Spondylolisthesis & Women: What You Need To Know

Spondylolisthesis and spondylolysis can affect all races, sexes, ages and makeups. Even though there are hundreds of thousands of men who are affected by this condition (myself included) statistics show as a whole that women are more likely to have a spondylolisthesis.

Some studies have shown that women develop one of the five types of spondylolisthesis between 4 and 6 times more often than males.

Note: if you are not aware of the different types of spondylolisthesis please read this article.

With such a high number in the amount of cases in females, what possibly could lead to these statistics and more importantly what can women do to help fix the pain?

Below I discuss one of the major reasons for the increased number of cases in women along with a plan of attack to help improve a common area of weakness.

Hormones and their role in spondylolisthesis:

For women with spondylolisthesis it is important to understand the affects their hormones have on ligaments. According to studies, hormones are a major factor in the prevalence of spondy’s in women(1).

Naturally, one of the hormones produce by women is estrogen which plays a direct role on ligaments.

One of the effects estrogen has on women is to loosen the ligaments.   Among other things, ligaments connect bone to bone and help to provide stability and support in the body’s skeletal system.

When estrogen loosens the ligaments some of the stability and support is compromised.  This can directly affect the skeletal system and more specifically, the vertebral column.  With this change in stability and support the vertebrae have greater movement and less stability,thus leaving them more susceptible to injury.

With the ligaments going through a greater range of motion due to their new laxity (looseness), the bones that they support also have the ability to move more and immediately become more likely to suffer an injury or slippage when compared to those with stronger more stable ligaments.

With all of these changes taking place women who perform what would normally be labeled as low risk activities are now more likely to suffer an injury due to the increased amount of instability.  Activities such as running, excessive standing, and walking typically require stability and support from ligaments and surrounding muscles.

young couple jogging at morning

Women are more likely to suffer from a lack of stability which may affect common activities such as running.

Those with loose ligaments may not receive the proper stability which can lead to stress fractures in the spine, slippage, or discomfort and muscle spasms.

Young teenage girls who participate in sports such as gymnastics and cheerleading are at increasingly higher risk for spondylolisthesis due to the hormonal changes at this time of their lives in combination with the demanding positions the spine is placed in on a daily basis.

vulnerable back position for spondylolisthesis

Growing kids who are constantly placing stress on the low back without stability are at an increased risk for spondylolisthesis.

A combination that unfortunately produces a large number of spondy patients.

Additional problems may arise during pregnancy due to even  greater changes in ligaments and pelvic structure.  Those  who suffer from spondylolisthesis or spondylolysis going through pregnancy may notice additional slippage and an increase in pain due to these natural occurances in the human body.

Women who suffer from degenertive spondylolisthesis may find this study interesting. This study shows that women who have given birth and suffer from back pain are twice as likely to suffer from degenerative spondylolisthesis when compared to those who have not given birth.

Possible reasons may be the changes in abdominal structure and the effect giving birth has on ligaments and joint capsules (2).

Guy’s…….It’s not just the girls!

Sometimes people are born with loose ligaments or what doctors would call laxity in the ligaments or joints. 

These are sometimes the people that can touch their thumbs to their wrists or bend their arms or legs in positions must of us could never dream of. These people are also candidates for having a lack of stability in needed areas.

I believe this may have contributed to my spondy as I have suffered two injuries related to ligament damage.  The other being a torn ACL (knee ligament).

So men, you are not in the clear. Those born with loose ligaments might also be at greater risk for spondy’s.

What you can do…Your plan of attack.

The answer is not as easy as it sounds, but you need to shift your focus to improving your stability and strength.

Flexibility may not be an issue for those with loose ligaments; therefore the focus needs to shift to providing the spines support system with the proper amount of stability and strength.

Since estrogen and ligament laxity (loosening) happens naturally and you do not want to stop this process, it is best to focus on improving your stability to aid your ligaments and spine with extra support. 

Those with loose ligaments who go through the typical spondy protocol of stretching and a few core exercises could be missing out on a VERY important component (stability) of a their treament program.

The main support system(s) of the spine include the midsection, hips, and most importantly the glutes.

Focus on improving the strength and stability of these areas with exercises that are safe on the spine and encourage a neutral (straight) spine and proper movement mechanics. Doing so will help to provide your spine with additional support and prevent further slippage if a spondylolisthesis is already present.

Some of our favorites include planks to strengthen the core, various forms of glute bridges to attack the hips and gluteals, and different half kneeling exercises to help with proper movement are just to name a few.

Below are a few video examples of these exercises. Simply click the link to watch these exercises in action along with some helpful descriptions.

When focusing on stability the focus should remain on technique and proper mechanics.  Don’t stress over the amount of weight being lifted or how long you can hold each position. When performing stability technique is king!

When the stability and strength are increased, you will develop a greater support system that will hopefully provide you with less pain and the ability to perform activities you love. You may then be able to begin activities you love once you improve these areas and start to improve your movement as a whole.

References
1. Jacobsen S, Sonne-Holm S, Rovsing H, Monrad H, Gebuhr P. Degenerative lumbar Spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study. Spine 2007;32:120-5.
2. Sanderson P, Fraser R. The influence of pregnancy on the development of degenerative spondylolisthesis: the Journal of Bone and Joint Surgery. 1996; 78-B:951-4.

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