Get to know the “Spondylo” family

The “Spondylo” family must be the most confusing and similar looking group of words in the sports medicine world! It is one of the most confusing conditions to remember. So what is the difference?
Spondylosis
Essentially refers to osteoarthritis. Mostly occurs in the neck due to prolonged poor posture, age and lifestyle. This can be simply diagnosed with an x-ray.
Spondylolysis
This particular condition refers to stress fractures of the pars interarticularis and it often occurs in young athletes who are involved in sports that require hyperextension of the spine. Examples include a cricket fast bowler, rowing, high jumps, tennis (especially during serve)…etc. Typically patients will show unilateral back pain and/or pain into lumbar extension.
Spondylolisthesis
This refers to slipping of part or all of one vertebra forward on another. This particular condition is seen most common in children between ages 9-14. Most commonly the L5 vertebra slips forward on the S1. Lateral x-rays best show the extent of the slipped vertebra. It is graded from 1-4.
Grading of Spondylolisthesis
Grade 1: The vertebra has slipped up to 25% over the body of the underlying vertebra
Grade 2: The vertebra has slipped more than 25% over the body of the underlying vertebra
Grade 3: The vertebra has slipped more than 50% over the body of the underlying vertebra
Grade 4: The vertebra has slipped more than 75% over the body of the underlying vertebra
How Can Physio Room Pymble Help?
It is essential for patients know the right exercises to do for their condition. Patients with spondylosis should concentrate on strengthening to muscles around the neck and lumbar spine (especially core) to prevent excessive pressure going into the joints. For those with spondylolysis or spondylolisthesis, patients should be prescribed the right exercises especially avoiding extension movements which can worsen the pars defect.
Athletes who are playing sport will require an in-depth analysis of their technique to ensure they are not putting further pressure on the vertebra.
Core strengthening will be essential in this population in order to ensure stability around the vertebra to offload the pressure going on the spine.
It is also important to strengthen the Gluteal region in order to help support the back especially lifting. Patients should be educated on the correct lifting posture and movements to avoid.