Core's Spinal Pre-Hab Program


Even if Surgery is on the cards, there is scope for maintaining muscle tissue and expediting recovery.

Even when surgery may be required, continuing to engage the spinal muscles will help to maintain quality and optimal outcomes. Post surgery, within a day, patients are up and standing and walking, often with far less pain than when they went into have their surgical procedure. While the surgical role is to rectify the failed structure - this does not automatically restore normal muscle activation and function to support the surrounding area.


Deterioration in musculo-skeletal muscle happens very rapidly with disuse. We see rapid wasting of thigh muscles when someone is non weight bearing on crutches, and while it is not so visible through someones shirt, the same process happens in the back and the neck. There is evidence to suggest that there is fatty infiltration into the deep lumbar supporting muscles within 3 days of a discal injury. Failure to engage these muscles as much as possible as soon as possible so the body does not forget how to activate them is a critical part of our rehabilitation focus at Core. It is no less important - and perhaps more important for pre-hab prior to surgery than it is with an injury not requiring surgery.

These muscles that deteriorate are the key ones that maintain lumbar curvature, lumbar segmental positioning, and control the subtle motions above, below and adjacent to the damaged point in the spine. With pain the body splints to brace the area. The natural strategy when someone has an injury or fear of reinjury is to activate the top layer (or superficial muscles) to hold and guards the spine prevent motion. This process bypasses the deeper structures that normally provide the segmental support between the vertebrae. The deeper layers normally act like shoe laces - as they provide structure with a little bit of flex and give to allow subtle motion.

Have you ever tried going for a long walk with your shoelaces undone? Your legs will be achey and sore, and once tired, your vulnerability to trip and cause further injury is increased. The same goes for your back without your deep muscle, spinal shoe laces, working as they are designed to.


Our focused rehabilitation process reteaches the body how to engage these muscles, how to tense and tighten when you need it, and in doing so, helps to build the stable platform the spine requires so we can lift and load and carry things as we wish to once we have recovered. Delaying rehabilitation until after intervention - will only result in more disuse, fatty infiltration and a longer time to recover and reverse their state. Regardless how much pain someone is in, these muscles are subtle and the exercise program can be customized specifically to ensure it is manageable without any further provocation of symptoms.

We also have RTUS feedback available for muscle re-education of these muscles. We also utilize this for our anterior "core" muscle retraining - they too are critical in the recovery of the stability mechanisms via intra-abdominal pressure and the fascial attachments of the deep abdominal wall and associated stabilizing muscles.
spinal pre-hab before surgery by core healthcare logo

Continuing to engage the spinal muscles will help to maintain quality and optimal outcomes




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spinal pre-hab by core healthcare logo