Spondylolisthesis Exercises Guide

Spondylolisthesis is a spinal condition that causes a vertebra to slip out of its normal position. The resulting misalignment of the spine can trigger back pain and weakness, tingling, and numbness that spreads to the extremities. 

Many people assume that exercise is out of the question with a condition like spondylolisthesis. But, while certain activities should be avoided, low-impact exercise can benefit spondylolisthesis patients by preserving mobility, boosting circulation, and increasing muscle strength. 

Read on for a complete spondylolisthesis exercises guide, including the best (and worst) exercises to perform if you’ve received a spondylolisthesis diagnosis. 

Is It Safe to Exercise With Spondylolisthesis?

It’s safe to exercise with spondylolisthesis if:

  • Your physician has cleared you for physical activity.
  • The exercise doesn’t trigger pain or other symptoms.
  • The exercise is low-impact and doesn’t involve significant bending or twisting.

Which Type of Exercise Is Best for Spondylolisthesis?

The best type of exercise for spondylolisthesis is low-impact exercise. 

Low-impact exercise, like walking and water aerobics, is the best exercise for spondylolisthesis because it doesn’t strain the spine. This form of exercise promotes mobility and improves circulation without placing stress on the spinal structures. This prevents flare-ups of pain and neurological symptoms, like numbness, tingling, and weakness. 

Gentle stretching and strengthening exercises are also beneficial forms of exercise for spondylolisthesis. Stretching helps patients improve and maintain their range of motion while reducing muscle tension. Strengthening exercises for the back and core muscles improve support for the spine, preventing stress on the spinal structures with various activities. 

Some of the best stretches and strengthening exercises for spondylolisthesis include:

  • Pelvic tilts: Pelvic tilts strengthen the deep core muscles and support healthy spinal motion. To perform this exercise, lie on your back with your feet flat on the ground. Draw your belly button toward the spine to engage the abdominal muscles, flattening your lower back against the floor. Hold this position for 15 seconds, relax, and repeat for several sets. 
  • Curl-ups: This exercise targets the core muscles. To perform it, lie on the floor with your feet flat on the ground. Cross your arms over your chest or place your hands behind your neck, if it’s more comfortable. Gently engage your core muscles to lift your shoulder blades off the floor, keeping your head in alignment with your body. Stay in this position for a few seconds, return to the starting position, and repeat for up to 12 sets. 
  • Double knee to chest: Lie on your back with your feet flat on the ground and your knees bent. Engage your stomach muscles, pressing your lower back into the floor. Draw both knees toward your chest, holding them with your hands. Hold this position for five seconds, return to the starting position, and repeat for 10 to 20 sets. 

What Exercises Should You Avoid With Spondylolisthesis?

The exercises that you should avoid with spondylolisthesis include high-impact sports and exercises that involve excessively twisting or bending the spine. 

High-Impact Sports and Spondylolisthesis

High-impact sports and activities are dangerous for patients with spondylolisthesis. This is because excessive impact on the spine can cause pain flare-ups, worsen existing nerve impingement, and cause further damage to the spine. 

Examples of high-impact sports and exercises to avoid with spondylolisthesis include:

  • Soccer
  • Football
  • Rugby
  • Running
  • Weightlifting 
  • Basketball
  • Hockey 
  • Burpees 
  • Jumping rope
  • Sledding
  • Skiing
  • Snowmobiling
  • Trampolining 

High-impact exercise includes all contact sports, as well as any activities that involve both of the feet leaving the ground at the same time. These activities place significant stress on the joints throughout your body, including your spinal joints. 

Excessive Spinal Twisting and Bending

Exercises and activities that involve excessively twisting and bending the spine aren’t advised with spondylolisthesis. Twisting and bending the spine can stress the tissues affected by spondylolisthesis, leading to increased pain and neurological symptoms. 

Activities that require the spine to significantly twist and bend include:

  • Gymnastics
  • Certain yoga and Pilates poses (i.e. cobra)
  • Tennis
  • Pickleball
  • Diving
  • Golfing 

Can Physio Fix Spondylolisthesis?

Physio can fix spondylolisthesis in some cases. 

Also known as physical therapy or PT, physio is often the first treatment that doctors recommend for spondylolisthesis. It involves:

  • Strengthening the abdominal and back muscles to more effectively support the spine
  • Correcting inefficient or harmful movement patterns
  • Improving your posture and spinal alignment
  • Alleviating muscle tension to promote pain relief

Physical therapists recommend exercises to perform both during your PT appointments and at home. Over time, these exercises can reduce the strain on your spine and improve circulation to the injured tissue. 

Along with targeted exercises, your PT may provide passive treatments. These treatments help lessen inflammation, pain, and tension:

  • Heat and/or cold therapy
  • Transcutaneous electrical nerve stimulation (TENS), uses electrical currents to stimulate the muscles, boost endorphin production, and encourage natural pain relief
  • Ultrasound therapy, which boosts blood flow to the spine for relief from tension, spasms, and stiffness
  • Deep tissue massage, which involves imparting pressure on the affected soft tissues in the spine to release tension

Is Massage Good for Spondylolisthesis?

Massage is good for spondylolisthesis because it boosts circulation and reduces muscle tension. 

Tight, stiff muscles in the back and hamstrings are a common problem among people with spondylolisthesis. This muscle tension can even lead to painful spasms, which may hold you back from your regular activities. Tight muscles are a sign that your body is compensating for the misaligned vertebrae, but can exacerbate spondylolisthesis symptoms. 

Massage therapy can improve or alleviate tight muscles from spondylolisthesis for relief from back pain and muscle spasms. Massage therapists manually manipulate the soft tissues to release points of tension and increase blood flow to the affected area. Healthy circulation to the spine is crucial for spondylolisthesis, as it ensures that the injured tissue receives oxygen and healing nutrients. 

Massage also reduces inflammation by improving inflammatory signaling, reduces the body’s production of cortisol (the primary stress hormone), and boosts endorphin production. Endorphins are a group of hormones with natural pain-relieving and mood-boosting benefits.   

It’s crucial to see a trained, licensed massage therapist for spondylolisthesis. The spine is a delicate area, and an inexperienced massage therapist may put you at risk of further injury. 

When is Surgery Necessary for Spondylolisthesis?

Surgery may be necessary for spondylolisthesis if conservative treatments fail after several months or the patient’s mobility is severely affected. 

In most cases, surgery is the last recommended course of treatment for spondylolisthesis. This is because surgery involves incisions, anesthesia, and significant downtime. Though rare, serious complications from spine surgery like paralysis and deep vein thrombosis are possible. 

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However, when spondylolisthesis symptoms persist despite months or years of non-surgical treatment, surgery may be the only remaining option to restore the patient’s quality of life. The most common surgical approach for spondylolisthesis is spinal fusion, which permanently fuses the affected vertebrae to restore stability. 

Modern, non-fusion solutions like the TOPS spinal implant can effectively treat spondylolisthesis while preserving the spine’s range of motion. With a superiority-to-fusion claim from the FDA, the TOPS System has emerged as a superior treatment option for degenerative spondylolisthesis of the lumbar spine. 

For personalized spondylolisthesis exercise recommendations and a comprehensive treatment plan, seek care from a spine specialist in your area.