His Sciatica has slowly been getting worse. His doctor now tells him, "do not climb ladders, don't lift anything heavier than half a gallon of milk, no running, jumping, golf, .... don't keep working as a handyman". Well, what about the bills? Doctor replies, "there is a very real chance that you will become a paraplegic if you don't follow the advice.
Spondylolisthesis is a condition where the (usually lumbar) curve and damage to vertebra and disks has become so sever that two vertebrae may slide one off the other severing or severely damaging the spinal cord. Picture a stack of childrens' blocks. Drill a hole down through the stack and put a strand of cooked spaghetti inside. As long as the stack is vertical, there is no stress on the noodle. Now tilt, wiggle and shake the stack a little bit. Pretty soon one block will start to slide off the one below it. Visualize the spaghetti noodle (spinal cord). Increase the tilt, jump a little, bend over just a little off balance. OOPS, that long noodle (spinal cord) is cut and the legs don't work anymore. This is pretty simplified. The spine is designed with normal curves. The curves help with shock absorption and flexibility. The spine is also wrapped with muscle and connective tissue which helps keep its' integrity. However, when damage and increasing lumbar curve occurs it can become a real problem. The traditional solution is to fuse the vertebrae. In my brothers advanced case it is probably the only viable solution. Any alternative seems pretty risky. Does he take a chance that therapy and exercise are able to reverse or lessen the spondylolisthesis? What if he stumbles and takes a fall before his spine improves?
Is there anything he could have done to prevent what has happened? I am not a doctor. My background is personal training, massage therapy and my personal experience. My brother has a significant anterior pelvic tilt, hence the spondylolisthesis. He also walks with his feet turned out (duck feet) which is a common thread shared with almost all persons with chronic fatigue syndrome, and Fibromyalgia victims. Abnormal pelvic tilt is usually the result of tight psoas muscles and lax abdominal muscles (again simplified). I am convinced that if a person realizes what is going on, there is a simple, inexpensive treatment and a very inexpensive self made orthotic . Treatment involves stretching short tight psoas muscles, strengthening flaccid abdominal muscles and massage which speeds recovery and helps teach the body that a new posture is "safe" and achievable.
You can estimate your pelvic tilt easily and with reasonable accuracy. Put your jeans on. Stand sideways to a full length mirror. Look at the belt line. It usually follows pelvic tilt. This method is not 100 percent accurate, but is usually pretty close. It is probably accurate enough for our purpose. My research indicates that men should have 0 to 10 degrees of anterior tilt and women should have 10 to 20 degrees of anterior tilt. If your tilt is significantly different or if tilt is posterior, I would predict that you have a head forward posture, hold pain / tension in your neck and shoulders, probably have or will develop knee / hip pain, and may also have plantar fasciatis (bottom of feet hurt) and may be diagnosed with Fibromyalgia or Chronic Fatigue Syndrome.
It seems that about 80 % of the people with chronic pain have an anterior pelvic tilt while about 20 % have a posterior tilt. Both situations cause similar fatigue, and pain. Look at the posture chart from my previous post and see if you recognize your posture.
Dr Janet Travell researched chronic pain and trigger points several decades ago. She was not some unknown "quack". She was the personal physician for both presidents Kennedy and Johnson. She recognized and published peer reviewed articles describing the relationship between chronic pain and turned out / in foot position while walking. Read my next blog to learn more the condition and how to inexpensively treat it.
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