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Old Forum Fused Spinal Column

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Danny Sawaya

Level 5 Valued Member
Team Leader Certified Instructor
Elite Certified Instructor
I just signed up a client that has her entire Thoracic and Lumbar spine fused surgically. She actually has decent hip mobility but shoulders of corse do not retract. She signed up for a handful of sessions to learn how to train on her own. SHe has been using machines exclusively.  Any one else have experience with something like this.
 
I have seen 2 clients with this, one you could visually tell she had it, very straight spine, she was very careful, only did Spin classes. The second one I wouldnt have known just by looking at her. She wasn't really limited in her exercises, swings were fine, most standing stuff okay, just a few floor exercises that I think I had to modify. Sorry not much info, didn't train them for long.
 
Danny,

I'm a licensed Athletic Trainer and manage a physical therapy practice.  Good on you for taking this client. I would make sure that her goals are realistic and aligned with your expertise & level of training. I would also want to know what the underlying pathology was that resulted in such a drastic procedure.

Candidly, I'm always concerned when a client wants us to "show" them a few things so that they can train on their own. I'm sure that she didn't ask her surgeon to show her how to fuse just a few of her vertibra and she did the rest (...you're okay with some sarcasm?). My suggestion is that you show her why you are the trained professional and  upon seeing the value of your coaching, will sign up with you for a long term relationship. Sell her (1) year of training with you: (2) training sessions one week; (1) follow up session, then see her again after (3) weeks and begin the cycle again. This will not only validate your expertise but provide her with some level of periodization that must be taken into consideration when working with a post surgical patient (regardless of how long ago the surgery occurred)

That being said, with any decrease mobility there would then be areas of increased mobility above or below the joints in question. Restoring mobility to those restrictions while increasing stability to her  lumbar and t-spine are critical.

It may be that a lot of the preliminary work be done in a de-loaded state with bands or TRX. Followed by an increase in volume (first) then intensity ) second.

The challenge will be to make sure that your program does not inadvertently cause pain or increase in her pathology. High levels of communication with her physician and physical therapist will help you coach your client but also potentially result in some client referrals.

Hope that this helps & good luck.

Honch
 
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