Exercise guide after lumbar decompression surgery

In this blog, we look at the types of exercises commonly used after lumbar decompression surgery, and how they’re progressed.

It has been developed with insights from Jakub Chudy, physiotherapist at HBF Physio Bull Creek, and reflects his clinical experience supporting people through recovery.

Always follow your care team’s advice

There’s no one-size-fits-all exercise program after lumbar decompression surgery. Rehabilitation plans are typically guided by your surgeon or physiotherapist, and may vary depending on factors like the type of procedure performed, healing progress and overall health.

Rehab should be guided by both time and how your spine is responding, with exercises introduced and progressed under clinical supervision.

Remember: Following your surgeon’s and healthcare team’s post-operative advice is essential for a safe recovery. This is especially important after spinal surgery, as failing to follow recovery guidelines can lead to serious complications and may negatively affect your surgical outcome.

Early-stage exercises: Supporting movement and circulation

In the early phase, exercises are focused on gentle movement and circulation, not building strength quickly. Examples of early exercises include:

• Ankle movements: Used to help improve circulation and support nerve movement in the legs.
• Pelvic tilts: Gentle movements that support back mobility and muscle activation.
• Knee rolling: Side-to-side movement that can help reduce pain and improve back mobility.
• Prone lying and gentle back extension: Positions that may help the back gradually adjust after surgery.

These exercises are often started early, even if there is mild discomfort, and are designed to help your body begin moving again in a controlled way.

Mid-stage exercises: Building strength and movement control

As recovery progresses, exercises are gradually introduced to support strength, stability and control. Examples include:

• Core activation exercises (e.g. transversus abdominis activation): Supporting stability in the lower spine.
• Bridging exercises: Strengthening the muscles around the hips and lower back.
• Hip and lower back strengthening (e.g. bent knee dropouts): Helping improve control and support for movement.
• Back arching movements (on hands and knees): Supporting movement and strength in the lumbar spine.

At this stage, walking is often continued and gradually increased, as it plays an important role in maintaining mobility and overall fitness.

Later-stage exercises: Returning to functional movement

As healing continues, exercises may become more functional and activity-based. Examples include:

• Progressing walking distance and endurance
• Introducing low-impact activities such as cycling or swimming (once guided as appropriate)
• Gradually returning to more demanding movements as strength improves

Activity progression is typically gradual, with a focus on rebuilding confidence in movement over time.

Exercise progression: From gentle movement to everyday activity

Rehabilitation after lumbar decompression surgery usually follows a gradual progression. Across different programs, exercises typically move from gentle, supported movements to strength and control exercises, and finally to functional, everyday movement and activity.

Progression is guided by pain and comfort levels, movement and mobility and strength and endurance. This gradual approach helps support recovery while reducing the risk of doing too much too soon.

Exercise should feel manageable, not overwhelming

It’s normal to have some ups and downs as you increase your activity. You may find that:

• Doing too much can make your back feel sore
• Scaling activity back temporarily can help symptoms settle
• Gentle movement can support healing

Fatigue is also common during recovery and tends to improve as your activity levels increase over time.

How can HBF help?

If you have eligible extras cover with HBF, you may be able to claim benefits for visits to a physiotherapist as part of your recovery after lumbar decompression surgery.

Physiotherapy can support recovery by:

• Guiding safe exercise progression based on your recovery stage
• Supporting strength, mobility and confidence
• Monitoring how your spine responds to activity
• Adjusting your program as your recovery progresses