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Best Exercises for Spondylolisthesis

Medically Reviewed by Dan Brennan, MD on November 14, 2020

Your spine consists of bones, called vertebrae, that are separated by soft discs that act as shock absorbers. The discs keep the vertebrae from touching one another. 

Spondylolisthesis occurs when one of your vertebrae slips forward out of alignment and rests on the bone below it, causing pain. It generally happens in the lower spine and has a few different causes, such as:

  • Trauma
  • Overextension of the spine
  • Degeneration of the disc or vertebrae
  • Genetics

In severe cases, people with spondylolisthesis may require surgery. Invasive procedures aren’t always needed, though. Gentle exercises can help alleviate pain and improve your quality of life. 

Exercises to Help Spondylolisthesis

Although some cases of spondylolisthesis may need surgery, the American Academy of Orthopaedic Surgeons recommends trying noninvasive treatments first. Your doctor is likely to suggest some strengthening exercises or recommend physical therapy to give you guidance on similar exercises. There are plenty of easy moves you can try at home to build strength and improve flexibility.

Pelvic Tilt

Pelvic tilt exercises engage some of your core muscles, which helps provide stability for your lower spine.

Step 1: Lie on your back with your knees bent and your feet flat on the floor.

Step 2: Pull your belly button in toward your spine using your abdominal muscles and flatten your lower back onto the floor.

Step 3: Keeping your core muscles engaged, hold the position for 15 seconds, and then relax.

Repeat the exercise 5 to 10 times. 

Knee to Chest

This exercise works the deep muscles of your core, again, helping stabilize your spine and relieve pain.

Step 1: Lie on your back with your knees bent and your feet flat on the ground. Keep your arms by your sides and your palms face down.

Step 2: Engage your core muscles by pulling your belly button inward toward your spine.

Step 3: Using your arms for extra stability, pull one of your knees up toward your chest. Hold the position for 5 seconds and relax back to the start position.

Step 4: Repeat the stretch with your other leg, pulling your knee to your chest and holding for a count of 5 before returning to the starting position.

Step 5: Finally, complete the same stretch by pulling both knees to your chest, counting to 5, and relaxing back to the starting position.

Repeat this sequence 2 to 3 times, ideally once in the morning and again at night.

Quadruped Arm and Leg Raise

Also called the bird dog exercise, the quadruped arm and leg raise targets core muscles to build strength in your abdomen hip flexors, glutes, and spine.

Step 1: Start on your hands and knees.

Step 2: Raise one arm and the opposite leg straight out while tightening your core.

Step 3: Hold the position for 5 seconds, and then lower your arm and leg back to the starting position. 

Step 4: Repeat the move with the opposite arm and leg.

Perform the exercise 10 times for each side. 

Multifidus Activation

The multifidus muscles are small muscles close to your spine that assist with twisting and bending motions. As many people with spondylolisthesis have weak multifidus muscles, this exercise helps strengthen them. 

Step 1: Lying on your side, use your free hand to find the groove in your back next to your spine.

Step 2: Activate your core by imagining that you’re moving your chest (don’t actually move your leg). You should feel the multifidus muscles bulge under your fingers. 

Step 3: Hold the pose for 3 seconds and relax. 

Repeat the exercise 10 times. Then lie on your other side and repeat the exercise another 10 times. 

Gluteal Stretch

Stretching your glute muscles can help to relieve tightness and tension. It can also lessen lower back pain, including pain caused by spondylolisthesis. 

Step 1: Start by laying on your back with your knees bent.

Step 2: Rest one ankle over the other leg, just above the knee. 

Step 3: Grab the thigh of the bottom leg and pull it toward your chest until you feel the stretch in your buttocks. It should not be painful.

Step 4: Hold your leg for 15 to 30 seconds and release it.

Repeat the exercise 3 times for each leg. 

Hamstring Stretch

Spondylolisthesis may cause tension in the hamstrings. If those muscles are tight, they can pull on your lower back, increasing your pain. Stretching your hamstrings helps to lengthen and loosen them, alleviating the tension in your lower back. 

Step 1: Sit on the floor with your legs straight out in front of you and your toes pointed toward the ceiling. 

Step 2: Lean forward slowly toward your feet until you feel a pull in your hamstrings. Don’t worry if you can’t touch your toes. 

Step 3: Hold the position for 30 seconds and then sit up straight. 

Repeat the stretch 3 times, trying to reach a little further each time. 

Safety Considerations

Keep in mind that all of the exercises you do shouldn’t cause you pain. They’re supposed to help ease it. Avoid rapid movements or forcing yourself to hold positions that you find painful. You should feel slight tension or gentle stretching. If the exercises cause you pain, try reducing the number of repetitions, or hold the positions for fewer seconds. Avoid heavy lifting, lifting with your back, and strenuous exercises. 

If you feel some minor discomfort after performing these exercises, try using an ice pack or an over the counter pain reliever to help. If the pain is severe, or it doesn’t go away, contact your doctor. 

WebMD Medical Reference

Sources

Sources:

The American Academy of Orthopaedic Surgeons: “Spondylolysis and Spondylolisthesis.”

Journal of Physical Therapy Science: “Core Strength Training for Patients with Chronic Low Back Pain.”

Cleveland Clinic: “Spondylolisthesis.”

Focus Physiotherapy: Spondylolisthesis Exercises: Which Are Safe & Which To Avoid.”

Mayo Clinic: “Back Exercises.”

Physiopedia: “Lumbar Multifidus.”

Physical Medicine and Rehabilitation Clinics of North America: “Muscular Balance, Core Stability, and Injury Prevention for Middle- and Long-Distance Runners.”

Spine Health: “Specific Hamstring Stretches for Back Pain Relief.”

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