Pilates Elephants
Pilates Elephants
May 30, 2021
37. Pilates for Spondylolisthesis, with Raphael Bender and Cloe Bunter
Play • 1 hr 14 min

In This Show, We Look At Pilates For Spondylolisthesis And The Related Condition Spondylolysis, Explore How The Conditions Present, The Differences Between Them, And How We, As Pilates Instructors Can Help People Who Have Them. The Pilates ‘Elephant In The Room’ In This Discussion Is The Myth That Spondylolisthesis And Spondylolysis Always Correlate Directly With Pain. Pilates Teachers Are Often Anxious That There Are Specific Exercises That They Should Or Shouldn’t Be Recommending To Clients With The Conditions So In This Episode We Dive Into Why It’s So Vital To Rely On Evidence And Data And Ensure You Are Up To Date With Best Practice So That You Aren’t Engendering Fear In Students With Outdated Beliefs. 

What You Will Learn:

  • Pilates for Spondylolisthesis may not be what you think
  • Key similarities and differences between spondylolisthesis and spondylolysis
  • Current best practice and evidence on treating spondylolisthesis and spondylolysis
  • The anatomy of the spinal column and why we need this information as Pilates professionals
  • Cloe’s experience of spondylolisthesis and what a nocebo response from ill-informed healthcare professions did for her confidence
  • How we can avoid creating an atmosphere of fear around movement based on pseudoscience

Exercising with Spondylolisthesis

Spondylolisthesis is the forward displacement or movement of one vertebra, relative to the one below it, typically, the L5 slips forward on the sacrum although it can happen with other vertebrae. Spondylolysis is a related condition, but instead of a displacement, there is a hairline stress fracture on the back of the vertebra. That people with these conditions shouldn’t do certain types of exercise is a misconception, and we can use evidence-based studies to see how we can support students and use Pilates for spondylolisthesis and spondylolysis. 

Causes of Spondylolisthesis and Spondylolysis

The causes of the conditions tend to be a combination of things — but there is a significant component of genetic inheritance with spondylolisthesis, in that a major risk factor is a first degree relative with the condition. Spondylolysis, in contrast, seems to be common in lots of different athletes in a variety of sports. We examine the evidence around movement in Pilates students with these conditions and share that data that shows neither surgery nor physiotherapy are the definitive answer. 

Managing Back Pain

If your client’s back pain and spondylolysis or spondylolisthesis are both in the same location, then it’s possible that they are related. But you still can work with that client within their pain tolerance levels, a little bit of pain or discomfort is unlikely to be a problem, the critical principle is not to aggravate the back to the point where it doesn't settle after the workout — build in time to rest and recuperate but don’t nocebo your client and make them fearful of movement. 

Links

  • Brinjikji et al. 2015 prevalence of spondylolisthesis in pain-free people here, and people with pain here
  • No link between either spondylolisis or spondylolisthesis and back pain here
  • For back pain associated with spondylolisthesis, surgery is better than exercise at long-term follow up by 17-25 points on a 100 point scale here
  • But that benefit is so small most patients can't tell the difference here
  • For high grade spondylolisthesis surgery and exercise give the same outcome here
  • No form of exercise has been shown to be superior (or dangerous) for spondylolisthesis here and here
  • Stabilisation training and general exercise are equally effective for spondylolisthesis here

About Raphael and Cloe:

Raphael Bender, CEO, Breathe Education

Raph believes everyone deserves the opportunity to transform into a better version of themselves. His main strength as a teacher and movement professional is the ability to distill complex research findings into a simple, science-based approach to help people move fearlessly, thoughtlessly, and painlessly. He LOVES running, weights, cycling, and Contrology.

Raph holds a Master’s degree in Clinical Exercise Physiology (Rehabilitation), a Bachelor’s degree in Exercise and Sports Science, Diploma of Pilates Movement Therapy, and STOTT PILATES full certification.

Cloe Bunter, Lead Trainer, Breathe Education

With 8+ years in the industry, both teaching Pilates and nurturing new instructors, Cloe is passionate about empowering new and seasoned instructors to think critically and move fearlessly. Empowered instructors empower their clients, and in turn, change lives. 

She finds great joy in building connections with clients, students, colleagues, and the broader movement and rehab community.  Co-hosting the Pilates Elephants Podcast, with Raphael Bender, has provided an incredible platform to bust common Pilates, movement, and rehab myths whilst creating a worldwide community of critical thinkers who are elevating health literacy.

Cloe is fascinated by movement in general, and its ability to enhance our lives, at any age. Her own movement practice includes Contrology/Pilates, running, weights, and kettlebells. Close has a Diploma of Clinical Pilates, Cert IV in Pilates, and Cert IV in Training and Assessing.

How to Connect with Raphael and Cloe:


Our Pilates instructor training is 100 percent online, so you can study from anywhere in the world. 

Earn recognition: Your Breathe Education Pilates qualifications are recognized by the Australian Government, Exercise & Sport Science Australia, and all major insurers.

Build your skills: with our pilates instructor training, you’ll learn the original Contrology exercises created by Joseph Pilates. Plus, you’ll learn the most current, science-based ways to cue and program those exercises, how to work with injured and pregnant clients, and nurture beginners.

Gain confidence: Learning is fun and easy when you engage with our state-of-the-art eLearning system, filled with straightforward, relevant content and structured to guide your training as you build skills and confidence.

Feel supported: You’ll learn world-class problem-solving skills, not just a list of answers. Our student success team and trainers will provide you with all the guidance, challenge, and support you’ll need to become what you want to become.

Take your first step to becoming a certified Pilates instructor by scheduling a 20-minute Discovery Call with us here.



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