L3 L4 Spinal Fusion with L5 Compromised

by Patricia
(Fremont, 03044)

L3 and L4 have been fused 1 yr ago.

I started Pilates in May a year after my fusion.

My instructor is wonderful but I am not sure if there are some movements that I should not be doing.

I currently have L5 issuse with pain in the hip flexors and across back and down my legs.

I find it difficult to walk.

Could you help me decide if Pilates is right for me?


Hello Patricia and thank you for putting your trust in me.

Pilates exercises can be beneficial for most people when the right exercises and modifications are chosen.

I assume you are working with an instructor on the equipment.

One question I have for you is this...

Has the pain increased since you began Pilates?

Keep the instructor informed as to any changes in your physical condition. Ask if he/she is comfortable working with someone with your condition. Even though you really enjoy them personally it may not be a good fit for you. Especially, if they don't have experience working with someone with your back condition.

You should definitely avoid any excessive spinal side bending, rotation, forward flexion and back extension.

I am guessing you are on the reformer doing footwork lying. You might suggest doing the footwork sitting upright on the wunda chair. I do this with my own clients who have spinal conditions such as yours until they are strong enough to hold neutral while lying. Otherwise you may strain your back as you glide in and out on the carriage.

Learn neutral spine position and do all of your exercises here to begin with until the pain subsides, then begin to add some gentle spinal flexion, rotation, and bending.

Find all of my mat exercises with modifications for back and joint conditions from beginner to advanced moves here:

Pilates Ebook

I believe Pilates is right for you, you just need the right combination of exercises to overcome your pain and to move forward with your strength. Maybe you need to back up and revisit the fundamental movements that you should have started with.

Have an open discussion with your Pilates instructor and let them know how you are feeling good/bad and then make the changes you need to to move forward with your progression. Whether with this instructor or another.

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Pilates after L4/L5 Fusion and Autograft

by Treasa
(Granby ,CO USA)


I have had L4/L5 fusion with autograft.

My surgeon has certain restrictions I must follow.

These restrictions are:

No Lifting (over ten pounds)
No bending
No twisting.

These restrictions are for 12 weeks.

My question is after the 12 weeks are up, would I be able to use a Reformer with cardio rebounder...immediately or will I have to go through a rehab progam first.


Jennifer's Response

I would recommend doing several weeks of regular Pilates equipment training first to restrengthen your core muscles.

The cardio rebounder requires quite a bit of core muscle activation and support from there to stay in neutral spine while jumping.

Following the regular Pilates work I would suggest adding in short bouts of cardio jumping over several weeks to safely and progressively gain your strength back and make sure you are not overdoing.

Best to you!

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Mar 10, 2023
Stomach Massage exercise
by: Anonymous

I believe my pain during pilates is the stomach massage exercise. I’m fused from L5 to S1. Any other fused pilate members wish to share or teachers?

Mar 17, 2012
L4/L5 fusion
by: Treasa

Thank you, Jennifer.
Seeing that I basically did not have any core muscles left prior to the surgery. I think that your advice is sound.

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