Spondylolithesis -I need help with this please

[physioo]

Hi all,

In Spondylolithesis, hamstrings stretches are advocated.

I cannot understand why this is so.

Can someone explain what is really happening biomechanically? shortening / lengtehning of abs/Lumbar ext, vs hip flex hamst

thanks.

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[Damonhfcheng]

hi,
it may be that:
- Tight Hamstrings:
- restricted flexion of hips due to tight hamstrings may be the only finding;
- 80% of symptomatic pts have tight hamstrings;
- tight hamstrings may be found in pts who have spondylolysis or any grade of spondylolisthesis;
- tightness may be extreme, so that child cannot bend forward at hips or, during straight leg-raising test,
examiner cannot lift foot more than a few cm from the examining table;

- Gait:
- tight hamstrings cause peculiar gait (pelvic waddle) in children w/ Spondylolisthesis;
- excessively tight hamstring muscles tilt the pelvis backward and do not permit the hip to flex sufficiently for a normal stride;
- consequently, pt has stiff-legged & short-stride gait, & pelvis rotates with each step.
- child may prefer to jog or run rather than walk, or to walk on the toes with the knees bent;

ref site: www.wheelessonline.com/or...lolithesis

[binmath]

hi guys
i also couln't understand the suggestion of abdominal strengthening exercises in spondylolisthesis.crunches and lower limb cyclic movement will also recruit the hip flexers which has origin from lumbar vertebrae,so it will only worsen the listhesis.i think strengthening of transverse abdominis and multifidus only will help.i like to know your openions and suggestions.gud day

[neurospast]

I do understand the confusion. In case one has an instability of the back it does not make a lot of sense to stretch the hamstrings since this might be the last protection to avoid more backproblems. One can think that it might be the last restraint to avoid a total colapse. But the decreased mobility of the hamstrings might result in more movement of the vertebrae suffering from spondylolisthesis
In order to restore stability of the back it seems to me that the first resort should be increasing core stability. Segmental as well as global. When you do this you might find that the hamstrings respond with a lower tone and an increased mobility. Research has shown that stretching any how is questionable and that it does not have any longterm effect.