- Hi, I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course.
- Hey Brad, we're gonna talk about Sphondylosis,
Spondylolysis. Spondylolosis
- It's a mouthful.
- It's on the inter- - Spondylolosis
- Can you spell that out
on the bottom of the screen, please.
- Spondylosis is a little bit different.
Spondylolysis, and that's a fracture.
Do you want to talk to it, Brad?
- You got it. You go ahead, Bob.
- Okay. It's a fracture
in one of the vertebrae of your back
often like an impact fracture.
Isn't it? A lot of gymnasts get it?
- Yeah. Extension activities
like a gymnast that overextend, hyper extend
- Okay.
- People who do a lot of work overhead
it may happen with.
- All right, these are the bones that make up your back.
You know, 1, 2, 3, 4, 5.
That's the five lumbar vertebrae.
Where does this often occur, Brad?
- Typically the lower lumbar.
- So, maybe like L4 and L5.
- Correct
- And it happens in what we call the pars interarticularis
which you don't need to know, but just to show you
about where it is, Brad, do you wanna take this one?
- Yeah, from looking at here, we got L5,
the lowest vertebrae you have.
And this black line we put in there,
'cause that's where the fracture
and oftentimes it's can be just a stress fracture,
not a complete fracture.
- [Bob} Right.
- But they produce a lot of pain.
And when that gets stressed, Ouch!
- [Bob] Pain is associated with that.
- And we're gonna show you some tests
that the doctor may do, the therapist may do.
And are two of them that you probably could do
yourself to maybe try to even narrow it down a little bit.
- Right. - All right. Should we start?
- Sure. Okay, again, it's the injury is from...
Are we gonna go on this camera?
This one, okay.
The injury, it happens with hyperextension.
So, the test is, actually you do it on one leg,
because it emphasizes one side or the other.
- Okay. So, let's say you're gonna test the
left side first, Brad.
- So we're gonna go...
- You lift the right leg.
- Yep and go back. - Go back
- Straight back.
And if it's painful right in that area,
it doesn't mean you have that fracture just
means that it's... - It's a possibility
Yeah. It's a positive... - There's other things...
There's other things that could cause pain
on that side just as well as this problem.
- Right. - Arthritis alone,
- Sure - Just arthritis
could cause stenosis, I think.
So, we're back like this and you're gonna do both legs.
- Both sides.
- Yep. And then the other one is
we're gonna do what we call a quadrant test.
We're not gonna go straight back.
We're gonna go back and off to one side about a 45.
And then if you have someone else do some vertical pressure.
- Should I push here or on this side?
- On this side, push down.
There you go.
Actually put one hand on both shoulders there.
- Oh. - And down.
We're just putting a little more stress
on that area and that'll also create pain.
It'll be a positive sign.
- So then we go the other direction.
- Right.
- The other quadrant...
- Test the left side.
- Okay. When you say quadrant, it means four.
Do you also do forwards then or no?
- No. No. Just the back two quadrants.
- Just the back two quadrants.
- Okay. Good question, Bob.
Okay. And the last one.
- This one takes probably someone who's skilled.
- Skilled. Yeah, absolutely.
- I'll lay down. - Okay.
And we're gonna put some pressure straight down
on the lumbar spine. This is where hand placement...
I'm not gonna go into that
because you'd pretty much need a therapist for this
or a doctor.
And then you're gonna push straight down
and that is gonna cause, let's say pain.
So the idea is you have three tests.
If you're positive on all three,
you're more likely to have this diagnosis.
It doesn't mean you must, but it's more likely.
If you go all three
and all of them are negative, you probably don't.
- And then they're gonna probably do some maybe x-rays
or CT scans.
And the thing is sometimes you can have these things
and they're not giving you pain.
- Right.
- So, if you do an x-ray and they see it,
I still do these tests, because then you can determine
whether or not it's actually the source of your pain.
Quite often, doctors will see something on x-ray
and they'll go, oh, you have arthritis
on your back, you know,
in your back, that's what's giving you pain
and actually it may not be.
- Right.
- You have to do tests to really determine what
is giving you a problem. - Sure.
Now, the other thing I wanna mention is there's
I have a hard time pronouncing these, but Bob help me out.
There's Spondylolysis and Spondololisthesis.
And we've done a video on Spondololisthesis.
- And do you wanna spell these maybe out Spondylolysis
and Spondylolisthesis.
So, Nancy is gonna put it on the screen.
- Yeah.
And then she can link up.
We also have a video
with x-rays of someone with Spondylo...
- Spondololisthesis.
- Yeah. I should learn to pronounce it
because I have that in my own back.
And that's what I actually have.
- And that's the one where you actually have the fracture
and the bone is actually separated apart a little bit.
- Oh,
- It's more serious.
- It's dramatic. Yeah.
- So it gives you a lot of pain. All right. Good luck.
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