This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2023. For the original video go to https://youtu.be/UXNX94Eb0xs
Brad: All right. We're talking today about spondylolisthesis. I personally had it. I've been diagnosed with it for over 10 years now, but more importantly, we'll discuss how you can actually function, learn how to regain strength, and stability, and live a normal life again with a little bit of work.
Mike: We will show you key exercises and management for success.
Brad: That's right. Okay, spondylolisthesis. From now on, we're going to refer to it as Spondy, so when I say Spondy, that's what we're talking about. If we look at a spine, we're looking at the lumbar spine, and the spondylolisthesis refers to a shift. Oftentimes, like mine, it's between the fourth and the fifth vertebrae. That's a common place to have it. It could be between other vertebras, but where the red disc is, you'll see in mine the shift is forward.
Brad: I have a better model here. You can see L4 is shifted forward over L5, and you can see there is no disc in between them.
Brad: Now, what happens with Spondy, earlier on I did have a disc in there, it was on X-rays, you could see the gap, but it shifted forward. But over time, the disc actually disappeared and the body absorbed it, and that takes time, and there's usually some pain associated with that. But the whole idea is to stabilize this bone on top of this bone by strengthening the core as well as avoiding motions and positions that irritate it and will promote or force this bone to go forward. We'll talk about that in detail. It's not hard.
Mike: So typical symptoms with Spondy include low back pain, and oftentimes the pain refers down into one leg, but not always because it does vary from person to person.
Brad: In my experience, after I'd walk about three-fourths of a mile, it was pretty consistent for about a year or two, pain, numbness, tingling down my left leg, right to my shin area.
Mike: So oftentimes, like Brad was saying, you can have an increased amount of pain when you stand up, or even with walking.
Brad: Right, or standing for some time. Oh, that back will hurt, or if you're working overhead, that will turn it on. The neat thing about it is if you sit down, typically, it makes the pain go down quite rapidly.
Mike: Also, you may experience increased pain when you extend your back, so doing some type of press-ups, overhead work like Brad was saying, or anything where your spine is going backward.
Brad: And avoid this back stretch, or press up, because it's going to cause pain and irritation, and it's going to make the bone move forward in the direction we don't want it to go.
Mike: So if you're not sure if you have Spondy, if you go in extension and it feels good, you probably don't.
Brad: All right, that does bring a good point. Make sure you get diagnosed with X-rays. It's the best way, and it's very definite and easy to see. Now, other things that we talked about, things to avoid, we just went over them. If you did irritate your back, and it's sore, and you want to get comfortable, lying down and putting something under your legs will very much help. What that does, is it takes the pressure off that sore area where the Spondy is located. This is what I do. I take a cold pack, and I'd put this right under that sore area, and I'd lie with my feet elevated. Now, what works a lot better than pillows, although pillows work well, you might need three of them, is one of these leg wedges. Bob and I have used these in the clinic with patients for years, and almost everyone says, "Wow, does that feel good," including myself. I would lay like this for about 15, to 20 minutes. My pain would drop down dramatically, and I'd get up and continue with my day, and avoid doing silly things that I shouldn't have been doing. Typically, yard work, because I like doing yard work.
Mike: That works, because when I was lying with my feet up, my spine was flexed, and if you remember from earlier, extension normally causes pain, so flexion usually feels better.
Brad: That's right. Good clarification, Mike. Now, the other thing is back support while sitting, particularly in a car. You'll find out that it can get very uncomfortable after an hour or two in a car driving. You'll find back supports, like this round one, are typically for someone with sciatica, not from Spondy, but from something else like a disc, injured disc.
Brad: These will only make it worse. I found the below backrest was a game changer for me. It's memory foam, and it works fantastic for me. In the winter when it gets below zero, it's not memory foam anymore. It's just hard.
Mike: It's safe to say not every back support's going to work for everyone. They're all shaped differently. People's Spondy is in different areas, so it's going to be trial and error. You can use throw pillows at first, and then once you feel comfortable, you can purchase something that's similar in size.
Brad: All right, we did spend a little bit of time on that, but it's absolutely critical that you do avoid the things you shouldn't be doing, and then the back support when seated. Let's go on to the exercises. This is key. You have to strengthen that core. We'll show you them right now.
Mike: So the first thing we're going to do is work on your walking and your standing posture. What you want to do is you want to have soft bent knees. You do not want to lock them out. When you lock them out, you're going to put more pressure on your low back, because it's going to go ankle, knee, hip, and then back. It's also going to probably cause you to arch your back more, increasing your pain, so you want to stand with a soft knee. This also pertains to walking. When you walk, you want to land on your forefoot, which is this part of your shoe, and you're going to kind of walk, not on your toes, but the front of your foot and not heel strike. This is a no-no. Land on the forefoot, soft bent knees as you're walking. This is going to take time to figure out and adjust to. I would suggest doing it in your house first, maybe in socks, or even barefoot if you can handle that, and try that initially.
Mike: Eventually, you can get some shoes that do not have a built-up arch. I have minimalist shoes. There's not much to them. You don't have to get this flimsy of ones. There are zero-drop shoes with more cushioning, but that is step one to try to decrease your back pain.
Brad: With walking.
Mike: With walking.
Brad: Now for strengthening that core, this is by far my number one, go-to exercise. Lie on your back. You can bring your knees up, and arms across your chest, and simply do crunches. Think about keeping your back flat on the floor. You could do them here lifting your knees, and then I do double crunches where I lift my knees and bring my elbows toward my knees. Now, what works really well, and I would suggest if you have Spondy, get a ball. This makes this exercise much better. It forces your back into that neutral position. It feels better already. I can feel it now. Then you simply lift the ball. Make sure you have your shoes on, makes it easier. You can take your heels, dig it into the ball, and it works well. This is an excellent exercise, strengthening the front where you want the strength, and then you can do the double crunch. I'll do these at least three days a week. Start at 10 reps, and work yourself up to 50 reps. It's really important to strengthen the abdominal core muscles.
Mike: The last suggestion we have for you is to go to YouTube, and you can search Bob and Brad spondylolisthesis.
Brad: I think you can just put Spondy, and it might get there.
Mike: Anyway, we have a playlist on there with tons of different videos with Bob and Brad throughout the years, and there's core strengthening, recommendation of things to do and not to do. If this works for you and you want more stuff to work on, you can go there and find out more.
Brad: That's right. If you want to get back to all the activities that you used to do before Spondy, I think it's going to be very beneficial. Take some time, and good luck.
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