As an update for me, I continue to work out and live pain free. I am still following my previously described guidance, deadlifting rarely, watching my loads during CrossFit, and only going heavy in low rep situations. That being said, I have hit a couple of new PR's on the olympic lifts, so I am pretty stoked about that, and it hasn't seemed to introduce any new symptoms. Again, I am very careful to maintain good form and lock in my midline before and during every lift. I use a lifting belt for most lifts (this one, since it has a section that goes over L5-S1). I also played my sport all summer without any issues and continue to walk, run and dance pain-free. Hoping it will last!
Anyway, as always, feel free to post questions or comments to the blog!
Be well!
#crossfit #weightlifting #spondylolisthesis
I have been diagnosed with Spondylolthesis and I have been going to PT for two weeks now and I've seen a little difference but I have not seen much of a difference. I also stopped lifting for this period of time and I feel like that has done more bad than good. What is your opinion on me returning to lifting before I am "cured", which I don't think is going to happen.
ReplyDeleteHi Amanda,
DeleteSorry to hear about your diagnosis. Is it in your lumbar region? Is it an active spondylolysis (pars fracture) or a confirmed spondylolisthesis (vertebral slip)? If it's a -listhesis, think a lot depends on how stable the slip is (can be seen on flexion/extension x-rays). If it's stable, then I don't see any reason not to lift if:
a) you're not in an active severe pain/inflammation cycle,
b) your core strength is solid, and
c) your lifting form is good.
FYI - Chiropractic, PT, injections, etc. might provide some help, though the only "cure" for spondylolisthesis is surgical, either decompression or fusion or both, and unless you are really in horrible pain and can't walk more than 100 meters, it's probably too early to think about those options.
I would exhaust non-surgical options, continue to work hard on core strength and lifting form with no or very light weights, and gradually rebuild once the pain is under control.
Hope this helps and good luck!
Oh, and feel free to reply back with more questions!
DeleteWhat would your recommendations be for someone diagnosed with just spondylolysis (pars fracture L5)? I'm a 22 year old active male with high aspirations for a military career. Surgery isn't really an option, IMO. That being said, do you think the decompression surgery would help? Chiro, Sports Med, PT and Surgeon haven't been able to find much success with my case thus far.
ReplyDeleteMy pain hasn't been shooting nerve pain, but rather extreme lower back muscle tightness during high intensity WODS which I assume is because my CNS wants to protect that problem area, as well as dull aching pain when I am sitting or laying (bad posture/high compression forces on L5).
My workout plan recently has been:
"Crossfit"- 5-6 times a week with pull ups, push ups, HSPU, dips, planks, muscle ups, rope climbs, low weight bench press
Swim - 2-3 times a week
Run - 1-2 times a week (long and slow or short and fast)
+ PT exercises.
Interested to hear your opinion. Good luck moving forward.
Best,
Lee
Hi Lee, Thanks for the comment and for providing the info. Sorry to hear you're dealing with a spondy. I'm not doctor, so you'd definitely want to consult with a few different ortho and neuro surgeons, but my understanding is that if it's an active fracture, that the literature says that immobilization (back brace) for some period of time is called for as first response until the fracture heals/stabilizes. That tends to be the recommendation for children and adolescents, at least:
ReplyDeletehttp://www.ncbi.nlm.nih.gov/pubmed/11806390
http://www.ncbi.nlm.nih.gov/pubmed/22002572
The last article mentions that if it fails to respond, then surgery to repair the pars defect is possible. You may need to get several opinions on this.
Either way, I'd doubt that decompression alone would help you since you say you're not experiencing nerve impingement, and that surgery doesn't really have high success with back pain only, to my knowledge. It (along with fusion) has high success for leg pain only.
I'd be careful about CF and heavy loading until you know more about the spondy (i.e. is it "active"), and until you've tried the bracing/healing first.
Good luck and let me know how it goes!
Curious to know, do you wear a weight belt while lifting? I never have, but I am going to try it.
ReplyDeleteI am in the process of getting a full diagnosis but it looks like for me its spondy between L4/L5. The first Dr I talked too mentioned deadlifts were likely the cause, but I think more likely it was either congenital or early on as a teenager in football (I can recall having issues running long distance because my back would get “tired” back when I was in high school), or a fracture from an ATV wreck 10 or so years ago (had a 500lb ATV land directly on my lower back from at least 12-15ft up).
Prior to now, the only issue I have ever had from this was back tightness/tiredness when trying to run, or sometimes from heavy KB swings or other WOD combinations. I could not even jog a ¼ mile before I could feel my back tighten, at ½ mile my back is “numb.” It’s always been strange to me because my core/back is quite strong, and over the past couple of years I have added about 100lbs to my DL max, and 130lbs to my squat max and my back never hurt a bit during the training. Today it still doesn’t hurt under weight, though back squats (low bar) seem to aggravate it later on, sometimes right after and sometimes the next day.
I started seeking answers because my hips felt inflamed towards the end of the day, like they were bone on bone almost. Issue is gone in the mornings, and doesn’t always flare up noticeably, but some days by 8-9pm it was grating – though sitting for a bit lessens the pain for a while (no pain at all sitting).
I had xrays on my hips and they looked normal ot the ortho, so they suggested MRI on my lower back. This Dr doesn’t work on spines so he didn’t have all the answers, going to do another consult with a spinal Dr at some point soon.
At any rate, I have never used a belt partly because of wanting to “not use gear” and partly because I never really found one that fit well (though didn’t try many), it seems like it should help out in particular in my issue being between L4/L5. I am also going to swap to high bar squats, I can squat more weight low bar but it is a much weirder angle for my spine I feel considering my condition.
Hi Matt,
DeleteSorry to hear about the Dx of spondy. I doubt it's from "too many deadlifts" and more likely from congenital cause or from football (lots of hyperextension under load), but I don't think it's possible to really know for sure. I sure don't in my case.
I think in your case you'll want to spend some time working hard on hib mobility and ensuring that your hip flexors, hamstrings and glutes are mobile and not overly tight in one area. Kelly Starrett has great stuff for this on mobilitywod.
I do indeed use a belt when I get over 60-70% on my lifts. I've linked to the one I use in the post above, but really any decent belt that's 4"+ should be fine as you're really just using it as a crutch to remind you to lock in your core before the lift.
Along with going to high bar BS, you may also want to consider switching to sumo DL's primarily instead of conventional DL's since the shear stresses are a bit lower (though compression stresses are a bit higher).
Good luck and let me know if you have more questions.
Sorry I missed the belt part; I read the first parts of your story and after seeing "I continue to work and live pain free" in this one I guess I tuned out.
DeleteI am hoping that is the case for me at some point, one thing I will pass along I have recently bought a small Rogue sled to which I have been dragging a lot (instead of jogging I’ll do a light sled drag for 20-45min). I’ll also maximally load it and drag it on some days - I still have issues but I'd say lately it’s perhaps 1/3 of the peak of what it used to be, so a substantial improvement. It had improved so much I was literally expecting maybe just a bulging disc issue at my Dr appointment but no such luck. My theory with the sled was if walking seems to bother me (walking/standing is where I notice my issue the most, other than jogging obviously), weighted walking will beef everything up to support that.
I had also been walk/jogging, on a soft surface like a track I can go about 3 miles before I start to notice issues with my back tiring out, pavement about 1/2 that – but still it is walk/jog instead of jogging like I want. Never have wanted to be a runner, but I’d still like to be able jog 3 miles at a decent pace.
I have the supple leopard book somewhere I’ll start going through it, also I been curious about sumo DL but never taken the time to work on them yet, perhaps this is the time to do so. Odd thing for me though is my back/hips usually feel better after deadlifts, it’s the squats that seem to kill me. Even a lot of air squats can occasionally start to cause me issues.
At this point considering where I am at with it overall, I also think I will avoid a fusion (mentioned by the ortho Dr as a possible fix, but deferred to spinal doctor) as long as I can. If they want to clear out broken bone (assuming it’s there, I can’t tell on my MRI myself and I am waiting on the MRI annotations to be mailed to me) that is another thing I might try.
Anyway appreciate you sharing your story and answering my questions.