a class of five people. Each of them would have been ordinary except that they’d shown up for intense 90-minute sessions for so many years they were standing on their heads and gliding from “downward dog” to an array of poses suitable for Gumby or other rubber beings. For a while, I’d kept up with the others, but in the years before surgery as my spine declined by a degree each year, I found my pelvis was bumping into my rib cage, and one by one I had to sit out the poses. Finally, I quit.

I downgraded to yoga at the gym where every inch of floor was claimed by someone’s towel. Here, I figured I’d do what I could, and hide the rest of the time. Personally, I don’t recommend that kind of mass yoga. You could injure yourself if you’re not holding a pose properly, and no one would notice. Anyway, I was becoming too limited even for this group.

I wish I’d continued the hip-opening moves, though. After surgery, when I could no longer bend, being able to move my hip to the side and elevate my foot to the opposite thigh (as in the Lotus position) would be essential to maintaining a relationship with my feet. I should mention, though, that my pelvis is not fused, so my hips can move. If you’re fused down to your pelvis, this probably won’t be an option.

Besides Pilates twice a week, I intended to go to the gym three other days. I said “intended.” Sometimes I got there twice; on busy weeks, only once. I pushed myself on the treadmill, hoping I’d release endorphins, though I often didn’t succeed. When I didn’t get to the gym I walked a mile or so each day. All that’s really not much, but I was increasing my stamina at least a little.

I was afraid of upper body weight-training because I couldn’t risk compressing my spine, but if I could have afforded it, I would have hired a personal trainer at the gym. If your back is degenerating, as mine was, the risk of worsening the pressure on discs or that your spine might actually give way altogether is real. A professional might have provided the security to grow stronger, safely.

Working by myself, the treadmill, bikes, and various leg-lift machines built quads (thigh muscles) that I needed more than I’d anticipated. Now if I’m on a soft low chair and I can’t reach anything to pull myself up, or a hard surface from which to push off, my only resource has been these tough thighs (which women often lament as “too big”). Placing my hands on my upper legs, I can stand using the thigh muscles alone. If I couldn’t, I’d still be sitting there, waiting to be rescued.

Similarly, deep knee bends allow you to pick up stuff from the floor. Remember, you can’t lean over, so your only means of reaching earth and standing again is by working those thighs.

In hindsight, I wish I’d developed other muscles too. Lying in bed for weeks, my hamstrings (in back of my legs) began to shorten. When hamstrings are tight, it’s difficult to straighten your legs. And the stress of taking steps on legs that won’t lift or reach forward might send pain up into your lower back. The remedy is stretching, and if I’d known then what I know now, I would have lengthened those rubber bands plenty.

I also wish I’d improved my arms. It didn’t seem relevant before surgery, but when I was stuck in bed and my back and abs were too damaged to move me, the only way to turn or roll or lift up from the bed was to push with my arms. I’m told that men have greater upper body strength, so this might be easy for them. But if your shoulders aren’t flexible and your arms can’t bear your weight (as in push-ups), you’re stuck flat in that bed like a flounder.

But please don’t beat yourself up for having only 24 hours in a day, or having to go to work. Whatever you can do, do it, and that will help.

Josh Beard, associate head athletic trainer at Longwood University, answers questions about paralysis in the wake of the recent injury to Rutgers football player Eric LeGrand. Trend Line contributes Longwood University voices to the online conversation, sharing expert perspective on the day’s news, societal issues, popular culture and other topics trending across Google, Twitter, YouTube, and others.