Spondylolisthesis & Spondylolysis - treatment & exercises
It is thought that athletic activities that require repeated hyperextension and rotation or repetitive combined flexion-extension predisposes athletes to develop pars defects. There are multiple types of spondylolisthesis and the exact cause is unknown.Isthmic and degenerative are the two types that are most common in adults. The three other types include traumatic, pathological, and dysplastic. The case study patient was a Lytic spondylolisthesis, which is always due to a fatigue fracture and is commonly seen in patients less than 50 years old.Overall, as the vertebral body slips forward there is narrowing of the spinal canal and intervertebral foramen which results in stenosis. As stenosis occurs the typical presentation changes from one of back pain to one that includes radicular symptoms. The typical clinical presentation of a spondylolisthesis is pain generally localized in the lumbar paraspinals, gluteals, and posterior aspects of the thighs. The symptoms usually increase with standing or walking. As the slippage progresses there is typically more irritation of the nerve root and the hamstrings become tight. This may be of benefit to a patient because of the hamstring insertion into the ischial tuberosities which would support a posterior pelvic tilt and subsequently decrease lumbar lordosis. Patients tend to walk in a more flexed position and develop increased hip flexor muscle tension. Flattening of the sacrum can be seen as the patient attempts to stop the slippage.Diagnosis usually occurs by radiographs and the slip can be graded by the Meyerding’s system. In this system a Grade I is up to 25% displacement, Grade II 50%, Grade III 75%, Grade IV 100%, and Grade V greater than 100% displacement.It has been found that only 10-15% of these patients go on to have spinal surgery and that most improve with nonoperative treatment. Typical nonoperative care includes rest, NSAIDS, ESIs, and a physical therapy program. Clinical significant improvements have been found with interventions that included lumbar flexion exercises and walking, but even more substantial improvement was found with the addition of manual therapy (joint mobilization and manual stretching) when performed to the lumbar spine and lower extremities.
Spondylolisthesis Exercises To Avoid - Therapy For …
There must be a good balance between fitness frequency, intensity, and healthy movement habits to enjoy the best possible health benefits from your efforts.If you don’t realize that every time you do a squat, you’re rolling out on your feet, or twisting your hips to use one leg a little more than the other… and you do this over and over again (with or without weights for extra resistance) sooner or later your ankles, knee, hips, or back are going to bail out causing pain and potential injury. But, taking the time to focus on your form and learn how to find and use the right muscles from your feet, through your hips, core, and all the way up to your head, you can do lots of squats to stay fit and injury-free! This is just one example of using an exercise to benefit your health.If what you’re doing hurts…it’s probably not something you should continue. But that doesn’t mean that there is NOTHING you can do safely to keep moving!
Physiotherapy treatment of people with grade I or grade II symptomatic spondylolisthesis involves rest from aggravating activities, advice about correct posture and lifting techniques while you are recovering combined with abdominal and extensor stabilizing exercises and hamstring stretching.