First you must remember that the body works as a unit, which means don't just focus on the spondy, but rather what is happening above and below the spondy and throughout the rest of the body that might be contributing to or causing the vertebra to slide out of position.
Areas I always look at are:
- Pelvis - Is the pelvis anteriorly or posteriorly tilted? Does the pelvis has good movement or is it limited in its range of motion?
- Spinal column - Is there a normal curve throughout the spinal column or any areas of excessive flexion or extension? Does the spinal column have good range of motion into flexion and extension or are there sections that either don't move much or move excessively?
- Load joints - Are the eight load bearing joints (ankles, knees, hips, shoulders) of the body vertically aligned and if not, what joints are out of alignment and how? Do all load joints have normal range of motion or, if limited, which ones and how?
Looking at these other parts of the body will give us clues as to why the body has caused a spondylolisthesis and help direct us to what we need to correct posturally and biomechanically to relieve the symptoms and prevent further damage to the spine.
Surgery is often brought up as a treatment option, mostly when symptoms are severe, but surgery is only going to treat the symptom of the slipping vertebra not the cause of the slipping vertebra. Surgeons will usually tell you that many people who they operate on for a spondy will be back in the office for another spondy surgery a couple years later because they have developed another spondy. Why? Because that person never addressed the postural and biomechanical reasons why the spondy occurred in the first place, they only had surgery to address the symptom.
Watch this video to learn more about spondylolisthesis:
If you would like to learn more, discuss this further, or for a free posture evaluation and consultation, contact Matt at matt@oregonexercisetherapy.com or 971-279-2189
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