Spondylolisthesis and Intrinsic Strengthening

by Jane Coburn

Hi Sarah
You might recall my question about spondylolisthesis and the Back Block in February. Since then, I have been doing your segmental instability exercises and my back has improved, so many thanks! I can do all the exercises OK except the intrinsics, which provoke my pain for a day or two (until the next ones). However, you stressed the importance of intrinsic stengthening, so what to do?
I have been offered facet joint injections. If I have the injections, then I might be able to do the intrinsics. If I stop the intrinsics, then I can probably manage without the injections. My dilemma: is it worth having the injections so I can do the intrinsics or should I settle for toe-touching?
Thanks in anticipation,

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May 17, 2013
intrinsics strengthening
by: Sarah

Hello Jane,
As is typical with this regime, you are stuck between a rock and a hard place here because yes, the Grade 4 spinal intrinsics strengthening off the end of the table are hugely strengthening but at the same time VERY irritating to the back (it often brings on leg pain for a day or two). There is no way round it - unless you cover the period after the exercises for 2-3 days with taking NSAIDs and even Panadol too every 4 hours. Otherwise, you have no option but just going the slower route - as you say - of the toe touches. But remember too, functional activity of bending freely and unselfconsciously all the time during the day is the most efficient and effective strengthening of all, across a weak spinal link.
But if you persevere with the Grade 4 strengthening (for the rest of you, you can see these in Back Sufferers' Bible, Chapter 6 and 7) make sure you do lots of knees-rocking and general 'appeasing' for up to ten minutes afterwards.

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