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Old 10-03-2010, 04:53 PM   #1
Nick Horn
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Inversion Therapy and Reverse Hypers for Spondylolisthesis

Are there any medical professionals here who could offer me some good advice regarding my condition and measures to minimize the effects and still continue training?

I am an active duty Army officer diagnosed with Spondylolisthesis, L5 shifted approx 30-35% forward (anterior) over S1. I most likely incurred my injury during my early years in the military. To my knowledge, the degree of shift has not changed over the years. I have been crossfitting for 4 years, and my back issues have fluctuated over the years in terms of severity and impact to my workouts. However, it has not impacted my ability to do my job or deploy. At this time, I am mid way through my 8th deployment, and I'm trying to proactively minimze my syptoms as much as possible on a daily basis.

At this time, I avoid heavy deadlifts and GHDs, but pretty much do every thing else as Rx'd. My symptoms sometimes include back soreness, which gets too severe to exercise about 1-2 times a year for a few days. I do my best to listen to my body and reduce my activity when this happens.

Of more concern though, is the fact that I have tingling in my lower legs and feet. I have not had any negative effects in terms of strength, but it is a nusiance, and concerns me, especially long term.

In addition to staying in excellent shape, I try to ensure that my hamstrings stay stretched out and I probably spend more time than your average crossfitter warming up.

I have a pair of inversion boots that I use on a semi-regular basis, the idea being that the traction I'm pulling on my back will help. However, a recent book I was reading on stretching discouraged inversion therapy for spine issues and now I'm a bit gun shy about using them. Any thoughts? Also, when I return from Afghanistan, I am considering buying a Reverse Hyper Machine for the sole purpose of improving my condition or minimizing my symptoms. Having never used one, can anyone speculate if this would be a great, good, neutral, or bad idea?

Any thoughts or advice would be greatly appreciated.
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Old 10-03-2010, 06:24 PM   #2
Brian Strump
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

We use reverse hypers for alot of our patients with LBP for overall conditioning for most cases. I think that would be helpful for you, I don't know enough about the suspension boots to give you a good answer.
Of a bigger concern would be the numbness you get into your legs, could be a sign of cord compression from the spondylo, given that it's bilateral.
With someone in your condition we'd focus on flexion exercises, and mobility of the hips and lumbar spine, while avoiding most if not all hyperextension exercises.
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Old 10-03-2010, 06:40 PM   #3
William Hunter
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

Numbness is a concern. In addition to neutral position x-rays you should have up to date flexion and extension views to check for stability vs instability
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Old 10-03-2010, 08:29 PM   #4
Ben Moore
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

I have the same problem as you - spondo at the l5/s1. I went through PT and specifically asked about deads and squats. I was told to watch the squatting and that deadlifting was ok. I pulled 705 prior to the injury and have worked my way back up to 635 post injury with no ill effects.

I've also worked in reverse hypers on a fairly consistent basis and it seems to keep everything aligned right.

At this point I go as hard as I can when I feel good and hold back when I don't. Although I'm new to crossfit, this has been training through powerlifting and strongman so alot of similiar loading to the body.
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Old 01-10-2011, 11:05 PM   #5
Shane McGrotty
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

As everyone else has said... reverse hypers are phenomenal for the lower back. Physical therapists have been using them for years. However, they can be extremely expensive... 1k+... so in the interest of your back AND wallet, try the one listed here...

imaspammer.com
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Old 01-11-2011, 08:58 AM   #6
Megan Zetter
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

Spondylolisthesis is often asymptomatic and an incidental finding when imaging for other reasons. I'm not suggesting yours is not the cause of your pain/numbness, as it is possible. However, addressing just that as your "problem" could likely miss something very important, such as instability of the musculature in your back. Research supports that instability is often due to do poor neuro control of the muscular system, rather than the boney spine itself. If you think about it, without the surrounding tissues; muscles, tendon and ligaments, we'd all be a pile of bone. Most people, if not all, have muscular imbalances and when that happens we end up with inhibited (not firing properly) and over facilitated (tight and overactive) muscles. The imbalance can create all sorts of issues, including lumbar instability.

The numbness is definitely concerning. Is this a constant phenomena? How long has this been going on?
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Old 01-11-2011, 11:01 AM   #7
Megan Zetter
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

Had a thought, changed my mind ...

Last edited by Megan Zetter; 01-11-2011 at 11:07 AM..
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Old 01-11-2011, 11:25 AM   #8
Dave Hancock
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

What book discouraged inversion?

My understanding on inversion is that after a short period the muscles tense up and prevent the desired stretching. This is why the decompresion tables used by chiros cycle the stretching off and on.

I had low back pain several years ago. I went to a chiro that did the decompression therapy. That plus stretching and strengthening has kept it away. I also have a teeter hangups inversion table, though I haven't felt the need to use it in a while.
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Old 01-11-2011, 04:40 PM   #9
Anthony Ricci
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

I have had good results in office with reverse hypers if grade 1 (0-25%) with no annular tears and obviously no instability of pars defects. The spondylo should not be shifting in and out. Brian is correct with flexion\williams type exercises. Inversion is more helpful for uncomplicated decompression of lower back. Most times pain from spondylo is SI joint or compensations in kinetic chain. Just my 2 cents
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Old 01-11-2011, 04:46 PM   #10
Rene Forestier
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Re: Inversion Therapy and Reverse Hypers for Spondylolisthesis

Quote:
Originally Posted by Anthony Ricci View Post
I have had good results in office with reverse hypers if grade 1 (0-25%) with no annular tears and obviously no instability of pars defects. The spondylo should not be shifting in and out. Brian is correct with flexion\williams type exercises. Inversion is more helpful for uncomplicated decompression of lower back. Most times pain from spondylo is SI joint or compensations in kinetic chain. Just my 2 cents
Can you briefly explain the mechanism?
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