Patient Exercises to be Performed Daily as Tolerated
(to be instructed by physical therapist with diagram handouts)

Initial Exercises (beginning 6 to 12 weeks post procedure)

• Supine hamstring stretch ----- 3 reps bilateral 30 sec hold (with back flat)
• Pyriformis stretch ----------- 3 reps bilateral 30 sec hold ( with back flat)
• Knee to chest (with back flat)
  • single --------- 3 reps bilateral 30 second hold
  • double --------- 3 reps 30 second hold
• Prone over pillow (butt/glut squeeze)-- 10 reps - 10 second hold (if patient tolerates extension and prone lying)
• Walking --------------------- 20-30 minutes daily (as tolerated)

Supplemental Exercises (Care must be taken with extension sensitive patients)

Patient may advance to Supplemental exercises after 4 weeks of Initial exercises if pain is minimal and exercise tolerance is high (i.e., no increase in pain due to exercise).

• Pelvic Brace ------------------------ 30 reps - 10 second hold
• Abdominal curls with feet on floor -- 30-50 reps
• Swimming (optional) - all strokes, moderate speed, limited kicking, primary pull
• Stationary bike (optional) ---------- not recumbent
• No stairmaster
• No rowing machine
• No aerobic classes

Patients are encouraged to walk daily and gently perform their pre-procedure program of stretching exercise.

Months 3-4

Advanced Exercises	Aerobic Exercises
Bridging (as tolerated)	Walking
Dying bug progression	Swimming (no flip turns)
Prone superman progression	Stationary bicycle
Gym ball: bridging, prone (optional for Month 3)
Advance swimming
Supervised gym program Biceps Triceps Flat bench Lateral raise Lat pull Seated (straight) row NO back or abdominal machines NO torso machines NO squats - leg press machine with proper instruction at 75% capacity

Months 4-6

Resumption of athletic pursuits will be individualized. The decision is dependent upon pain level, physical performance level and the number of disc levels treated. Special instruction for golf and tennis are necessary.