Spondylolisthesis- The Most Dangerous Exercise To Avoid
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- Опубліковано 9 лип 2024
- Avoid aggravating your spondylolisthesis back pain by safely modifying this common exercise with spondylolisthesis exercise and spondylolisthesis rehabilitation expert Dr. Michael C Remy, DABCO, CCSP. Learn more spondylolithesis exercises, spondylolisthesis fitness tips, and how to build your very own custom spondylolisthesis exercise program at: www.painfreeandfit.com
Beginners who are having trouble with this exercise often need to start with the leg resting flat on the floor and leave the heel down while bending the knee only slightly (less than one inch). It also helps to mentally imagine the hip bone (greater trochanter) pressing into the floor rather than trying to tighten the buttock. The more you imagine the action happening, your nervous system will actually do it. You've definitely mastered it when you feel the hip pushing backwards and away from your forward finger. Once you feel the hip bone moving backwards , you can then advance to bending the knee with the heel off the floor.
These videos are so great! Thank you for all the free advice!
Thank you for all what you do to help people getting better. I have the L5 vertebra that sildes back on S1 (not forward) . What are the adequats movements for this case
Such great info. When i have time, need to watch more about weight training with spondy. Have osteoporosis too & want to start without aggravation.
I personally need as much information as I can get! Thank you so much!
Your Welcome. I hope the info is helpful Jeanette.
Thanks for the good tips. Been doing the most dangerous exercises wondering why I would be in more pain afterward!
You are welcome. I hope the tips are helpful
I have a grade 1 spondylolisthesis with bilateral pars defect with disc herination..i feel no pain in body but no urgency in urine..😢😢 doctors says no problem but i feel bladder problem..
Great video and great explanations, while doing the emotions thumbs up
Glad you enjoyed it!
Thanku so much im 29 year old mother i have spondylolisthesis grade 2...after going physio they told me to do tat alternative leg raise exercise..my pain shoots up and didn't feel right to do tat... thanks for your knowledge
I think i just reset my hip or si joint, the roll the hip backwards thing, i felt the muscle grab the top front and rotate towards the glute, pop! Been bothering me for years.
Thank you so much!
You're very welcome KeyJM!
I have spondy L4 injury from many yrs ago. A bone spur formed and made my canal smaller. I got a shot but lasted only 2 weeks. Hope these work anyway because my hammys and glutes hurt.
Great advice
Thank you, I hope it continues to help!
Thank you Dr. Michael for this informative video. Does stretching acts like baby cobra is harmful for those with spondylolisthesis problems?
It all depends on the amount of extension in the lower back and it being able to be controlled with neutral spine range of motion and RPI tensions. If it is past the point of neutral spine and tolerance, then injury is more likely. This is specific to the individual
Thank you for your channel! Do you think it's possible to move the spondylolesthesis into correct position and receive prolotherapy to restore the ligaments and that could keep it stable? My surgery doc is taking fusion surgery, but my L2-L3 have degeneration so I imagine that would go next,......I started watching your channel after about 20 years of back pain gave way to the very unsettling numbness I now experience in my right leg after sitting for 40 minutes and especially after wearing any type of elevation on my heel---even 1/2".
Hi Mary.
The question in a case like this is if the symptoms are simply due to the instability or other factors. In my experience, most cases of painful spoindylolisthesis are more functionally based rather than anatomical. This is why there are so many people who resolve their symptoms with exercise, posture and movement rehab, and manipulation , but have the same imaging study findings pre and post treatment. In these cases, the spondylolisthesis itself did not change, but rather the function and physical conditioning of the spine. If leg numbess comes on after sitting, it would be highly suggestive of disc involvement, which often responds to the above without surgery. I would suggest getting a second or third opinion from a doctor who specializes in a more functional approach before you make your decision.
Thank you 🙏
You are very welcome. I hope the advice helps you.
Dr. Michael, what you think about inverse table to who has Spondylolisthesis grade 2?
Hi Stoic.
The problem with inversion tables is that you cannot control the decompression to the particular segment involved. This can over-stretch adjacent spinal segments that may be over-stretched to begin with as adjacent segments often compensate with hypermobility for spondylo segments that have become hypomobile in an effort to stabilize the forward vertebrae. The other typical mistake with inversion or chin bar hanging is excessive time held in the stretch position (longer than 10-15 seconds per stretch) which can also lead to over-stretch. This is why therapeutic stretching in clinics typically use more intermittent decompressions performed in sets of 5-6 reps holding each stretch position 3-5 seconds and localized to the involved segment using the doctor or therapists hand to monitor and hold the segment.
Thanks for the great question.
There aren't many choices of doctors or physical therapists in my town. I've been to a PT for 6 weeks mainly for L3-L4 and L4-L5 disc bulge and anterolisthesis of L4 on L5. My doctor only read me what the MRI said. My PT only tells me to do certain exercises roughly without explaining what they are for, what to avoid, or what part to engage. Over these past 6 weeks, some parts got little better, while others worse. I've been having wrong positions and postures with workouts and activities. I mainly want to thank you for making this video and others with details and tips, which are most helpful. If possible, may I ask what to avoid for my condition with BOTH disc bulge and anterolisthesis problems? thanks
Exercise recommendations will be based on an analysis of your body mechanics, posture/movement tendencies, muscle imbalances, and spinal stability issues related to your unique condition. Sorry, but a generic answer will typically not give you the best results. Check out the programs and online consulting options available at painfreeandfit.com to learn more about this.
My PT gav3 me the straight leg raises to do. It hurts from time to time so I’m going to try this way and let yo7 know. I’m used to being active and no5 being able has really made me miserable. I am willing to try anything to get better and avoid surgery.
Straight leg raises are classically one of the worst exercises for those with lower back spondylolisthesis due to the inherent demand on lower back and hip stability, which most people with spondylolisthesis lack. Both of these regions require custom stability training based on an individual's unique posture and mechanical faults. Two of the most common errors with leg raises are anterior pelvic tilting causing increased lower back arching (hyperlordosis) and anterior hip glide (malposition). Both of these are so common in spondylolisthesis that they are the usual culprits to cause pain and damage to discs, facet, sacroiliac and hip joints during leg raises. Other common faults include pelvic rotation, torso side leaning, and an imbalance in hip flexor recruitment patterns. This video will get you going on the right track, but you really need an analysis on your unique posture and mechanics to get the most out of any healing exercise. Check out the other videos on these subjects on the channel, and the analysis, exercises, and programs to address this on www.painfreeandfit.com. Surgery is generally not needed for spondylolisthesis unless a gross instability is not responding to proper, customized, progressive rehab. And the all too common problem is that the rehab given is typically generic for spondylo and not tailored to the individual- thus the failure rate of many spondylo generic rehab programs. Hope this helps you, and thanks for the question.
I was diagnosed with High grade 2 L5-S1 spondylolisthesis in 2015 by an MRI, which it was caused by a slip and fall in 2010. That fall also caused my left leg to go under my thigh, causing my leg to turn in, and having a total knee replacement in 2015. Its almost impossible for me to do exercises because of the pain in the back and right hip which I also fell on. Not sure what exercises are safe>
Hi Carol.
There a plenty of exercises that can be modified in a case such as you describe that are typically helpful. You will need an advanced rehab specialist to perform a thorough assessment on your body mechanics and spine stability issues, from which a tailored program should be developed. If you have such a specialist near you, that would be the place to start. If not, you may wish to consider an online assessment and exercise sessions(s) with me through zoom, or pick up a copy of the FAST TRACK Spondylo Program. Both of these options are available through the painfreeandfit.com website.
Dr. Remy
Hi Dr Michael Remy
I hv grade 1 spondy under L3, L4 and L5 with lower back pain and also kind of tingling pain frim the hips, buttock that radiates into the back of legs. Hence legs feel weak, discomfort and fatigue. Chiro told to apply ice pack to relieve pain or discomfort.i realised that performing certain lower body exercises at gym ie.leg press, leg raises kr high impact exrrcises aggravates the pain. May i seek your advice whether the following exercises can help to manage the pain eg.
Pelvic tilt, gluteal stretch, double knee to chest, side plank, bridge squeeze, push up, deadbug exercise, front & back lunges without weights, squats.
Is it advisable to walk uphill?
Besides sitting too long also causes discomfort at lower pain. Tqvm
Hi Florence.
The answer to your question is based on a thorough exam of your posture, movement, spine stability issues related to your pain. Everyone's spondylo case is unique. I would advise a consult/ exam with a local advanced spine rehab specialist near you or alternatively you can perform a self exam with the FAST TRACK Spondylo Program at painfreeandfit.com, or have an online zoom consult with myself. From there, a program can be designed that is tailored to your specific body issues and needs.
Dr. Remy
Hey, what about a Glute Hamstring raise or romanian deadlift? Are these dangerous if performed correctly?
Hi Anthony.
If "correctly" means that you understand what your unique back stability issues are in terms of movement patterns and recruitment strategies, then yes, any exercise could theoretically be performed if you know how to engage your proper RPI and hold a neutral spine that is tailored for you. Generically speaking ( if you are just trying to avoid low back extension stress), then the glute ham raise is more dangerous than romanians. The bottom line is learning how to correct your spinal instability through an analysis of your posture/movement/asymmetries and weak links, and then choosing exercises on a continuum that safely progresses your ability to hold a neutral spine. I hope this helps you.
Dr. Remy
My hip pops quite loud (to me at least) when I've done this exercise in the past. No sure if its Spondylolisthesis, Scoliosis, Hyperlordosis, Spina Bifida Occulta or the spike on my hip. I'm booked in with a physiotherapist in a few days to find out
Hi did you find out what that noise was?
So, evidently, I've been doing everything wrong my whole life.
I have spondylolisthesis and FAI.
I've always been pretty fit, though.
I'm really focusing on my deep core now. Unfortunately, how complicated it can get is a bit overwhelming. One exercise affects the other. One exercise might be good for one but bad for the other.
Hi Heather.
To make it less overwhelming and simplify your training, remember that core work should always focus on your weaknesses ( problematic directions of movement, inhibited muscles, alignment problems, and abnormal sequencing of muscles in a particular movement). Begin with simple recruitment and alignment exercises, build strength in proper directions and sequences to follow, and finish with using balance challenges and more resistance/endurance to meet your unique daily/sports requirements with reflexive stability and adequate conditioning. All of the Healing Exercise Programs at painfreeandfit.com guide you through this, and I am always available for online consults if you are still overwhelmed ( info at same site).
just seen this thanks. How do you know what you are suffering though? My chiro has suggested degenerative disks (L4), so i assume that means the padding between the discs have eroded, but is this Spondylolisthesis, hernitated disk or disk budge? The exercises are different so i assume it matters. It could happen tying my shoe and then i am on my back for 3 days, very painful, curved back the whole 9 yards.
What you need is a proper complete diagnosis, including the pain generating tissues and the mechanical stresses that are behind the pain
Spondylolisthesis is not a herniated disc or a disc bulge, it’s the actual vertebrae that has slipped over the other vertebrae below it. Think of it as a rock ledge hanging over another ledge. But it’s your vertebrae
Hi sir my physio actually recommended the leg raise to me as a good exercise but i have spondylolysis (i.e it has not progressed to spondylolysis) do you think it is ok for me to do the leg raise of course if I ensure a proper posterior pelvis when doing it ?
It depends on what your unique neutral spine position is and what directions of movement aggravate your condition. Leg raises are notorious for anterior tilting the pelvis but also can directly pull on the spine via the psoas muscle. On the other hand, if your pain is relieved with extension ( disc related in most cases), leg raises may be a good choice. Avoid generic advice and always be sure to have your treating Dr and therapist explain the specific "why" in exercise selection.
If someone has mild anterolithesis should they avoid psoas exercise? I was considering training weighted one legged knee raise while standing as the supporting leg would also protect the disk from being pulled forward by psoas; does this sound like a safe alternative/
Hi Chris.
Great ?... Most spondylolisthesis sufferers need to stretch (not strengthen) the hip flexors, including the psoas. However, in some cases, psoas strengthening is needed to properly stabilize the hip joint, and in lesser circumstances to augment vertebral stability through axial (vertical) spine compression- although the psoas is not considered a major factor in vertical spine compression by most authors and researchers. Many spondylolisthesis sufferers lack the spinal stability coordination and strength needed to avoid the anterior pull on the spondylo segment with leg raises, which makes this exercise typically dangerous for low back spondylolisthesis. In the end, it really all depends on the unique individual's stability issues and conditioning levels to be able to hold a neutral spine position for their unique situation with any particular movement, including leg raises.
Dr. Remy
@@DrMichaelCRemypainfreeandfit Thank you for responding, I wasn't aware that I had spondylolisthesis until a routine x-ray for an artificial hip revealed, "...moderate degenerative disc disease at C4-5 and multilevel degenerative changes throughout the thoracic and lumbar spine.... There is mild anterolisthesis at L4-5." Leg raise or holding a pike position (only while hanging) elicits popping in my back; understanding that the psoas is probably pulling on the vertebrae is enlightening. I've discovered conditioning the transverse abdominis and pelvic floor from following a UA-cam protocol reduced popping in my spine; the video involves isometric transverse abdominis hold while performing basic planks and/or moving legs or upper torso ( ua-cam.com/video/CMKw77fbkOs/v-deo.html ). Thanks to you, instead grinding through movements that exacerbate spinal instability, I use that popping as a barometer of my limits and back off accordingly. However, I'm still confused as to strengthening the psoas with one legged weighted knee raise on the ground is safe (the other leg will anchor spine stability?) and whether or not a stronger psoas can potentially aggravate spondylolisthesis doing more damage to the spine?
Dr. I'm sure you love to hear your voice and scientific explanations; i for one would rather prefer to see you moving and acting your science accordingly. Please.
There is a way to stabilise spondylolithesis and after continue all of "bad" exercises ?
Hi Tornik.
I'm not sure what you mean by "bad" exercise, but if you have stabilized your spondylo with your unique posture and stability corrections (RPI), and maintain this neutral spine stability during all exercise, then your back should be safe regardless of any other movement in the short term, but in the long run improper exercise form will cause some other mechanical problem which may negatively affect the spondylo. I hope this helps- Dr. Remy
please I need your help!when I do leg raises with straight legs or bend legs even hanging leg raises in the negative phase when I return the legs in the starting position my lower back pops why this happens?what can I do?sometimes it doesent pops at all if i maintain braced core with and posterior plevlic tilt it doesnt pops so much..sometimes it doesent pops at all if i control my pelvic floor..but if i l lose the posterior pevliv tilt and get to anterior pelvic tilit in abs exercises and in knee raises standing up it pops ...whtats happening and what can i do?is it spondylolesthesis?thanks in advance
The popping is most likely a sign of spinal instability, where you have uncontrolled motion at one or more spinal segments and the sound is either movement of a vertebral segment or the sound of cavitation (exchange of gases in the synovial fluid in the facet joint with motion). Whether or not a spondylolisthesis is present could be determined with xray. My advice is to have a thorough body analysis of your global and local mechanical factors of posture/movement/muscle core imbalances as they relate to joint stability and learn how to engage your core correctly to increase a tailored spinal stability contraction to avoid spinal damage.
Does this exercise require you to engage your glutes? Mine don't. But I am doing it on the floor, not a bench. Should it be on a bench for to glutes to kick in?
Hip flexion that is faulty in its movement (such as an anterior glide of the thigh in the hip socket) requires the gluteus max to stabilize the joint and correct from to decrease extension stress at the lower back levels. However, this rarely requires conscious buttock tensing, but rather a backwards slide consciousness of the thigh bone (femoral head) at the hip. Flat bench vs. floor is same, unless you start with the hip in extension hanging off the bench which is more advanced.
What about running and push up pull up ?
OK, you got it MrSyso. These are exercises that definitely can aggravate spondylolisthesis if not performed correctly. I've added them to my video to do list, and you will most likely see them within the next 2-6 weeks on the channel. Thanks for the input, and I hope they will help.
Dr. Michael C Remy thanks too much
Hello Doctor
I'm from Saudi Arabia, I'm 42 years old, I suffer from ( anterior spondylolistheses of L4/5 with bilateral pars interarticularis defect and endplate degenerative changes. )
The second degree, according to the report of the radiologist, and the third degree, according to the words of the doctor
I want to do an interview with you online, but I am not good at speaking English, do you have a translator among us?
Hello Saudi neighbor, Did anyone reply to your message? Google translate works really well to translate Arabic to English and English to Arabic. You can type in your language and it will "speak" and "write in English". مرحبا صديق كيف حالك اليوم؟ أقترح عليك محاولة الاتصال بالطبيب على هذا الفيديو في عيادته مباشرة. الذهاب إلى موقعه على شبكة الإنترنت ومعلومات الاتصال. آمل أن يساعد هذا. أجبته عندما رأيت أن أي شخص آخر لم يفعل ذلك. أنا آسف لأنك تتألم ، مثلي. إنه لألم رهيب العيش معه. أتمنى أن تجد الراحة. يعتني.
@@juliekailihiwa8150 thank you very much🙏
I have maxed out my PT visits for the year and I am still in pain. I feel the tightness and numbness in my hip and back of my calf never leaves. Any advice.
My problem l5 & s1 problem spondyloslisthesis I am very said sir please help me I am now playing cricket . This problem in playing cricket Rong ya write please sajeson me sir..
Hi Anurag,
Cricket involves a combination of leaning sideways, twisting and bending forwards and backwards. A spondylolisthesis must be held stable to avoid pain in this or any movement. Pain free stability includes 3 factors: (1) maintaining a neutral spine or "safe zone" position during movement, (2) Using your supporting muscles correctly to hold the neutral spine position as you move, and (3) moving over a limited pain free range of motion which includes keeping the spondylolisthesis area immobile while you emphasize the motion from other body regions. It is VERY important to use your supporting muscles (2) correctly as you do this because almost everyone has some dysfunction in their supporting muscles of the spine due to posture and unique mechanical muscle imbalances that most people have (pain free or not). Our free body analysis available at www.painfreeandfit.com will help you find these supporting muscle problems so that you can hold a neutral spine or safe zone of spondylolisthesis position as you play cricket. I have just released a video describing these 3 factors in more detail for you today on this channel titled " Spondylolisthesis- The 3 most essential exercise tips for pain free movement" . Watch it and practice your cricket movements in slow motion using these tips, and gradually build the speed up of your spinal stability over the next few weeks. This is the same rehab theme I use with my patients, and is usually highly successful. If you want more healing exercises to support this, we have a FAST TRACK healing exercise program coming out this July specifically for Spondylolisthesis on the pain free and fit website mentioned above. Hope this helps you, and thanks for the question.
@@DrMichaelCRemypainfreeandfit
I am over 70 and have significant scoliosis. My left hip is considerably lower than the right and I have spondylolisthesis at
L5-S1. I have right side back pain that radiates down the right side of my right leg. Which of your videos or groups of exercises would be best to help toward alleviating the pain.
Hi Alvin.
You will need to start with a thorough analysis of your spinal and body mechanics/spine stability issues as they relate to your pain. This would be best accomplished by a specialist near you with advanced training in this field. If you do not have such a specialist nearby, you may wish to consider the self -help Fast Track Program for Spondylolisthesis available at painfreeandfit.com, as it will guide you through a self analysis and help you design an appropriate tailored exercise program to meet your needs and issues. Another option is to have an online consult of your body mechanics as they relate to your pain with myself through zoom (info also at painfreeandfit.com). Either way, you will need an analysis of your body first so the appropriate exercises can be chosen and a progressive spinal stability program can be designed. Otherwise you will be attempting generic exercises that have little benefit (and possible harm) unless they are tailored to meet your unique situation.
Dr. Remy
@@DrMichaelCRemypainfreeandfit Thanks Doc. I did find a specialist in my City and had my evaluation session with him. I really appreciate your prompt response. Alvin
Thank you.
You are welcome Isaac
I had to seriously fight with my physiotherapist for refusing to do the straight leg raise i know it is wrong for me
Sometimes this happens, and I would suggest getting a few professional opinions to determine what is best for you
I have scoliosis and spondylolisthesis plus a number of other things. I work as an iron worker and still go to the gym
Can wall pilates aggravate spondylolisthesis?
If the movements are in the same direction as the spinal instability and pain, then yes, it is quite possible to aggravate. You will know this by analyzing your body mechanics and spine stability weakness/ directions. Work with an advanced rehab specialist to find your unique issues. If you have no none locally, you may make an appointment with myself through Zoom for an online consult (info at www.painfreeandfit.com). You may also use the free self-help beginners analysis or any of the healing exercise programs available at the same website. I hope this helps.
@2:40 👌 hip hip pain
Yes. We will do some videos on hip pain in the coming year. Thanks for the input.
I thought he was going to say squats and deadlifts lol
😂
Dangerous to avoid? or dangerous to do?
The exercise is typically dangerous to do for those with spondylolisthesis, therefore most spondylolisthesis sufferers should avoid doing it
I just want to thank you so much, doctors told me not to lift weights no to go to the gym. Recently went to chiropractic who told me to have a pelvic tilt and I could do it. But i still didnt have gym guidance, a personal trainer doesnt know this. So all your videos have helped me immensely! I may be able to build my body now and avoid surgery as well I have a 52% L5-S1 spondy little into grade 3 from grade 2.
You are very welcome. It is always better to find a doctor who has the experience with the type of rehab and sports /fitness pursuits that you are interested in. That way, a tailored program can be more appropriately designed. Unfortunately, there seems to be a large void in the number of doctors who are also trainers and have the advanced rehab expertise needed by many sufferers. It is essential to make that doctor and training rehab advice practical for the gym. That is why my online consult business is so busy.
Vorbim să nu tăcem fals totul .
Audio no good.
Spondylolisthesis
Guys jogging helps me
too much talking not enough action in showing us
Show more examples and less talking, please 😊