Dr. Bookspan's Ab Revolution™ Core Retraining Relieves Spondylolisthesis Pain

When a vertebra in the lower spine slides forward on the one below it, it is called spondylolisthesis. In June, I will be presenting my research at an international medical meeting, on a technique I developed to relieve the lower back pain that results from spondylolisthesis.

Like many medical words, spondylolisthesis comes from two Greek words - spondylo, means "spine," and listhesis, means "to slide." Why do the bones slide?

The standard medical literature contains several customary explanations for the condition, each repeated from the next. Often, people who are found on x-ray to have spondylolisthesis are told they have a disease. Often, one of the remedies repeated is surgery. Having spondylolisthesis does not mean you have a disease, or a condition that need medical treatments or surgery. I have found in laboratory studies of many patients with spondylolisthesis, that the lower spine can slide like that when they stand with too much inward curve of the lower back, called swayback and hyperlordosis. It is a slouch, that over time, can push the lower spine bones forward on each other. It is reversible without surgery or medicines.

Normally, your spine bones are held in place, like other joints, by the shape and action of the joints between them. The joints of the vertebrae are called facets, which means "little faces." Facet joints are oval and flat, and look like they are looking at you when you look at them. When you stand and move with your lower spine overarched, that overarched bad posture is a common cause of lower back pain. Nothing much may show up on x-ray for many years. After years overarching the lower spine, the facet joints begin to abrade and grind, and show degenerative change. The vertebrae may also begin to slide.

Fixing the slide involves deliberately moving your lower spine out of slouching and into neutral spine. The forward slouching (slipping) vertebrae can normalize right then. By no longer slouching in a way that slides the vertebrae, the cause of the pain is stopped. I will be presenting this work at the annual meeting of the American College of Sports Medicine (ACSM).


Fitness Fixer reader Teresa recently finished her PhD. Teresa wrote:

"Two abstracts I submitted for the ACSM Annual Meeting from my dissertation have been accepted for poster sessions (one for Exercise is Medicine, the other for scientific abstract)! So I get to go to Baltimore for the ACSM Annual Meeting/Exercise is Medicine Congress. The first one is "Are Physicians Discussing Strength Exercise with their Patients Over Age 40." The second one -"Influence of Physicians’ Knowledge, Beliefs, and Attitudes on Strength Exercise Adoption by Adults over 40."

"Your example in submitting your abstracts on the Ab Revolution training for low back pain was an inspiration that has helped me. I am excited to be doing these two!

"I love keeping up on the FitnessFixer. Thank you all for your help and support!

"This is my first time doing this and any suggestions from a veteran like yourself of (presenting at these) meetings would be HIGHLY APPRECIATED. Also, I really look forward to meeting you in person!

"I look forward to hearing from you soon (now with my tax paperwork off to
the preparer, I'm ready to buckle down to make my posters).
"Teresa Merrick, PhD"

Congratulations Teresa.


How to relieve pain from spondylolisthesis and other injuries, without surgery or medical treatments:

1. Here is the book, The Ab Revolution™, available through my books page - www.DrBookspan.com/books or click the image below:
2. Read related Fitness Fixers below and more on my web site www.DrBookspan.com.

Related Fitness Fixer:

• Fast Fitness - New Understanding of Hyperlordosis and Disc Injury
• Video of How to do neutral spine - The movement is a simple "pelvic tilt" done while standing to reduce an overarch to neutral spine. It is not an exercise to repeat 10 times, or other number of times. It is stopping the painful injurious slouch one time and remaining in healthful relaxed neutral position for general life and movement - Friday Fast Fitness - Neutral Spine in 5 Seconds.

Related ACSM Conference Adventures:

• News from the ACSM Conference
• American College of Sports Medicine Meeting
• What I Learned at the Aging Conference
• Conference on Aging Dec 2, 2006 in Midtown New York

Labels: education, facet joints, facets, lower back, spondylolisthesis

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Fast Fitness - New Understanding of Hyperlordosis and Disc Injury

Here is Friday Fast Fitness - a new possible contributor to vertebral disc injury, and how to avoid it:

1. In my previous studies, I found that overdoing the inward lower spine curve (hyperlordosis) pinches the lower spine like a soda straw. It forces the spine joints, called facets, backward against each other, eventually wearing them, and compresses surrounding soft tissue. After long periods of standing, exercise, and lifting with too much inward curve, lower back pain is not a big surprise or mysterious to fix.


2. Hyperlordosis was not previously thought of as a direct herniating force on discs. The major factor was and still is too much forward bending. Weighted flexion (bending forward bearing your body weight) opens the space between vertebrae in back, and over years of slouched sitting and bad bending and lifting forward, presses discs outward through that space creating herniated discs (an injury, not a disease). In my previous work I found that for someone with a disc already herniated, hyperlordosis pinches it, adding pain to the separate problem of the disc. Showing people how to stop standing in hyperlordosis greatly reduced their disc pain. In recent work, I found that hyperlordosis exacerbates, and possibly initiates disc herniation itself.


3. My new work is showing that hyperlordosis is a probable mechanism to directly shift disc position. I made a diagram showing the disc injury coming from overarching/ hyperlordosis/ hyperextending the spine that is so common in pop fitness.

Hyperlordosis (overarching the lower spine) is a spine damaging posture. Hyperlordosis and the pain from it can be changed as easily as moving your spine to a smaller, healthier degree of arch (neutral spine). It is not tightening your abs, just moving your spine, as simply as bending your elbow. Links below tell more.

Related Fun Fitness Fixer:

• I wrote of this in May 2009 when I was on the way to present my work at a medical conference - Comments, A Medical Conference, New Findings on Discs
• How To Spot and Stop Damage from Hyperlordosis - Prevent Back Surgery
• Damage from the opposite problem of injuriously done forward bending - The Cause of Disc and Back Pain and Disc Pain - Not a Mystery, Easy to Fix

Random Fun Fitness Fixer:

• Down the Stairs

Labels: disc, facet joints, facets, fast fitness, fix pain, injury, lordosis, lower back, posture

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Comments, A Medical Conference, New Findings on Discs

By the time this post comes out, we should be halfway out West to a medical conference. I'm presenting a study, which took years to do, and which found something unexpected.

I am a medical researcher. I find out the things that doctors (with any luck) then learn and put into practice. A research career has all (and more) of the medical schooling, but without the burden of the medical salary. In previous studies, I found that chronically overdoing the inward lower spine curve pinches the lower spine. It forces the spine joints, called facets, backward against each other, eventually wearing them out, and compresses surrounding soft tissue. After long periods of standing, exercise, and lifting with too much inward curve, lower back pain is not a big surprise or mysterious to fix. In the work I am presenting, I found that although it is known that the main factor to injure vertebral discs is too much bending forward, that overarching backward can hurt discs too. This is a new proposed mechanism of disc injury.

There is supposed to be a small inward curve to the lower spine. With the (very) small normal inward curve, spine bones line up on top of each other like stacks of cups so that there is equal pressure on discs from front to back. That is called normal lordosis (inward curve). Chronic bending forward manages to unequally load the discs so that they push out in back. Overarching also unequally loads the area. It seems to pinch already protruded discs, and may even factor in the herniation process. I will be presenting on years of my work that lead to this finding.

I made a diagram showing the disc injury coming from overarching/ hyperlordosis/ hyperextending the spine that is so common in pop fitness. The Healthline blog software is still not loading any new photos of my own. Stock photos or those from other people's sharing sites appear, but I the blogger is not letting us get my own diagrams and student photos to you, for now. I mailed the image to Healthline.com staffer Jerry, who said he could upload it for you. It should appear here, below this paragraph, so you can understand better why hyper-lordosis, although common, and often taught, it not neutral spine and can make unnecessary pain. The damage and pain can be quick to fix when you know how. Click the labels "facets" and "lordosis" for posts explaining this issue.

I have to pay the travel to get to the conference, pay the conference fee, essentially, pay to work. I have to bring a computer and projector to give my own presentation (or pay an AV fee to the conference) but won't have Internet access to see or answer questions. Leave fun comments but hold questions for the next two weeks.

Related:

Neutral Spine or Not?
What is Neutral Spine and Why Does Sticking Out In Back Harm?
Friday Fast Fitness - Neutral Spine in 5 Seconds
Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?
Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine
Prevent Main Factor in Back Pain After Running and Walking
Back Pain From Running
Disc Pain - Not a Mystery, Easy to Fix

Our Travel to Another Conference Last Year:

The Coming Two Weeks

Story of Past Travel to Underwater Medicine Conference:

Hyperbaric and Aquatic Medicine On Travel

Photo is me, taken on the way on the way to a previous medical conference, out for some barefoot climbing.

Labels: disc, education, facet joints, facets, fix pain, lordosis, lower back

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Back Pain in Pregnancy - and Why Men Can Get It

In school, we were taught about the "unavoidable lordosis of pregnancy." Lordosis (technically, hyperlordosis) is when you allow too much inward arching in the lower spine - Drawing 1 at right.

Over-arching causes one kind of lower back pain. It was taught as something that "just happens" to the spine during pregnancy. I asked the professors why women could also get it before and after pregnancy, and why men got the same kind of compressive force on the joints of the spine, called facet joints. It became a focus of study in my lab with lifters for many years.

The post Neutral Spine or Not? and What is Neutral Spine and Why Does Sticking Out In Back Harm? show how slouching so that you increase the inward curve in the lower spine (increase the lordosis so that it is no longer neutral spine) pinches the lower back under the weight of the upper body. Both also show what neutral spine looks like compared to lordotic.


The upper body should be upright (vertical) and the hip level to be in neutral spine. Drawing 2, with x-ray, shows what hyperlordosis looks like when the front of the hip tilts down and the upper body leans backward. This is not the normal curve - it is too much. The back of the spine gets pinched and pressured.


I found that hyperlordosis is not caused by a pregnant belly or beer belly or carrying groceries or backpacks. The over-arching (hyperlordosis) is not unchangeable anatomy. It is leaning back to offset the load in front.

Note the same over-arching occurring with the overhead lift in drawing 3, below left.

Overarched spine position is something that you can decide whether to allow or not. You can easily use your muscles to prevent hyperlordosis and hold you in healthy upright position.


Try it for yourself:

1. Stand up and pick up your chair (bend right to pick it up for more exercise and back injury prevention).
2. Hold the chair like any package in front, or on your hip, and notice if you lean back to shift the weight off your muscles (make it easier). Where does the weight shift to? On to your lower spine.
3. Instead, stand straight. You will get free, built-in healthful exercise that protects your spine.

When carrying or lifting any load in front, from groceries, to a chair, to a pregnancy, or a baby on your hip, don't lean back to offset the load. To stop the arching and the lower back pain that results, tuck your hips under you as if doing a small abdominal crunch standing up until you are straight, without rounding forward. Don't over-tuck, tighten up, round your shoulders, or lean forward or backward. Just stand straight. When you tuck properly by moving your spine (not by tightening anything) the too-large arch will lessen to normal, and pressure in your lower back from the arching should immediately disappear.

The pelvic tilt to tuck the spine to restore an overly arched lower back to neutral spine was introduced in Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique and Healthier Carrying - Get Free Ab Exercise and Stop Pain.

Don't overarch or lean the upper body backward while you stand and carry - center and right-hand figures in the drawing at left. That is the missing link. Stand upright in neutral spine - left hand figure. There is a small lower spine curve, not a large one, and the lower spine is not pinched and folding backward, which squashes the soft tissue, discs, and vertebral joints called facets.

I have heard argument that nine months is too long to expect someone to think about their spine, and the muscles get tired. As they say in computers, "that's not a bug, that's a feature." It's good news that you get a free core muscle workout and free back pain prevention. Pregnancy (and any weight lifting) is a key time to have that.

Labels: disc, facet joints, facets, fix pain, lordosis, lower back, neutral spine, posture, pregnancy

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