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Spondylolithesis Treatment Tip - A Female Approach

6/12/2012

4 Comments

 
A few weeks ago we provided a post with statistics that related directly to spondylolisthesis and spondyloliysis. 
These statistics covered various types of spondylolisthesis.  

If you are unfamiliar with the types of spondylolisthesis you can read our post here. 

One statistic that we did not cover that relates to spondylolisthesis as a whole is how prevelant spondylolisthesis is amongst women.
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As a whole, spondylolisthesis studies have shown that women develop one of the five types of spondylolisthesis between 4-6 times more often than males. 
 
With such a high number in the amount of cases in females, what possibly could lead to these statistics and more importantly what can women do to help fix the pain?

Hormones and Their Role in Spondylolisthesis
For women with spondylolisthesis it is important to understand the affects their hormones have on ligaments. According to studies, hormones are a major factor in the prevalence of spondy's in women(1).

Naturally, one of the hormones produce by women is estrogen which
plays a direct role on ligaments.  

One of the effects estrogen has on women is to loosen the ligaments.   Among other things, ligaments connect bone to bone and help to provide stability and support in the body’s skeletal system. 

When estrogen loosens the ligaments some of the stability and support is compromised.  This can directly affect the skeletal system and more specifically, the vertebral column.  With this change in stability and support the vertebrae have greater movement and less stability,thus leaving them more susceptible to injury.  

With the ligaments going through a greater range of motion due to their new laxity (looseness), the bones that they support also have the ability to move more and immediately become more likely to suffer an injury or slippage when compared to those with stronger more stable ligaments. 

With all of these changes taking place women who perform what would normally be labeled as low risk activities are now more likely to suffer an injury due to the increased amount of instability.

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Activities such as running, excessive standing, and walking typically require stability and support from ligaments and surrounding muscles. 

Those with loose ligaments may not receive the proper stability which can lead to stress fractures in the spine, slippage, or discomfort and muscle spasms. 

Young teenage girls who participate in sports such as gymnastics and cheerleading are at increasingly higher risk for spondylolisthesis due to the hormonal changes in combination with the demanding positions the spine is placed in on a daily basis.  

A combination that unfortunately produces a large number of spondy patients. 

Additional problems may arise during pregnancy due to even greater changess in ligaments and pelvic structure.  Those who suffer from spondylolisthesis or spondylolysis going through pregnancy may notice additional slippage and an increase in pain due to these natural occurances in the human body.

Women who suffer from degenerative spondylolysisthesis may find this following study interesting. This study shows that women who have given birth and suffer from back pain are twice as likely to suffer from degenerative spondylolisthesis when compared to those who have not given birth. 

Possible reasons may be the changes in abdominal structure and the effect giving birth has on ligaments and joint capsules (2). 


Fella's, It's Not Just The Ladies
Sometimes people are born with loose ligaments or what doctors would call laxity in the ligaments or joints. These people are also candidates to having a lack of stability in needed areas. 

I believe this may have contributed to my spondy as I have suffered two injuries related to ligament damage.  The other being a torn ACL (knee ligament).

So men, you are not in the clear. Those born with loose ligaments might also be at greater risk for spondy's.


What Can Be Done - FOCUS ON STABILITY!

Since estrogen and ligament laxity (loosening) happens naturally and you do not want to stop this process, it is best to focus on improving your stability to aid your ligaments and spine with extra support.  

Flexibility may not be an issue for many who have loose ligaments; therefore the focus needs to shift to providing the spines support system with the proper amount of stability and strength. 
 
Those with loose ligaments who go through the typical spondy protocol of stretching and a few core exercises could be missing out on a VERY important component (stability) of a their treament program.

The main support system(s) of the spine include the midsection, hips, and most importantly the glutes. 

Focus on improving the strength and stability of these areas with exercises that are safe on the spine and encourage a neutral (straight) spine and proper movement mechanics. Doing so will help to provide your spine with additional support and prevent further slippage if a spondylolisthesis is already present. 

Some of our favorites include planks to strengthen the core, various forms of glute bridges to attack the hips and gluteals, and band lifts to help with proper movement are just to name a few.

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Planks
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Various forms of bridges
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Band lifts
When focusing on stability the focus should remain on technique and proper mechanics.  Don't stress over the amount of weight being lifted or how long you can hold each position.  When improving stability, technique is king.

When the stability and strength are increased, you will develop a greater support system that will hopefully provide you with less pain and the ability to perform activities you love. 

STABILITY is the key for those with lax ligaments who suffer from spondylolisthesis.  Our program SpondySolution offers several progressive forms of stability exercises to help you develop the proper stability in the right areas.  You can click HERE for more information.

If you are a woman who is suffering from a spondylolisthesis let us know what has or hasn't worked for you. You can reach us on facebook at www.facebook.com/SpondySolution or on our contact us page.


References
1. Jacobsen S, Sonne-Holm S, Rovsing H, Monrad H, Gebuhr P. Degenerative lumbar Spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study. Spine 2007;32:120-5.
2. Sanderson P, Fraser R. The influence of pregnancy on the development of degenerative spondylolisthesis: the Journal of Bone and Joint Surgery. 1996; 78-B:951-4.

4 Comments
Mary Jane Pichoff
6/15/2012 07:41:34 pm

Women who have given birth supposely suffer from spondy. Being pregnant was for me the only time I did NOT have backache. Why would that be? I have been suffering from back pain since the age of 12, and have been diagnosed with spondy. Thank you!

Reply
SpondySolution
6/16/2012 04:02:03 am

Hi Mary Jane. That is a very good question. Again, everyone is different when it comes to spondy's, thats why it is such a misunderstood condition. I do not have an exact answer for your question due to the various individual weaknesses people may suffer from. A females body goes through so many changes during the pregnancy cycle. As mentioned in the blog post one of these changes involves hormones and structural changes to prepare for birth. One of these changes may have affected your spondy in a positive way. Or perhaps the added rest played a positive role. Again, this is just a quick observation and by no means what may have happened. This would be an excellent question for your doctor. If you do ask him/her, please let us know their answer. Sorry I could not give you an exact answer. Thanks for the post!

Reply
Mary Jane Pichoff link
6/16/2012 07:27:51 pm

The OB/GYN who delivered my child retired many years ago and no longer has my records. But this, I do know, I did not rest as long as more as other pregnant women did. At that time I was taking care of the 3 1/2 year old child who was going to be our adopted daughter and was always very busy. Any more comments?

SpondySolution
6/16/2012 08:36:51 pm

Unfortunately, without performing a screen on you or looking at your personal movement deficiencies it is impossible to determine your exact reason for the decrease in pain during pregnancy. I will perform some research on the situation and see if I can find any exact reasons for your case. Next time you see your medical proffesional mention this to them. Upon evaluating you they would be able to give you a better answer. Best of luck!

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