Member
24 y/o male with Spondylolisis (L5 Bilateral Pars Defect / "Scotty Dog" Syndrome)
Background:
After some severe back pain that knocked me on my ass and didn't go away after a few weeks, I got an X-Ray done by an orthopedic specialist and walked away with a diagnosis of Spondylolisis: a defect on both sides of my L5 vertebrae. Doc told me a few things about what to do and not to do to help it, but a few things he said stuck out to me. (One example: he told me to avoid going into hyper extension, yet that bench pressing was fine because my back "would be flat against the bench," which, as far as I understand having read SS Third Edition a couple times, is not strictly proper bench form because it lengthens the moment arm between the shoulders and nipple) He gave me a sheet with some "rehab" exercises on it, things like a hamstring stretch, half-crunches, and general mobility exercises fit for your average sedentary octogenarian (Link here). He told me to be wary of deadlifts as they could "stress" the lower back. I asked how my back was going to get stronger if I never stressed it and he allowed that it was a bit of a Catch-22: to at least be careful and do lower weight, higher rep if I'm going to be squatting and deadlifting.
I have poked around these forums and found some threads on spondylolisis/spondylolisthesis, and found some helpful information, but the following are some questions I have that I didn't find the answer to in the archives. As well, a lot of the threads were a couple years old and since this is my spine we're talking about and I only get one, I figured I could be forgiven for being a "double checker."
The Questions:
What alterations should I make to the basic SSLP in order to account for a total bilateral pars fracture?
My assumptions are that back extensions and power cleans are right out, as they both involve hyperextension, and the ballistic nature of power cleans make them especially deleterious for my spine. I know that these exercises cannot be "replaced" or "substituted" as such, meaning nothing can take the place and fulfill the express function of them, rather I'm asking what I should do if I can not (and I'm assuming I can not) do these exercises.
I have also never lifted with a belt, and was wondering if doing that would be recommended (and almost necessary) now.
As for the horizontal and vertical press, should I start benching "wrong", with my back flat on the bench, to avoid hyperextending my lower back? Or would it be okay to continue benching as I have been since the spine is rigid.
The vertical press has been vexing me - it's what first aggravated my defect. I'm nervous to do it again. Should I replace it completely with seated dumbbell presses or incline benches? I know the answer to some degree is "don't hyperextend your back, idiot," but if anyone here who has experience coaching people with Spondy, I don't know if the press should be avoided outright or if I just have to use extreme caution and accept that it will be my weakest and slowest progressing lift. As you can see I'm totally lost here.
For deadlifting, should I continue a 1 set of 5 reps scheme, or do I have to back off on the intensity a little bit? Am I still okay to squat and deadlift in the same session?
Finally, are there any ancillary exercises anyone here can recommend that would be useful for a person dealing with an L5 pars defect? Should I do the silly bodyweight stuff recommended by my doctor every morning in addition to the LP, or will the LP be sufficient?
Thank you for your time and consideration.
TMPHBITEU
What is the "grade" of your spondylolisthesis? You should know this. In the meantime:
Back Pain and Back Strength | Mark Rippetoe
Bad Advice About Higher Reps | Mark Rippetoe
What Your Doctor Doesn’t Know About Squats | Mark Rippetoe
Your Gut, Your Health, and Situps | Mark Rippetoe
✓ Member
Isn't it possible to have Spondylolysis (pars fracture) without Spondylolisthesis (vertebral displacement)? If so, would he still be assigned a "grade" even if there was no displacement? I guess you could say it was Grade 1 in that case.
FWIW I have grade I spondylolisthesis and my back has never felt better than after strengthening it with heavy (for me) squats, deadlifts, press, and bench.
Member
Originally Posted by Mark Rippetoe
Hi, coach, thank you for responding
I have spondylolisis (stress fracture of the vertebrae), not spondylolisthesis (movement of the disc due to the fracture) and as such was not given a "grade," which I believe (and may be wrong) is used to describe the degree or severity of slippage of the disk. Thank you for the links, at any rate. Are my questions still germane to my situation? (w/r/t proposed changes to the Program?)
TMPHBITEU
Sorry, I saw your misspelling and filled in the blank incorrectly. Do you know what caused this?
Member
No; the doctor told me that this typically happens during growth spurts during puberty, esp. if the patient is exposed to repeated ballistic hyperextension, common in kids who do gymnastics or football. I never really did anything of the sort during my pubescent years and it's possible it's just genetic.
TMPHBITEU
Could have been there a long time. Is there any evidence that it is unstable, i.e. progressing towards spondylolisthesis?
Member
I have not been alerted to any evidence that it is unstable. I've seen the orthopedic specialist twice, and had x-rays done on my first visit. He's not told me I'm in any especial danger of developing spondylolisthesis.
TMPHBITEU
Then you train. Use a belt. Don't do situps or back extensions. Don't clean. Press in a belt.
Member
Thank you, coach. What should I do instead of PCs on the days they're scheduled?
also, is the BP safe to perform with an arched back or no?
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