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How to manage a spondylolisthesis with exercise.

What is Spondylolisthesis?

A spondylolisthesis is a condition where one vertebrae will slip forward relative to the one below. A spondylolisthesis can occur at any vertebral level, however it will most commonly occur in L5 sitting on S1.

There are a number of reasons why a spondylolisthesis can occur. The most common causes are due to a pars defect (fracture of the pars interarticularis), congenital abnormalities, excessive physical activity, heavy loading and sustained poor posture.

What are common symptoms of Spondylolisthesis?

The most common symptoms one will experience will be localised pain and stiffness in the area which is often intensified by intense exercise or by prolonged sitting. A common complaint is that the lower back feels "locked up". It is also common for people who have spondylolisthesis to present with other symptoms which are related to movement disfunction of the lumbopelvic area. These may include neck pain and associated headaches, tight hip musculature, sciatica and even plantar fasciitis. Due to the nature of the condition, the disc inbetween the two vertebrae will experience more shear force than what is normal and can also become injured and may also budge, which can impinge nerves. Symptoms associated with this are intense local pain, shooting pain down the back of the leg, pins and needles and paralysis or weakeness of the muscles of the legs.

What exercises are best for spondyloisthesis?

The goals for performing specific exercise for spondylolisthesis would be to reduce pain and symptoms, prevent further forward slippage of one vertebrae and strengthen the musculature which is responsible to providing stability and support of the lumbopelvic area. The key muscles groups that should be incorporated into a strength training program would include:

- Abdominal Muscles

- Pelvic Floor

- Hamstrings

- Gluteals

- Diaphragm

- Serratus anterior

- Lower Trapezius

It is also important to note that the selection of exercises and the way in which they are performed is paramount to treating spondylolisthesis with exercises.

What exercises should I avoid?

The exercises that are best avoided are those which are performed in a seated position and those which require the person to extent their lower back. Depending on the severity of the condition and other individual variations there may be other exercises that pose problems or are exacerbating to the condition. It is always recommended to consult a professional when exercising with this condition.

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