Spondylolisthesis

You are probably looking at my blog title and saying...spondyloli-what???
Well, I have been seeing this condition more often in the clinic lately and so I thought I would write a blog about it since I "had" the condition.

Spondylolisthesis sounds like a big word, however breaking it down makes it more simple. Spondylo- refers to the "spine" and -listhesis refers to "slippage of". Put it together and it means a slippage of the spine. Spondylolisthesis is the condition where one vertebrae (bone of your spine) slips forward on an adjacent one. This usually occurs in the lumbar spine (lower back). The slippage can be present at birth, occur in early childhood, or appear at any time later on in life. It can be the result of a structural deformity, trauma, or degeneration of the vertebrae. It is common in dancers, gymnasts, javelin throwers, divers, football linemen, weight lifters with improper technique. It can be easily diagnosed with an x-ray. Sounds scary, doesn't it? Well, it can be, but I had one and I live to tell so it can't be that bad, right?

Here is my story...
I have been dancing since I was 5 years old (jazz, tap, theater dancing) and playing sports since I was 9 years old (basketball and softball mostly). In high school, I picked up a new hobby...throwing a javelin. Random, I know. The track and field team at my high school needed more athletes and my friends were on the team. So, I joined so I could hang out with them after school and pass time before dance practice at night. I quickly learned to throw discus, shot put, and javelin. Those of you who know me probably cannot picture me throwing a shot put (haha). Hey, I never said I was actually good at throwing shot put, however, I was decent at discus and very good at javelin. When I graduated, I went to college and threw javelin there as well. I had a blast doing it, until one day I woke up with severe back pain. Long story short, I had to stop throwing javelin once my physician discovered that I had a spondylolithesis. Just like most of you when you read the title of this blog, I said spondyloli....whhhaaaat?!? So, needless to say I had to give up throwing javelin. I decided to workout as often as I could and focus on my core in order to keep my back feeling strong and decrease the amount of "ache" on an everyday basis. Unfortunately, my spondy (as I like to call it) become more unstable and slipped from a 25% in 1999 to an 85% in 2004. I required surgery known as spinal fusion in order to stabilize my spine. Many people live with spondylolisthesis from 25-50% and are very functional with minimal pain. I was living with an 85% with minimal pain, but an 85% slippage is too unstable to "play it safe". I received spinal fusion surgery in 2004. They fused three of my vertebral levels in my lumbar spine (lower back). Following surgery, I received physical therapy 3x/week for 3 months (what my insurance would allow) and I also did my exercises on my own. Physical therapy is essentially what brought me back to "normal function" again. I was able to be the energetic and active person I have always been. The true test was working Rutgers football camp the summer (a year and 2 months) after my surgery. I made it through with flying colors! I cannot tell you how happy and relieved I was. I never said it was easy or that I had no aches and pains throughout the way, but I took good care of my back and made it through with a huge smile on my face. I am currently a full-time physical therapist and it definitely helps my back having such an active job. Prolonged sitting and standing are still not something I can tolerate for longer than an hour or two. I feel so stiff as well as muscle tightness and ache if I sit or stand for too long. I must work out my core, stretch, and keep my body strong in order to counteract back pain. If I stop being active/training my body feels like I have aged 10 years! It's amazing what a difference exercise and stretching can do for back pain. I barely notice my back when I am on a consistent workout schedule. So, I make time in my busy schedule to keep active (working on my patients all day helps with this too!).

So now that you know a little more about me and my condition let's talk about you.
Back pain is not an end to life the way you know or knew it. The pain is grueling, extremely depressing, and it may feel as if you have an annoying little devil riding on your back 24/7, but I promise you there is hope. You NEED to seek professional medical help. Don't Google your symptoms and expect an answer. Don't print out stretches and exercises online until consulting with a medical professional first because they may not be the right exercises for you. When it comes to back pain there are certain motions that should be avoided depending on the condition. Many of these exercises contain all different motions and you may harm yourself more and not know it.

Here are common symptoms of a spondylolisthesis (that I have had or patients with this condition have explained to me):
- general ache in lower back region
- in some cases, sciatica pain, numbness, tingling, or weakness in the leg(s)
- aching pain in lower back when lying flat on stomach
- aching pain when lying flat on back with knees straight (usually unable to tolerate)
- intermittent muscle spasms on one side/both sides of the spine (usually in the lower back)
- pain when bending backward/with back extension (in standing/sitting/lying down)

Tips on how to prevent further slippage and decrease back pain if you have spondylolisthesis:
- avoid hyperextension of your spine (excessive backward bending) - try to keep your spine in neutral during sitting, standing, and exercise.
- avoid lying or sleeping on your stomach - if you are lying on your belly place 1-2 pillows underneath your hips and a bolster/rolled towel under your ankles.
- avoid lying or sleeping flat on your back with both legs straight - try keeping your knees bent or placing 2 pillows underneath your knees to relieve the pressure off of your lower back.
- DO stretch your lower back muscles (sit with pillow on your lap and lean forward 3 x 30 sec./perform Child's pose stretch), hamstrings (back of your thigh), hip flexors (front of your thigh), glutes (buttocks)/piriformis.
- DO perform core strengthening exercises everyday. Your core should be activated during everything that you do!!
-DO seek advice from a medical professional if you believe you have this condition. Don't be afraid. A year from now you will be happy you did what you did today.

Any questions please email me (sara@mavenpt.com) or comment on my blog.