Lumbar Spondylolisthesis and Spondylolisthesis Exercises

Lumbar Spondylolisthesis — Another Cause of Low Back Pain.

Occa­sion­al­ly I see a young per­son in my office with a par­tic­u­lar pat­tern of low back pain.  It could be a high school base­ball play­er of 16 or a dancer of 22.

(If you’re old­er than that, keep read­ing – there’s use­ful infor­ma­tion in here for you, too.)

Often, the prob­lem begins after an ath­let­ic activ­i­ty involv­ing lots of back­ward bend­ing – gym­nas­tics, for instance.  The pain is typ­i­cal­ly locat­ed in the cen­ter-line of the low back.  It’s worse when adopt­ing a sag­ging pos­ture.

With this pat­tern of pain, I’m begin­ning to sus­pect that they may have lum­bar spondy­lolis­the­sis.

lumbar vertebra

Spondylolysis

Spondy­lolis­the­sis starts as a stress frac­ture of the ver­te­bral arch.  (The break itself is called spondy­lol­y­sis.)  The frac­ture occurs from over­load­ing the spine in a back-bend­ing motion.  Some­times it occurs from a one-time trau­mat­ic injury.  But more often it’s a grad­ual dete­ri­o­ra­tion of the bone from repet­i­tive stress.

Once you have spondy­lol­y­sis and the ver­te­bral arch has lost its integri­ty, the front part of the ver­te­bra (called the ver­te­bral body) can glide for­ward rel­a­tive to the ver­te­bra beneath.  Then you’ve got spondy­lolis­the­sis.

Spondy­lolis­the­sis doesn’t always hurt or cause oth­er symp­toms.  That’s why a lot of peo­ple – up to 5% of adults are believed to have spondy­lolis­the­sis – may not even know they have it.

Spondylolisthesis Treatment

If the spinal stress frac­ture is detect­ed soon after it starts, the treat­ment con­sists of wear­ing a brace for a num­ber of weeks.  The goal is to actu­al­ly get the bone to knit back togeth­er.

But in an old­er per­son, it’s too late for that.  Nor­mal frac­ture heal­ing is nev­er going to occur.  Instead, the treat­ment goal is to reduce pain, pre­vent fur­ther for­ward slip­ping of the ver­te­bral body, and restore nor­mal spinal func­tion as much as pos­si­ble.

Lum­bar brac­ing can still be an impor­tant part of the treat­ment, as well as selec­tive strength­en­ing and range of motion exer­cis­es.

When the for­ward ver­te­bral slip­page gets severe, and the symp­toms are unre­spon­sive to con­ser­v­a­tive mea­sures, surgery for spondy­lolis­the­sis becomes an option.

Spondylolisthesis Exercises

Exer­cis­ing cor­rect­ly is crit­i­cal for treat­ing spondy­lolis­the­sis.  The prin­ci­ples of prop­er align­ment and body use — which are impor­tant for every­one — are dou­bly and triply impor­tant for some­one with spondy­lolis­the­sis.

Because the details of pos­ture and exer­cise are so crit­i­cal for some­one with spondy­lolis­the­sis, I’m  hes­i­tant to include any spe­cif­ic exer­cise infor­ma­tion in an arti­cle this brief.  That’s why I’ve writ­ten a more exten­sive, ful­ly illus­trat­ed report on spondy­lolis­the­sis which you can access here.

But here are a few impor­tant prin­ci­ples.

  1. You want to prac­tice prop­er low back align­ment when you’re stand­ing.  Elim­i­nate any for­ward sag­ging of the pelvis.  This is a sim­ple idea but can be dif­fi­cult to imple­ment, since you may have a life­time of pos­tur­al imbal­ance and sub­con­scious move­ment habits to undo.   Hint: It doesn’t involve tuck­ing the pelvis under.
  2. Give your­self plen­ty of rest/recovery time with the low back in a flexed posi­tion.  That could mean lying on your back and hug­ging both knees toward the chest, curv­ing the low back in the process.  Anoth­er vari­ant is the child’s pose in yoga.
  3. Like every­one, you want to devel­op prop­er abdom­i­nal mus­cle sup­port for pos­ture.  The plank pose (and its vari­ants) is my favorite exer­cise for this.
  4. You need to stretch the psoas mus­cle, one of the main hip flex­ors.  But here’s what’s real­ly tricky: you have to main­tain the low back in a flexed posi­tion while you stretch the psoas.  That rules out a lot of the com­mon­ly rec­om­mend­ed hip flex­or stretch­es.  The details of cor­rect­ly per­form­ing this impor­tant exer­cise, as well as much more infor­ma­tion about spondy­lolis­the­sis, can be found in Dr. Lavine’s down­load­able report Liv­ing Well With Spondy­lolis­the­sis.

 

MORE SPONDYLOLISTHESIS INFO

Access your copy of Dr. Lavine’s com­plete report, Liv­ing Well with Spondy­lolis­the­sis, includ­ing a ful­ly illus­trat­ed exer­cise guide.

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About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website, askdrlavine.com, provides more information about his approach.

Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.

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4 Responses to Lumbar Spondylolisthesis and Spondylolisthesis Exercises

  1. Thank you so much for com­ment­ing on my blog post at http://www.fortheloveofcorbin.blogspot.co.nz. I real­ly appre­ci­ate your input. Hav­ing read your com­ment and now this post, you have con­firmed what has been run­ning through my mind, that the find­ing of spondy­lol­y­sis in my son is inci­den­tal. In your pro­fes­sion­al opin­ion or in your pro­fes­sion­al expe­ri­ence have you heard of any instances where spondy­lo­y­sis has result­ed in cramp­ing type mus­cu­lar pain in the thigh area? Can be in quads or ham­strings or both.

    • I don’t have expe­ri­ence with that exact sit­u­a­tion. The spondy­lol­y­sis and the cramp­ing pain may be relat­ed to each oth­er but I would also look for oth­er caus­es of the cramp­ing.

  2. Thank-you that was real­ly great knowl­ege. I would like to know more about doin exer­cise?

  3. The exer­cise is great want to learn more.

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