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Training with Spondylolisthesis

Hey guys, I was just diagnosed with Spondylolisthesis Grade 1 at L5-S1. My doc advised me to lay off the weights, especially overhead pressing movements, and all spinal compressing movements in general. What does this leave me with, exactly? I’m guessing squats,deads,oly lifts,rows are a big no-no? Or for that matter, anything that isn’t a horizontal push or pull? I also sit a lot so my hip region is a total mess, so my doc told me to work on my core a lot more and stretch my hips & hammies regularly. Any insight would be welcome

Hey dude. Do you suffer chronic pain or is the pain acute?

I don’t wanna be giving information out as I don’t know an awful lot on the subject, although I’ve been told I have sponydlolisthesis. I went to an osteopath and I seem to be missing a spinous process, and there seems to be a slip of the vertebrae.

This isn’t conclusive for me though as I have had no imaging done so it could just be spina bifida occulta.

But, to the point. This happened to me over a year ago, I went to the osteopath due to back pain incurred through poor form on power cleans.

He told me to stop doing pretty much any physical excercise (especially lifting and running) apart from swimming. I stopped exercising and guess what? my pain got worse.

I got sick of this and thought fuck it, im gonna be old and dead one day and started doing everything I did before. I’m now stronger than I ever have been and completely painless

Now I’m not saying you should do this cause it could go in the complete opposite direction for you and make you hurt more, but it might work, just like it did for me.

Just as a sidenote, there are plenty of people walking about, lifting, excercising and working with “fucked” backs and they don’t have a clue.

Some interesting reads.

“Both spondylolysis and spondylolisthesis are often asymptomatic, and the degree of spondylolisthesis does not necessarily correlate with the incidence or severity of symptoms, even when a patient is experiencing back pain” http://emedicine.medscape.com/article/95556-overview

http://www.backsense.org/ >>> the ideas in this book are not quackery in my opinion. The book is well backed up by alot of reliable research. This really helped me.

http://www.backsense.org/resrch_pg.htm >>> http://www.backsense.org/full_bibliography_pg.htm

I have a spondy at the L5 as well. I think that it tends to be aggravated by flexion but rarely by compression but you will have to experiment for yourself (and don’t feel afraid to experiment, Grade 1 is not as big a deal as your doc may lead you to believe). I think that sit-ups, lifts with a rounded back, and improper twisting (see Stuart McGill’s work for more info.) may be an issue but not strict squats or deadlifts.

I’m not going to tell to go against your doctor… but he sounds like an idiot. That being said, if you have pain after a squat or deadlift workout everytime you do it then try taking out that exercise and replacing it with a different one. Back squats can be substituted with front squats. Deadlifts can be substituted with trap bar deadlifts or sumo deadlifts. You can always buy a hip belt and do hip belt squats if those don’t work for you. I don’t have issues with pressing while standing but that could be an issue for some. Dumbell presses solve the issue of having to lean back at the beginning.

Here is some food for thought from Mark Rippetoe’s Starting Strength forum startingstrength.com/resources/forum/showthread.php?t=12093&page=1

I’ve actually never had back pain in my life, except for a deep muscle strain in the right hip region, a bit lower and to the right of L5 that has something to do with lymph circulation (or so I was told). I was also diagnosed with spina bifida occulta, not really sure if its a big deal or if it affects anything (guessing its not). After a bit of digging I figured out that my back is extension-intolerant and standing does aggravate it quite noticeably. This basically means I should be careful around exercises with excessive hip extension, like snatches and swings, yes?

My doc also told me to stop any physical activity apart from swimming, but I didnt think for a second I’d be doing that, no way. I started lifting about a year and a half ago, and since then I’ve been absolutely pain free. Before that, my back would kill me after a long day at work (note I’m only 19 y.o.), and a game of footy would have me barely walking for days due to knee pain. Having read the links you guys posted, I suppose I’ll keep squatting and deadlifting properly and avoid excessive twisting and flexion/extension, and also include more mobility and stability exercises.

How comes you got scanned if you dont have back pain?

In my opinion, if it doesn’t hurt dont worry about it.

About the swings and hip extension excercises, as long as you make sure your using hip extension and not lumbar extension you should be fine, but again I aint a professional so take whatever I say with a pinch of salt.

The major thing that CAN exacerbate spondylo is extension. So, if you do overhead work, be militant about your form and avoid “layback”. If you have done squats and deads without pain for a year and a half, I think you are safe to continue. pgtips was correct in saying that many cases of spondylo are asymptomatic, and I’ll take that a step further by saying those cases should not be any basis for restricting activity. If you’re really concerned or curious, you can have a special MRI done that specifically looks for edema. Dr. Terry Yochum recommends doing this and then categorizing the spondylo as “active” or “inactive”. He says that far too many athletes are unnecessarily restricted for “inactive” spondylolisthesis. He has a pretty cool story about a promising D1 football player that he personally prohibited from playing. This guy, without telling anybody, went on to play an intramural sport instead (I think lacrosse) and won a national title without ever having a back issue.

I meant to say that one name for that MRI is a STIR sequence. You are looking specifically for edema in the pars interarticularis. Dr. Yochum’s assertion is that if there is no edema, there should be no restrictions.

Take this time to focus on your technique. Lower your weights and try to perfect your form. Work on your tight hip, this could be contributing especially if you have a tight psoas pulling your back into extension, as you said you have extension dysfunction. Increase your core strength,as you start to feel more comfortable and confident gradually start increasing the weights again.