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Keys To Understanding Your Spondylolisthesis Flare Ups (Part 1)

6/26/2012

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If you have been reading my post for any amount of time you have seen me use the term “flare up”. 
Many people don’t associate the term flare up with spondylolisthesis, but for those who have this condition I am sure you understand what I mean.

You may experience tightness, shooting pain, weakness and other uncomfortable pains in your hips, low back and even legs.  You may wake up or get up from a position and sometimes feel like falling over the pain stabs so badly.
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This is what I call a flare up. 

The pain is different for everybody. For some it is crippling and for others it may not be that bad. The bottom line is that you are experiencing discomfort that should not be there. 

My personal flare ups involve a horrible pain in my hips and low back (almost buttocks) with a feeling of weakness.  My walking pattern changes as I feel pain with every step. 

At the height of a flare up walking and certain sitting and laying positions are VERY painful.  It feels like there is a ton of swelling and discomfort in the hip/low back area. 
 
Fortunately I have learned how to control these horrible flare ups through proper exercise, understanding my strengths/weaknesses and education of the human body.  I also firmly believe everyone else can control these flare ups with a proper plan of attack. 

Before we go any further let’s get one thing straight. 
 
FLARE UPS WILL HAPPEN!

Every once in a while I have minor flare ups, but nothing compared to what I used to get.  So TRY NOT to get down on yourself or your condition.

The important thing to remember is to learn everything you can from each flare up. 

Try this simple plan and begin by asking yourself three questions during your next painful flare up:

1. What activities caused it?

2. What physical weaknesses could have caused the flare up?  Was it due to tightness, weakness, or instability?

3. Was the flare up preventable?

In a previous post we discussed how the actual pain associated with a flare up is usually a result of excessive inflammation and we listed a few ways to help with this. You can read more about this in our inflammation post HERE. If you are having extreme pain while reading this you may want to try reading this article first.

As mentioned earlier in this post, and as many of you probably already know, the flare up pain can be excruciating. In the midst of a painful flare up it is hard to think about what might have caused it. Your mind is stuck on getting rid of the pain as fast as possible. But try to take a few minutes and think about the following questions.


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1. What activity caused your flare up?

Was it a certain position you were in when resting? Was it a sport or activity and what exact movements created the pain?

Maybe it was certain exercise or activity that caused the pain.

Or perhaps it was your inactivity that caused the flare up.

One of the best ways to report this is to keep a log. We talked about that in a previous blog post HERE.

No matter how bad the pain, try to remember what caused it.  Then think about what movements were involved with this activity. 

For example, if golf causes you pain the main movement involves rotation in one plane.  If the pain occurs when you lay on your stomach this position may include hyperextension of the low back.  

Maybe you were running a mile when the pain started, possibly due to the excessive pounding caused from the running position.

Once you answer this you can move to question number 2. 


2. What physical weakness may have caused the flare up?
 

Let’s use my personal experience as an example. 

Over the years I have learned that I get flare ups after times of inactivity. Three days or more of doing no exercise or stretching usually causes my flare ups, it’s almost like clockwork. 

I believe this is due to certain physical weaknesses and instability in the muscles of my hips, core, and glutes. 

Locating an area that may be the "weakest link" will allow you to focus on improving that area and other areas involved with proper movement.

DISCUSS THIS STEP WITH A CERTIFIED PROFESSIONAL TO GET AN EXACT IDEA. OTHERWISE YOU WILL BE MAKING A  GUESS. AN EXPERT WILL BE ABLE TO GIVE YOU AN EXACT IDEA OF WHAT THEY SEE. THIS IS ANOTHER GREAT REASON TO GET A SCREEN BY A PROFESSIONAL. 

We cannot state this enough. Your doctor, therapist, personal trainer or strength coach will be able to give you an exact idea of what areas you lack strength, instability and flexibility in. Don’t take a wild guess and perform some random exercises because they look good. 

You will never get better by guessing! It’s like playing darts blindfolded. 


3. Finally ask yourself if the flare up was preventable?

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Maybe it was an accident that lead to the flare up. Maybe you were wrestling with a friend and got thrown to the ground (trust me, this happens). 

In this case the flare up was preventable ONLY if you didn’t participate in the activity, but for the most part you were in the wrong place at the wrong time.  
 
Avoiding risky activities is the key to these types of flare ups. 

But on the other hand if you were playing a certain sport, or were inactive (like me) the flare could be prevented. 

How?

Well if you had the right amount of strength and stability in certain areas perhaps the flare up would have never happened.  Perhaps the reason for the flare up was due to the fact that improper movement forced excessive stress on areas that lead to the flare up.

For example; in the past golf was an absolute pain causer for me.  It seemed that every time I played I got some kind of back pain. I was to the point where I thought about quitting the sport.

Recently, I have strengthened and supported the proper areas and have been playing golf a few times a week without pain. 

I have also worked with and helped several athletes who came for help with back pain related to their sport. After working on strengthen weaknesses and correcting movement patterns, those sports no longer caused the same pain.

These experiences have convinced me that with the proper approach you CAN take the necessary steps to prevent these flare ups and enjoy activities you love. 

Start with jotting down these 3 questions during your next flare up.  Remember, try not to get down, flare ups do happen. The key is to eliminate the number of times you have them and controlling the pain with each one.

Check back for part 2 as we will discuss what you can do after you have answered these three important questions.


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