Anterolisthesis - stability question

4 posts / 0 new
Last post
alpinist007
Offline
Last seen: 1 year 3 months ago
Joined: 08/01/2010 - 7:24pm
Anterolisthesis - stability question
I am grateful for your work. It is a beautiful thing what you are sharing.

I have worked as professional athlete (mountain guide) for 25 years and I am now 47.  In October I suddenly experienced lower back stiffness and was unable to bend forward comfortably, only sideways without discomfort.  This did not go away with the usual body work/massage and stretching.  Eventually I saw my D.O. and after an evaluation he suggested an x-ray. 

The x-ray revealed a 9mm anterior slip of my L4 vertebrae on top of L5.  He then suggested a CT scan to see if I had a pars defect, but the radiologist report indicated there were no abnormalities or fractures to indicate spondylothesis.  We believe it is an old injury from a bad, bouncing fall on my tailbone that I sustained almost 3 years ago.

Since the beginning I have been 100% focused on strengthening to stabilize my spine with PT exercises and adamant on avoiding any surgery.  After 3 months of being restful compared to my normal activity, I got back to ski guiding and seemed to be doing pretty well. However in having a follow-up x-ray in May (1st one was in December), it revealed another 2mm slippage bringing L4 to 11mm anterior to L5. The disk space has been preserved as indicated on the report.

Considering that L4 is over 1cm out of place on L5, I am very fortunate that I have no sciatica or any symptoms other than occasional tweaks of pain in my upper hip/back area.

Because my work is so physical, I am resting more than usual and doing everything I can to stabilize. My coach at the Mountain Athlete, gave me your book and suggested it might help.  I am through the 3rd lesson, have watched your Youtube video http://www.youtube.com/watch?v=-yYJ4hEYudE, and I am incredibly excited to have found you!

My question (sorry for the long post) is... because my L4 is FORWARD, will anteverting my pelvis compromise my spine stability?

When I do my back exercises, I've been advised to tilt my pelvis forward to keep everything tight, and it certainly seems to be the only way my back will tolerate a forward plank.  Is tilting the pelvis forward in my case a good idea when doing PT exercises, but then when sitstretching, etc. and normal activity should I always strive to keep my pelvis anteverted?

Thank you again for your expertise and guidance!  I can't read your book fast enough!
Esther Gokhale
Esther Gokhale's picture
Offline
Last seen: 52 min 58 sec ago
Joined: 09/10/2008 - 8:36pm
When you have any kind of spondy, especially an anterolisthesis, it's understandable to wonder about tipping your pelvis forward. The thing to remember is that what keeps your vertebrae in register is the facet joints and when you tip the pelvis to its natural (anteverted) position, your vertebrae (maybe for you, for the first time in many years) are better fitted to hold themselves in place. But I would focus on creating lots of length before changing the relative position of the vertebrae. I would get to the inner corset chapter and work on that for a while before doing a lot of stacksitting, for example. You want a good angle between L5 and S1, but not between L4 and L5 - there you want to focus on length, but the architecture at L4-5 depends on the architecture at L5-S1. Also, go a lot by what feels most comfortable - use that as your feedback tool and guide.
alpinist007
Offline
Last seen: 1 year 3 months ago
Joined: 08/01/2010 - 7:24pm
Excellent!  Thanks very much for this feedback.  I've finished your book and am engaging the inner corset as much as possible. I find it is really helping and the visuals of the stunning people you photographed in your book are constant reminders of what to strive for!  I will look forward to taking your classes when I can get to CA, and in the meantime I have a lot of new tools to work on! Thanks again!
mikeB
Offline
Last seen: 3 years 9 months ago
Joined: 07/16/2010 - 8:42am
Alpinist007,
Brand new here, found your post because I also was just this week reported to have 9mm anterolisthesis at L4-L5. .  Believe it's been developing that way for 10 years (pain for 5 years)  but only now could get MRI.  In shape for age 50, don't smoke, etc.  Now being sent to a neurosurgeon.  Of course a neurosurgeon who believes in self will recommend surgery.  But my listhesis creates "severe stenosis," (MRI report) both central and foraminal canals.  Other spots in spine "unremarkable" for my age, except for few bulges, which are nothing compared with this.  I can hold forward planks for 2.5 min, along with many of the other "therapies" I find on Youtube, but I can't walk two blocks without level 5 hip, LB, leg, pain then to 7 and 8 if I keep walking.  Sitting is instant relief .  Anyone think PT is still the way to go?
thanks,
mikeB 
Log in or register to post comments