Spondylolisthesis and disc protrusion

[guru_utkarsh]

hey guys,

This is one of the toughest cases i've come across in my clinicals.. plz help !!
The patient a 55 year old male has an anterolisthesis of L5 over Sacrum ( GRADE I) and Disc protrusion at L3-4 . Patient is also a Bronchitis patient.

The patient presents with buttock pain left sided with radiating pain down the whole lower limb. i've not assessed him completely for muscle strength, sensation.. etc.. Pain increases on sitting and walking short distances. Also dyspnoea on exertion.

I'm sooooooo confused wat to do.. give flexion exercises or extension exercises.. traction or mobilization.. god plz help..

Thanks a lot..

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[linbin]

hi
basically the core spinal strengthening ,concentrating on progressively strengthening transverse abdominis and multifidus.

[linbin]

hi
strengthening of core muscles-especially transverse abdominis and multifidus

[ina]

hi
so can you send photos that explain these especial exercises because there is much more exercises on the web site and I can not determine which exercises I should give to my pt. and can you also tel me the programe of that ex.s I mean how many the pt can repeated per a day . how the pt can gradually change these ex.s to more hard ex.s .
with my best regard

[linbin]

hi ina
there is a useful book
rehabilitation of spine-it gives discription with pictures and how to gradually progress

[alophysio]

Other useful books are

The pelvic Girdle by Diane Lee - can find it on Amazon.

Therapeutic Exercise for Lumbopelvic stabilization by Richardson, Hodges and hides - can also find on Amazon.

To prescribe exercises without seeing your patient is dangerous for us beyond the generalities.

These books might be worth a lot of money but they are invaluable in any physio's toolkit and should be a part of any good library. I understand that it may be difficult based on your location.

The O'Sullivan Article is attached here... You should be able to find descriptions of how to do the exercises on the internet somewhere...try Updates On Back Exercise For Pain Relief! for a summary of the researchers and the philosophy of core stability.

Good luck!

[ina]

hi alophysio
thank you for your post but can you tell me by which program can I open your attached file Iam trying with microsoft word and windows picture and fax viewers programes but they did not open it I downloaded it and Iam waiting for your answers. and your right I live in iraq and it is difficult for me to find these books.
with my best regards

[linbin]

Hi, Check out this attachment.

The attachment has been removed to to it being corrupted. I has been uploaded again in the post below. Thanks for that.. PB

[alophysio]

Hi ina,

I think the filename was too long - it is PDF and i have reattached it with a shorter file name.

The file Limbin attached is good as well.

Cheers

[dinku86]

why is the focus on orthosis missing in most cases....????
You should try a newly designed orthosis which is called
ANTERIOR FLAP AND POSTERIOR D-RING ORTHOSIS...

It simply prevents the wasting of Transverse Abdominis muscle by holding it in the correct biomechanics..

Then try TA recruitment exercises designed by Paul Hodges and Richardson and then try Multifidus recruitment. Once pain is alleviated then only start with rectus abd. training. Currently, I am treating a patient with l5-s1 listhesis and it is giving me best results.....

TRY THIS....

[alophysio]

hi dinku86 -

1. can't find your orthosis on Google so can't try it.
2. Can use a support belt if you like but you risk muscle atrophy and patient dependance on it.
3. Article above is by well respected author Peter O'Sullivan and considered a high quality study by PEDro - 7/10.
4. It works for my patients...

Thanks!

[alophysio]

What a load of crap!!!

random1982, be respectful of the power we can have over people in pain.

At these internet marketing courses, they teach you to go onto forums and post as above to gain more link backs to your site etc...

...i just followed your link back to your supposed PT protocol - if that is the best you have, then it is my duty to warn others that it is a pile of steaming crap...

At least add to the discussions!

Post some credible information!

The protocol i posted above is considered one of the highest quality studies of its type.

EVERYONE, BE WARNED!!

[alophysio]

I would like everyone to try this...click on Random1982's name and see what all his posts are about...

...notice how he refers to his website on protocols...

...notice how he doesn't really help or answer specific questions properly...

I suspect he is in it to promote his own website...

I will post this on all of his replies.

If you are going to spruik your website, at least have the decency to contribute to the discussion properly!