Dear all,
 
I remember reading a study a while back about patients who were put in braces to prevent extension which seemed to have reasonably good results if it was over a long period of time and included cessation of provoking activity (diving, fast bowling and gymastics). 
 
As a physio all I could suggest is advice (avoiding extension and ? rapid deceleration) and transversus abdominus exercises.  I had an asymptomatic spondylolisetheis surgically fixed which was OK (although it cramped my style at uni in a hip spica), it was apparently to prevent degeneration in later life, which might be a consideration.
 
Good luck,
 
John Willenbruch
 
PS Which lumbar stabilisation exs have you been doing?
 
Dear Nabil,
 
The literature largely agrees that spondies in young persons are the result of overtraining. Most authors say that discontinuation of the causative activity is necessary, until the complaints have resolved. From that point, a *gradual* resumption of activities could be tried. I would think, however, that you should prepare her for the possibility that she will have to give up gymnastics. If it were only to make her well aware of that at least for the time being she will have to give it up. And to not give her any false hope.
 
She will as good as certainly be able to lead a normal life. Usually, the complaints caused by spondies, in young persons, resolve over time (months to years). So there's nothing much for her to worry about that. But the human spine isn't made for twisting-and-upside-down-rotational-turning-flip-overs. Add to that a possible congenital relative weakness of her spine, and I'd think one has the causative mechanism. And the answers...  
 
R.,
Frank
 
F.J.J. Conijn, PT
Editor, Physical Therapist's Literature Update
The Internet Journal of Literature Updates for Clinicians in Primary Care Orthopaedic Medicine & Rehabilitation
www.ptlitup.com   
 
 
 
----- Oorspronkelijk bericht -----
Van: [log in to unmask] href="mailto:[log in to unmask]">nabil keshavjee
Aan: [log in to unmask] href="mailto:[log in to unmask]">[log in to unmask]
Verzonden: woensdag 6 augustus 2003 23:09
Onderwerp: spondylolisthesis!

Need to some help, hope you rack your brains and help
me out.
Seeing a gymnast, female, 11, with symptomatic
spondylolisthesis.
Pain produced on any extension.  Otherwise she has no
pain.
I have been working with her on lumbar stabilization
exercises, with limited success.
She has continued with her gymnastics training, but is
not doing any activity that puts her in extension.
Any other recommendations regarding treatment (?brace,
taping, ....)

Nabil K.



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