After back surgery, the first and most important exercise is WALKING. Start the day of surgery or the next, short and often, a little further each day.
Gentle core and hip exercises usually come in from about two weeks. Proper strengthening often starts around four to six weeks after a microdiscectomy or laminectomy, and later after a fusion.
Your surgeon’s protocol always comes first. Fusion in particular often comes with tighter limits, and some surgeons want to see the bone healing before you do anything beyond walking. Where this page and your surgeon disagree, follow your surgeon.
The work is worth doing. Structured exercise that starts four to six weeks after disc surgery tends to bring pain and disability down faster than doing nothing, and it hasn’t been shown to raise the chance of needing another operation.
The BLT rule: bending, lifting, twisting
Most spine surgeons give some version of this for the first weeks. How strict, and for how long, depends on your operation.
- Bending: bend at your hips and knees, not your lower back. Squat or kneel to reach low things
- Lifting: light things only, held close to your body. A common early limit is about 10 pounds, roughly 4 to 5 kg. That rules out laundry baskets, full grocery bags and small children
- Twisting: turn with your feet, not your spine. Move your shoulders and hips together
- Sitting: short spells at first, around 20 to 30 minutes, then get up and walk
- How long: often a few weeks after a microdiscectomy or laminectomy, and commonly several months after a fusion while the bone knits
MedlinePlus has a clear guide to activity after spine surgery that covers these limits.
Phase 1, weeks 0 to 2: walk and move gently
- Walking: 5 to 10 minutes, several times a day, on flat ground. Add a minute or two each day
- Ankle pumps: point your feet down, then pull them up, 10 to 20 times every hour while you’re awake. It keeps blood moving in your calves and lowers the risk of a blood clot
- Deep breathing: 5 to 10 slow, deep breaths every hour or so in the first few days
- Log roll out of bed: bend your knees, roll onto your side as one unit, let your legs drop over the edge and push up with your arms. Reverse it to lie down
- Gentle tummy tightening, if your team is happy: lying on your back with knees bent, draw your belly button gently in and keep breathing normally. Hold 5 to 10 seconds, 10 times
Phase 2, about weeks 2 to 6: gentle core and hips
Start this once walking for 20 minutes feels comfortable, usually after your first check-up. After a fusion, ask first.
- Heel slides: lying on your back, knees bent, gently tighten your tummy and slowly slide one heel out until the leg is straight, then back. Keep your back still. 10 each side
- Buttock squeezes: squeeze your buttocks together, hold 5 seconds, relax. 10 times
- Small bridges: lying on your back, knees bent, tighten your tummy and lift your hips a few inches. Hold 3 to 5 seconds and lower slowly. Start with 8 to 10
- Sit to stand: stand up from a firm chair, bending at the hips with your back straight, and sit down slowly. 5 to 10
- Longer walks: building toward 30 minutes or more, once or twice a day
Walking is the exercise. Everything else is built on top of it.
Phase 3, from about 6 weeks: build strength
After a microdiscectomy or laminectomy, this is often when formal physiotherapy begins. After a fusion it usually comes later, once your surgeon is happy with healing.
- Bird dog: on hands and knees with a flat back, slide one leg back and lift it level with your body. Later, add the opposite arm. Hold 5 seconds, 8 to 10 each side
- Clams: lying on your side, knees bent, keep your feet together and lift the top knee. 10 to 15 each side
- Side plank from the knees: lying on your side, prop on your elbow and lift your hips so your body is straight from knees to head. Start with 10 to 20 seconds
- Lifting practice: pick up a light box from a chair using your hips and knees. Over the weeks, lower the start height before you add weight
- Swimming and cycling: once the wound has fully healed and your surgeon agrees
- Progress one thing at a time: more repetitions first, then harder versions, then weight
For what else to expect in recovery, see microdiscectomy recovery, laminectomy recovery or spinal fusion recovery.
What to avoid early on
- Toe touches, sit-ups and crunches: they bend the spine under load
- Heavy lifting, including gym weights, until your surgeon clears you
- Twisting sports such as golf and tennis in the first months
- Running, jumping and contact sport: these come back last
- Doubling up after a bad day. Steady beats heroic
How much pain is OK?
- Wound soreness and a back ache with activity are normal in the early weeks
- During the exercise: a mild ache is fine. New or increasing leg pain, numbness or tingling means stop that exercise
- After the exercise: discomfort should settle within an hour or two
- The next morning: this is the real test. If your back or leg is worse than the morning before, you did too much. Drop back a step for a day or two. Don’t stop moving
- When to move up: when walking and your current exercises feel easy with no next-day flare, add one new thing
Go to the emergency department now if
- New numbness around your genitals, back passage or buttocks, the area that would touch a saddle
- New trouble peeing, not being able to pee, or leaking pee or poo without knowing
- New or quickly worsening weakness in one or both legs, or your foot starts to drag or slap
- Pain, numbness or weakness in BOTH legs
- Chest pain or sudden shortness of breath
The first four can be signs of cauda equina syndrome, pressure on the bundle of nerves at the bottom of the spine. It needs treatment within hours. Don’t wait to see if it passes.
Call your surgeon today if
- The wound is red, hot, swollen, spreading or oozing
- You have a fever or chills
- Clear fluid leaks from the wound, or you get a severe headache that’s worse sitting up and better lying flat
- Your calf is painful, swollen or warm: possible clot in the leg
- Your leg pain comes back after it had settled
Mention it at your next review if
- Pain is stopping you from walking further each week
- You aren’t sure which exercises your surgery allows
- Numbness or weakness isn’t improving after a few months
Walk first, brace second, lift last.