These are three common spinal injuries or dysfunctions that present with a myriad of different clinical presentations, pain and a treated different in physiotherapy. Most importantly when returning to the gym, require also a different training regime and approach as well. Contact chris for a full description, mgt strategies post therapy and how to train these clients’ for optimal health and well being!
You have spaces in your vertebrae where nerves in the spinal cord connect to the rest of your body. Spinal stenosis occurs when these spaces become narrower. Spondylosis is an umbrella term used to describe age-related degeneration of the spine. Spondylolisthesis is a specific condition in which a vertebra slips off the supporting vertebra below it.
ACtually that is not quite it. Spinal stenosis is a narrowing of the spinal canal. It can be caused by several factors, with obesity, posture, lack of flexibility being strong factors. Creating typically unitateral or bilateral leg pain.
Mgt post therapy is streching the tight hamstrings, hip flexors and incorporating effective cardio vascular training such as recumbent bike, progressed to aqua therapy(with no heart issues) then ultimately to yoga. Core strengthening and avoidance of exercises like cobra pressups or backbends which biomechanically creates more narrowing of the spinal canal. Avoidance of barbell squats and shoulder press can also exacerbate symptoms due to the axial loading.
Spondylosis is a degernative process of the vertebrae. Where the space between the bone, not spinal canal becomes smaller. This may create compression on the peripheral nerves leading to numbness or tingling. Mgt post therapy should focus on stretching the tight postural muscles(hip flexors, quadriceps and ITB), strengthening the weaker low traps, rhomboids and scapular retractors and core strengthening. Cardio is key making it individualized and both yoga and pilates can be extremely effective!
Spondylolisthesis is a forward translation graded from 1-4 or 25%(grade 1), 50%(grade 2), 75&(grade 3) and 100%(grade 4) measured by a physician on a radiograph. The bones can also slip backwards called retrolisthesis. Antero(forward) is more common due to individuals who participate in sports such as gymnastics, divers to name a few. Mgt post therapy should focus on avoidance of exercises like kettle bells, backward bending, shoulder press and barbell squats which all biomechanically place excessive axial loads on the spine. Core strengthening should be balanced between the trunk flexors and extensors targeting the weaker multifidi, QL.
Functional strengthening should also focus on strengthening weaker low traps, post delt, rhomboids and a nice balanced stretching program that avoids end of range.
Thank you for the acknowledgement, however, I am not a physician nor have my doctorate from physiotherapy. Just an advanced master’s degree in musculoskeletal & sports physiotherapy and experience.
If and when I do secure my doctorate, I will not call myself Dr. Gellert for personal reasons.
The reason I posed the question is that how much percentage of people truly have lateral stenosis?
Very few…In my 12 years working and over 60% of my patients I see are back patients and is the primary reason I love the spine and pursuing even more education in that area.