ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Spondylosis, Spondylolysis, Spondylolisthesis! How To Help Your Recovery!

Hi guys, my name is Tammy and I'm a doctor of physical therapy and this is Tito, the physio puppy.

And in this video, we are going to be talking about a condition called spondylolisthesis.

Actually, I will go over the three with similar names, spondylosis, spondylolisthesis, and spondylolisthesis.

I know they sound kind of complicated and sometimes scary,

but trust me, if we do corrective exercises, you can be pain-free.

Without surgery, without pain medication, it just takes a while to get there.

Now before we start, make sure to read the indications, contraindications, and red flags.

So how I'm going to do this video is that first I will start with the exercises, but I will go in depth over what these conditions are at the end of the video.

I'll make sure to put the timestamp for you guys

so you can just jump into it if you'd rather watch at the beginning.

And just have in mind that for all three conditions, you can pretty much do same exercises.

So the goal for our treatment is going to be strengthening the abdominal muscles

without putting a lot of pressure on the lower back while going into an extension movement.

So basically, we're trying to avoid any sort of extension.

So if you want to strengthen your core, you have to make sure that you are always in a neutral spine.

And the easiest way to do that is to start on the mat.

You're going to be lying on your back.

He's at that stage where he wants to chew on everything.

So the first exercise we're going to do is actually going to be a stretch, not a strengthening exercise.

This is going to feel great for almost all of you.

What I want you to do is take one knee, try to bring it all the way up towards your chest.

Your hands will either go on top of your knee

or you hold on underneath and you gently bring that knee in towards your chest.

You have a couple of options here.

You can have the other leg all the way down or you can keep it bent.

See how your lower back feels.

If you have too much pain, if you're here, come back up because you don't want to be in any pain when you're doing these stretches.

You're going to hold this for about 10 seconds.

You can do it for 30 seconds but 10 is enough and then you're going to try it on the other side.

So these are single knee to chest exercises.

Again they're actually just a stretch but it should feel fantastic.

The second exercise you're going to do is a double knee to chest.

Again now you bring both your knees all the way up towards your chest.

You have the option of holding on top or underneath,

interlocking your fingers, really pulling those knees all the way up towards your chest.

And again, you're going to hold it for 10 to 30 seconds.

And you can play around with the repetition, you guys.

You know, you can do 10, well, 10 seconds, repeat five times.

If you're holding 30 seconds, you can repeat three times.

Okay.

Now we are going to jump into our strengthening exercises.

So the first exercise is a posterior pelvic tilt.

What I want you to do is take both hands, put it right on your hip bones.

So you see the two bones you have here.

You're going to put your hands right there.

And all you're doing is pushing your pelvis into the mat.

So I'm rotating my pelvis backwards.

Go ahead, put your hands right like you see it.

It looks like a semicircle.

Put your hands right there and then tilt backwards.

Hold one, two, three, four, five, and relax.

Now you guys are using your deepest core muscles to do this.

You don't want to be lifting your bum up, okay?

We're just doing a tilt, holding for five seconds and relaxing.

Make sure you count out loud so you know you're actually breathing.

The next exercise is an isometric core exercise.

So all I want you to do is bring both your knees up, arms up, engage your core.

So what we just did in the last exercise, which was our posterior pelvic tilt, you kind of want to do that.

So your back is glued to the mat.

That means maybe my bum will come off the mat a little bit.

That's okay.

Keep your arms up, keep your feet up, your knees up, and we're going to hold it here for 30 seconds to a minute.

If this is too easy, you can always hold this position as long as it doesn't create any pain in your lower back.

Okay?

If these two are too easy for you, the third isometric exercise you can do instead of those two is take one hand,

put it on the opposite knee, and press.

So I'm pressing my hand down into my knee, pushing my knee up towards my hand, holding for five seconds.

Two, three, four, five.

Relax.

Switch to the other side.

Okay, the next exercise we're going to do for our upper core is going to be the beginning part of a crunch.

I actually never want you to come fully up.

So again, I'll show you the modifications.

So the first one, take your hands, put it right behind your neck, engage your core.

I'm just really bracing my head with my hands.

I'm not really using my hands to bring my body up.

That defeats the purpose, right?

elbows are apart, engage your core, try to reach up to the ceiling, hold, come back down.

Then up hold, come back down.

If you want to make it harder you can do the same thing with your knees up.

You go up, back down.

Uphold, back down.

And you should really feel your abdominal muscles really trying to contract.

So if you take your hands, put it right on your ribs where the ribs meet that's your sternum you want to imagine

that you're squeezing between that bone

and your belly button trying to bring the two together okay

guys the next exercise we're doing here is a bicycle crunch

but again i'm going to show you the modifications

so you take your hands uh put it right underneath your bum okay and now your knees are going around I'm sorry, I'm sorry puppy.

Your knees are at 90 degree angle.

Engage your core and then one at a time you're going to bring one leg down, back up, switch, back up, switch.

Great.

So this is for our lower abdomen.

As you bring one leg down, imagine that you're squeezing this leg all the way right

so we're really engaging that whole core

if again this is too easy you can always bring your

arms up put it behind your neck as you extend you

try to reach come back to center reach now please make sure

that you're not doing a fast movement you guys we're just

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starting to try to heal our lower back you don't want to go super crazy with these okay

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and remember controlled is always better.

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So then if you're doing a full bicycle, your head is up, engage your core and tilt.

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Tilt.

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Really try to lift that shoulder off, bring it towards the knee and reverse.

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Okay guys, so you are going to be on all fours here.

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What I want you to do is squeeze your shoulder blades back and down, engage that core.

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So make sure you're not tilting your belly down, engage that core, keep it in a neutral spine.

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And the first exercise, all I want you to do is,

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maintaining this position, you're going to bring your leg back from that kick up and back down.

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Up and back down.

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Now look at my lower back.

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I'm not going into an extension.

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I'm keeping the same position, just gently up and down.

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and then you can switch to the other side.

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Keep that core tucked in, up and down.

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See, my range of motion is not crazy.

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I'm still creating a little bit of extension in my spine.

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So for the next exercise, pretty similar to this, again, squeeze your shoulder blades back, engage that core.

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From here, you're going to just kick up into the ceiling and back down.

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So imagine you're bringing your heel towards the ceiling and back down.

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If I let go of my core, it's going to look like this.

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Okay, look what is happening to my lower back.

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I don't want to do that.

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So engage that core, keep it tight, bring your shoulder blades down, just kick up, squeeze that glute, back down.

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Okay, and then you can try it on the other side.

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And the last exercise that would be great to do is a bird dog.

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So again, same position, squeeze your shoulder blades back.

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As you kick back with one leg, you bring your opposite arm forward, bring it in, and switch to the other side.

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And now sometimes when we do the bird dog, we're doing it in the same position, right?

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But here, we're really going to focus on stabilizing our core so it's not moving side to side.

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Eventually, maybe we can even put a ball on our lower back

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and see if we can prevent it from falling as we do this.

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but what I want you to do is really focus on not letting your hips fall to one side or the other.

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So you just switch and switch.

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And so for these three exercises, I want you to do them three sets of 10 repetitions.

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Again, they're not really hard to do and you can incorporate them into your daily routine.

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But if they are causing pain because you've started doing this too early on in your rehab process,

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you need to wait, focus on the abdominal and the oblique exercises we did first, then move on to these.

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The last movement we are going to work on is going to be a rotation for our lower back.

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Bring your feet together, knees are together, and all I want you to do is bring your knees to one side and then the other side.

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Now I'm not going super deep in these exercises.

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I'm just rotating side to side.

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It's not causing any pain for me.

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If you find that maybe going one way is causing pain but not the other side, just go to that side.

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That doesn't hurt until it starts feeling better.

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Then you can move to both sides.

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Okay guys now I'm going to go over one more exercise

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that is going to be very helpful if you've had this condition for a

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while and now you are actually feeling better and you want to do more core strengthening exercises.

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You can definitely eventually add bands to these but today I'm going to show you just body weight okay.

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So what I want you to do is actually go into a half kneeling

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and that is when you bring one foot forward and your other knee is on the floor.

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Okay now engage your core, squeeze your shoulder blades back.

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What I want you to do is bring your arms forward,

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imagine that you're holding something really heavy and then go side to the other side.

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Now I'm rotating my upper body, pain-free range of motion, but I'm really trying to squeeze my glutes so I'm not wobbly.

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Even for me, I feel a little bit wobbly in my hips, but my goal is not to let my hips move up and down.

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So I'm engaging that core in.

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Squeeze your shoulder blades back, side to side.

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You can always go in a diagonal movement as well.

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So to one side or to the other side.

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And again, really try to squeeze your abs.

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So if I'm going this way, I'm thinking about squeezing my abs in and back out.

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In, slowly back out.

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I'm going to show you guys on the other side too.

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So again, I'm going to, so again, so again, I'm bringing one knee up, engaging my core.

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So I'm almost doing that posterior pelvic tilt again, making sure my back is not going into an extension.

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From there, If I'm doing rotation, just simple rotation, but if I'm going this way,

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I'm really thinking about squeezing my abs to one side, back to center.

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You can always go sideways or to the other side.

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And again, think about really squeezing your abs, engaging those glutes so your pelvis is not wobbly.

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Okay, so now that we've gone through some amazing exercises that you definitely need to incorporate in your daily routine,

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I'm going to talk about other things you can do in order to help your condition.

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So the first thing is make sure that you are actually doing some sort of stretching.

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You want to stretch your hamstring, your glutes, maybe you roll it.

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Again, you guys, we have great stretching and rolling videos.

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I'll put them in the description for you guys so you can easily access them.

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But also, what about our everyday routine?

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So first of all, you want to make sure to invest in a really good brace like a lumbar brace

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that will help you when you are doing heavy duty movements.

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So let's say this is two three years after your surgery

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and now you know you don't have pain

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but you want to maybe do your gardening

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or you know whatever it is that you want to do

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that is on a heavier side definitely invest in a good brace.

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Again my favorite brand is that are fine.

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I will put the link in the description for you guys.

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They are a little more on the pricey side, but honestly, I'm sure you can find other braces that will be helpful.

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The second thing is you want to try a lot of overhead activities.

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That is, you know, like painting your ceiling or something

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that inquires you to be in an extension overhead movement for a long period of time.

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You want to try to avoid that because it is going to aggravate your condition.

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The third thing is that you still want to be walking, but walking might aggravate your symptoms.

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So only walk as tolerated.

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Eventually, when you build that core strength, that upper back, lower back,

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glute strength, you will be able to walk as much as you want.

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You might even go back into running, but definitely at the beginning, that is something that's going to aggravate your symptoms because again standing

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and walking is when your lumbar spine is in an extension position right

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so you want to be careful with how much you're walking

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build up your tolerance before you go for a long distance walking

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and now I will actually go over what these conditions are

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and what has happened that is causing this pain the first condition is called spondylosis.

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Don't worry about this condition too much.

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This is just wear and tear in your spine.

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It is quite common.

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And just remember, just because you have this condition doesn't mean

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that your back pain is caused

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because of this that's why i really need you to start from video one

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and work your way down and even if you've had

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that diagnosis sometimes your pain could be coming from muscle imbalance from your glute

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or piriformis being too tight from um you know a pressure on your nerve

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and that we can get rid of with repeated movements the second condition is called spondylolysis

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This is where we have a hairline fracture on a part of our spine,

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our vertebrae, in the lower lumbar spine that is called pars interarticularis.

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To be honest, guys, if we don't start strengthening doing the exercises that we just went over at this stage, it can eventually turn into the third condition,

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which is actually quite painful and we don't want to get there.

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So if you have this condition you need to do these exercises every day as long as they're pain-free obviously

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and and what ends up happening is that because of

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that fracture there's inflammation in that area and

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that can cause inflammation in the nerve and

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that is why you are having

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that discomfort definitely with time the inflammation will go down

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if you are doing exercises that is helping your condition third condition is called spondylolisthesis

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and this is when there the fracture has actually happened and one vertebrae is now slipped over the other one.

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So if your vertebrae is sitting like this, the fracture has caused one vertebrae to move forward.

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So a lot of times, aside from doing your x-ray and actually seeing this has happened, you can actually see that step deformity as well.

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So if you touch your lower back, you'll see there's like a gap in the vertebrae.

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You can feel those spinous processes or those bumpy prominences in your back, you'll see that one is actually missing.

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So you guys, for those of you who are going through this, strengthening your core is essential, but especially your abdominal muscles.

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That's why again, we focused on exercises in neutral spine, focusing on the anterior part of our body,

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because these muscles will really protect and support the lower back in time.

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The vertebrae will hopefully fuse and then you won't mean as much pain, right?

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Because that's what we want.

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We don't want that instability in the joints.

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That is what you really, really have to do your strengthening exercises every day.

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Now, who are the people that might be suffering from this condition?

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This is usually seen in younger people, especially those who are involved in activities such as gymnastics,

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figure skating, diving, or even baseball, where there is multiple repeated stress on the lumbar spine,

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usually in an extension movement.

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Think about all the sports I just talked about.

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A lot of times there is a lot of stress on the joints when they are doing those movements,

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and that might have led to them presenting with this condition.

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And the symptoms you present with is that usually, again, extension makes your symptoms worse.

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So standing for a long period of time or walking or actually just extending backwards might increase your pain.

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The pain is localized to your lower back, then traveling down to your buttocks area, maybe even going down your leg.

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And you'll feel it more when you're doing that extension movement.

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So if you're walking after a while, you might feel that, you know shooting pain going down your leg

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and you might also be experiencing a catching pain

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when you bend forward and you want to come back up

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so you can easily go forward maybe

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but trying to back come back up you feel

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that your back might give up

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or it's just you don't have the strength you have to

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use your hands to press on your thighs to come back up into an extension position

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and but again regardless of all your symptoms you've probably have done an x-ray by now

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and you know that you are suffering from this condition now I'm I'm here to tell you

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that doing these exercises can definitely help you return to pretty much normal living activities,

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but you have to commit to them.

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And it is going to take a long time.

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So this is something that maybe after a year or two years of doing these exercises every day, you might be able to go back to your running,

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to whatever activities you were doing before.

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But you always have that in the back of your mind that if you do something that's too much extension, you are going to feel it.

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Right?

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So you kind of have to be able to negotiate and compromise with this type of lower back pain.

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However, if you're doing the exercises, then you don't really need to go through surgery.

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And maybe you can go off your pain medication, which is really what we're trying to achieve here.

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Okay, guys, I hope the video was good.

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I really tried to summarize everything to make it as simple as possible.

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if you have watched till the end of this video.

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I hope you enjoyed it.

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As always, if you have any questions, make sure to leave it in the comments for me and make sure to like the video, share, and subscribe to our channel.

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ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Spondylosis, Spondylolysis, Spondylolisthesis! How To Help Your Recovery!

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