Since it is a disease that usually does not heal, the treatment of the symptoms is the main focus. Physiotherapy is also a good way of preventing spondylolysis from progressing to spondylolisthesis (spondylolisthesis). Consistent stabilizing training is extremely important to improve and correct the posture of the spine. The musculature must learn to compensate for the instability of the intervertebral joints.
Exercises with existing spondylolysis
Our vertebral joints are stabilized by very small muscles that are close to the joints and cannot be controlled arbitrarily, the so-called autochthonous back muscles. To train these specifically is not so easy, because we cannot tense them arbitrarily. However, we can address and strengthen them through intensive, stabilizing training.
Exercises that strengthen the core muscles are ideal for this. There is a wide range of exercises that can be done, and a varied training plan is possible. Once the patient has learned how to perform the exercises correctly and in a controlled manner, the exercises for increasing stability can be integrated into almost any exercise.
1. forearm support Important Variation Weight shifts or lifting a support column should always be performed in a concentrated manner. First, slow and controlled movements are performed until the patient can safely stabilize the position. Then the speed and thus the difficulty can be increased.
If the exercise becomes unclean, a step back to an easier variation should be taken. 2. bridging 3. basic tension during the knee bend Basically the same applies to all exercises: technique before number and duration. The exercises can be done twice a day.
The focus is on quality. A training plan should be individually tailored to the patient and an introduction to the posture and exercises should be made with a therapist to counteract incorrect, possibly harmful, performance. It also makes sense in the treatment of spondylolysis to integrate targeted training for the abdominal muscles and to perform posture correction in order to avoid harmful stress in everyday life.
Further good exercises for the lumbar spine for trunk tension can be found in the articles:
- The forearm support is particularly suitable for training against spondylolysis. The patient rests on his forearms lying on the floor, bends his feet and puts his toes upright. He places his elbows under his shoulders and the forearms lie parallel to each other on the floor.
The patient now lifts the body upwards so that legs, buttocks, spine and head form a straight line. The gaze points diagonally downwards, the cervical spine is stretched.
- In spondylolysis, it is now extremely important to ensure that the patient does not fall into the hollow back. To do this, his trunk muscles must be working.
He can activate them even further by trying to stretch himself. The heels are pushed backwards, the back of the head is pushed forward for a long time. You can also try to pull the shoulder blades slightly towards the spine so that the arms support the patient and he does not hang passively in his shoulder joints.
The navel is actively pulled towards the spine so that the entire abdominal muscles are tensed. This tension should be particularly noticeable during exhalation. The buttocks are tense, the pelvis is tilted slightly backwards so that the pubic bone rotates slightly forward and upwards.
This tension is called basic tension and should be safely controlled. It is best to practice it first with the therapist so that the patient can apply it in a controlled manner. The position is strenuous and it is important to hold it securely for a certain time.
The aim should be to be able to remain in the forearm support for one minute. It is best to increase the load phases slowly. The execution technique takes precedence over duration!
- If the posture is mastered safely, the exercise can be extended.
The weight can be shifted from the right to the left elbow, while the pelvis remains in a straight line. The patient will notice how different areas of his abdominal muscles are activated while shifting the weight. It is also possible to carefully and in a controlled manner to lift one leg stretched out a few centimeters and hold it briefly in the air.Here too, it is important that the torso remains immobile in the forearm support.
The musculature should stabilize the posture.
- The basic voltage can also be built up in bridging. In this case the patient lies in a supine position on a support, the arms are loosely spread out next to the body on the floor, the palms of the hands point to the ceiling. The knees are bent 90°, the heels are upright, the feet are pulled up.
Now the pelvis is raised until it is in line with the thighs and the trunk. The gluteal muscles are tensed, the back remains straight, the abdomen and back muscles are also tensed. When the position is held securely, the legs can be lifted off the floor one after the other without the pelvis lowering or tilting to one side.
In addition, small quick hacking movements can also be made with the arms when they are stretched vertically in the air. An alternating tension should be felt in the trunk muscles while the patient tries to keep the position stable despite the arm movement.
- Such exercises are possible in almost all starting positions. For example, the knee bend starting position is particularly difficult.
The arms can be stretched to head height, while the back remains straight and stabilized. Now the patient can again perform small chopping movements with the arms stretched out, while the back remains stable. The spine is physiologically stretched and straight. The arm movement can be performed for about 10 seconds, then a break should be taken. This exercise is very difficult and should only be performed after consultation with the trainer with well prepared and trained patients.
- Isometric exercises for the lumbar spine
- Exercises against a hollow back
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