Part 2, Low back muscle endurance test-Lumbar FCE

2 Responses

1. Erik Petersen

   July 5th, 2009 at 1:56 pm

   1

   Hello,

   I was wondering what your take is on someone like myself who has a grade 1 spondylolisthesis that is asymptomatic and wants to continue lifting. I really enjoy ballistic kettlebell movements and have no problem with them. Are there any other support/assistance exercise that would be good to perform to keep my spine healthy? Are there any specific lifts that I should avoid at all costs?

   Thanks!
   Erik

2. Dr. Snell

   July 5th, 2009 at 6:06 pm

   2

   Hey Erik,
   Since I don’t know the specifics of your condition, I can’t give specific comments on what you should do in your exercise program. Hopefully, you have a good clinician to help guide you in that regard.

   Without going into an exhaustive explanation of this condition, let me try to get to the heart of the matter. Spondylolisthesis (”spondy” in the trade) refers to a slippage of one vertebra on another. This slippage is resisted by the bony structures (pars interarticulares), the discs and ligaments, and the extensor muscles primarily. Current trends in the literature find that previous history of spondy, does not correlate well with back pain. We think that similar to other fractures, if the fracture heals correctly, then the bony elements will be at least as strong as prior to the injury (if your spondy was due to injury).

   So developing the endurance and coordination of the supportive muscles resisting shear stress is paramount. Kettlebell swings should be good for this if form is solid. Heavier weights with KB swings will likely increase shear forces substantially and should be very cautiously applied with spondy. I would think that slightly de-emphasizing the end movement thrusting of the hips forward would be a good idea. If you notice pain with these movements, get checked by an orthopedist or qualified chiropractor so that you can get imaging and interpretation if necessary.

   “Are there any other support/assistance exercise that would be good to perform to keep my spine healthy?” Our website, FixYourOwnBack.com starts with Stuart McGill’s “Big 3″ stabilization exercises and the difficulty progression is carried out here on the blog. If you have passed the endurance test (lumbar FCE), then you’ve provided a good foundation to build on.

   Dr. Stuart McGill’s lab is currently exploring the effect of some novel exercises on disc pressure in the lumbar spine, stabilization, and muscle activity. They recently studied several interesting lifting activities in the Strongman competitions with interesting findings that may percolate into clinical care. I would LOVE to see them test Pavel and several of the RKC kettlebell crowd to see what kind of forces the commonly performed exercises in that arena impose on the lumbar spine. Are you listening Stu and Pavel?

   “Are there any specific lifts that I should avoid at all costs?” Mechanism of injury in a traumatic spondy is hyperextension of the lumbar spine. I’d recommend staying away from max weight on squats and deadlifts for those with spondys.