Spondylolisthesis and disc protrusion

[alophysio]

hi. Diane Lee has taken that article off her website so i haven't passed it around...

The key thing is that if you try 4 different ways to get it and the person still can't do it, fix the other problems like the joints and muscle spasms etc. Then try again.

Some people actually have LM that works just fine - have you tried the prone hip extension timing assessment? It should be LM, then Gluts then Hams. I think you will find most people with dysfunction usually have LM first then Gluts and Hams.

To isolate you LM is a Motor Learning Skill - it is a test of skill learning! You can ask some athletes who have perfectly fine LM contractions to isolate it and they can't - that is because it is a backward step for them to do it.

However, since people with dysfunction have a motor pattern in which they are limited to, learning to isolate breaks that pattern. It is then you can reintegrate the new pattern into the movement.

So rather than following a receipe of isolate, co-contract, integrate, we should actually assess whether people have all the muscles working as a team during a task like Active SLR then assess at what stage they need to begin their rehab.

I find that i start at co-contract more often than not and go from there.

Thanks!

[asha]

with regards to "core stability" exercises, does anyone have any tips/advice on teaching lumbar multifidus?

other ways of working the multifidus :
1-get the patient to lie prone. All that they have to do is just think/imagine they have extended their lower extremity unilaterally at the hip. Just the thought fires the multifidus. This could be done as a beginners exs.
2-The exs explained by alophysio to be done in sitting can also be done in standing. As the multifidus fires, come back to neutral & try to hold a isometric contraction. But this can be done as a progression & the technique needs to be mastered.
asha

[ina]

hi I have quastion is traction is benefit for patient with spo nylolisthesis? plz answer my quastion with my best regard
ina from iraq

[linbin]

hi
as already discussed traction gives temporary relief.it will reduce spasm,cause movement of discal pressure to negativity.
for long term results,evidence supports use of core spinal stabilization exercises.its logical too.
as you might be aware that core functioning will be altered due to pain in the back irrespective of the sourse of pain.so our main role i feel is to help to enhance core muscle functioning