Novice PT seeks advice for spondylolisthesis

[PhysioStudent88]

Hello. I wanted to ask a question about the rehab of an anterior spondylolisthesis. He got an MRI and the neurosurgeon told him that he has an anterior spondylo at the level of L5-S1. He advised him to start physio and sports activities (as tolerated) and he will see him again in 1 month.

• Patient, 30 yo presents pain in the lower back.
• Pain radiates down both lower limbs and saddle.
• Type of pain-Paresthesias(numbness, pins and needles, burning sensation).
• Frequent Urination ( ~ every 20 min).

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• SLR is present on both sides.
• Altered sensation on both sides (Dermatomes L1-L2-L3-L4-L5-S1).
• Muscle tests are normal (only abs score 4/5).

This particular patient was a semi-pro football player. He played football until he was 18 years old and gave up due to university studies. He has not done any sports for 12 years and mostly lives a sedetary life.

Now, my question are:

1- For this particular situation i was thinking of starting gentle abs strengthening exercises. Mostly focusing on the anterior part of the trunk and not so much the posterior part. Do you agree?
2- Also was thinking about telling him to start some swimming but i do not know what kind of strokes are advised for an anterior spondylo? Help!
3- What else would you advise?

If you have any questions about the patient tell me and i will try to respond

Thanks in advance,
Cheers

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[mmwr715]

Hello. I wanted to ask a question about the rehab of an anterior spondylolisthesis. He got an MRI and the neurosurgeon told him that he has an anterior spondylo at the level of L5-S1. He advised him to start physio and sports activities (as tolerated) and he will see him again in 1 month.

• Patient, 30 yo presents pain in the lower back.
• Pain radiates down both lower limbs and saddle.
• Type of pain-Paresthesias(numbness, pins and needles, burning sensation).
• Frequent Urination ( ~ every 20 min).

------------------------------------------------------------------------------------------------------

• SLR is present on both sides.
• Altered sensation on both sides (Dermatomes L1-L2-L3-L4-L5-S1).
• Muscle tests are normal (only abs score 4/5).

This particular patient was a semi-pro football player. He played football until he was 18 years old and gave up due to university studies. He has not done any sports for 12 years and mostly lives a sedetary life.

Now, my question are:

1- For this particular situation i was thinking of starting gentle abs strengthening exercises. Mostly focusing on the anterior part of the trunk and not so much the posterior part. Do you agree?
2- Also was thinking about telling him to start some swimming but i do not know what kind of strokes are advised for an anterior spondylo? Help!
3- What else would you advise?

If you have any questions about the patient tell me and i will try to respond

Thanks in advance,
Cheers

Obviously, He needs to see a urologist to find out if the frequent urination is a bladder(interstitial cystitis), prostate (prostatitis), or neurological problem...