Spondylolisthesis is a spine condition where a vertebra slips out of place and places pressure on the nerve and vertebra below it. It can be congenital, or as a result of arthritis or trauma. Many people that have it do not feel pain, but the pain can be severe in some individuals. Graded in severity from levels I to IV, most commonly spondylolisthesis is diagnosed at levels I and II, and a course of physical therapy is prescribed. Good outcomes can be obtained with persistence and patience.
Signs
Often people with spondylolisthesis do not have pain, but many of them have a bend in the lumbar spine toward the posterior. This is because the vertebra has slipped down, and the soft, spongy disc cannot keep the bone in place. Muscles that run up and down along the spinal cord should be strengthened, and flexibility exercises for the hips and hamstrings can often help with stiffness that is often present in those areas.
Back Strength Exercises
It's important to safely, gradually strengthen the core muscles of the lower back and abdomen without aggravating the problem. Most people with spondylolisthesis start physical therapy in an attempt to reduce pain and stiffness. For example, a wall squat exercise is good for hamstring and core strength, but should be done only under supervision of a therapist or certified trainer. Other good exercises are knee to chest reverse crunches, planks, side bends, and hamstring curls. It will take at least six weeks to start seeing results, and the exercises have to be maintained to stay effective.
Weight Training
For the elderly, small children and anyone with level III and IV spondylolisthesis, weight training is contra-indicated. People with milder grades that are in good health otherwise may benefit from strength training exercises done in conjunction with a certified personal trainer or licensed therapist. Gradual, slow progression is key. Many cable and pulley combination machines are excellent for this type of training, as they allow a full range of motion and maintain resistance while working the core.
Feet and Footwear
Maintaining good posture helps keep the core strong, and maximizes the range of motion of the diaphragm when breathing, resulting in more energy and less fatigue. Spondylolisthesis sufferers need to pay attention to how the feet support the body, as flat feet, high heels, or a pigeon-toed stance can all aggravate the problem. Footwear choices are very important, and a podiatrist or physical therapist should perform a gait analysis.
