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Questions about Spondylolisthesis and more

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Questions about Spondylolisthesis and more

Hi Esther et al,

I have the book and have found it helpful already.  I've had on-and-off chronic back pain since I was a pre-adolescent child - I "threw" my back out when I was pushing a desk at school and had to walk home bent - but doctors always told me the pain was muscular as they didn't find anything wrong.  At one point it was suspected my right hip was higher and tilted more backward than my left, whatever that meant.  After a recent CT scan, I was just notified that I have grade 1 spondylitic spondylolisthesis L5 on S1 and moderate diskogenic degenerative changes at L4-L5 and L5-S1, as well as vacuum disc phenomena at L5-S1.  I also have a largish (baseball sized) lipoma positioned at my right hip right in the front groin crease.  I have been feeling "sciatica-like" pain down my right leg for a few months now.

I have seen an orthopedist, physical therapists, chiropractor, and massage therapists.  Till now, the most help has been gained from using trigger point therapy.  It's really increased my flexibility and strength in muscles that were very tight and painful.  But it changed my stride - I'm more balanced now and traumatized muscles were starting to pull their weight, so to speak - and I began having that sciatica (at least I think that's what it is - I no longer have health insurance so can't consult with a doctor about it).

In the couple of weeks since I have been learning the Gokhale Method, I have been trying to apply the lessons in the book.  Although some things felt immediately better (hip-hinging, sitting, sometimes standing, sometimes sleeping), others have associated pain and recreate the sciatic pain, like stretchlying, standing, even my painstaking glidewalking attempts, and now stacksitting.  Hip-hinging so far seems fine.

I figure I'm probably overdoing it and have made myself somewhat inflamed - I overdid it at first too and had terrible migraines from too many shoulder rolls and trigger points in my neck and shoulders.  I'm trying to slow down.  It's hard when I know I'm doing things the wrong way and try to correct them!

But mostly I'm concerned that I should be altering the method somehow to account for the spondylolisthesis or the other factors noted by the radiologist.  Are there specific things you recommend for cases of spondylolisthesis?

Thanks so much in advance!

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The order of first lengthening and then reshaping is especially important if someone has a spondylolisthesis (or spondy). When the spine has instability, you always have to be especially attentive to whether any move (including lengthening) induces extra or new pain or discomfort - back away from all such movements. But to the extent the body tolerates it, stretchsitting, stretchlying and inner corset are the best first measures. Only after the back is more stable and the pain reduced, would I introduce Stacksitting or anteverting the pelvis in Stretchlying on the side. Rather, you could proceed to Glidewalking earlier than usual, again paying close attention to your comfort level.  Everything should be introduced slowly and conservatively.  An external corset may be useful part time.

I've seen very good results even in challenging siutations invovling spondy's. Sometimes, surgery is warranted, though of course that is a decision for you to make with your physician.

 

I hope this was helpful to you.

Warmly, 

Charlene Hannibal

Gokhale Method Teacher, San Francisco/Palo Alto

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Hi Charlene,

Thanks so much for your detailed reply!  Can you tell me the risks involved in anteverting the pelvis too early?  What kind of damage can I do? (I like to understand these things and unfortunately I don't understand the condition very well and no doctor has taken the time to talk to me about it.)

If it makes any difference, my slippage is Grade 1, which is a less than 25% slippage I believe.  Also, these days, I'm not in a lot of pain - just have sciatica when I stand too much or sit too much.  But I don't want to do damage to my disks or vertabrae by going too fast.

So far I like the method.  I've tried glidewalking and find it aggravates my sciatica pretty quickly.  I'm not sure if it's my form or inflammation - I suspect both!  I hope as I get stronger I can go farther.

Also, has anybody you know of with spondy gotten 100% pain free, backwise, by using this method?  As in, no more sciatica, no more back-going-out, except mild and in rare circumstances?  Knowing realistically what to expect would help me a lot.

Thanks again, I really appreciate the reply!

Karen

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Hi Karen, 


Wonderful questions.  Yes, we have had many students afflicted with Spondy et al. who become pain-free.  The amount of time this takes, of course, varies per person, but it is actually quite common in our experience.  

Glidewalking is one of the most complex things that we teach.  I'm not sure I've met anyone who can truly Glidewalk from the book alone.  If a course is coming to your town soon, I highly suggest you take one.  I find that movement is best taught in-person.  In the meantime, focus on tightening your gluteus medius with each step.  If this aggravates your sciatica, try using your Inner Corset or use a flexible external corset (as mentioned in the book) to create some additional length as you walk.  

Anteverting the pelvis too quickly, for some, can be painful.  Length first is the name of the game.  Once the body/back is used to its elongated form, the pelvis has room to tip properly without running into problems.

Good luck to you!

 

Very best, 

Charlene

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