 Hey, everybody, I'm Lance Coyke, and today we are going over spondylolisis and spondylolisthesis. So I've been working with a guy who has some pretty significant troubles, and today I want to emphasize how important the abs are for him and for anybody you might be working with who looks just like this guy. So when I, let's say we have a pretend person here, and we have a nice spinal curve like this. When I run my finger down his low back this way to feel his spine, let's make sure you know his face is in the front there. He's got his nice bald head with hair. When I run my finger down that area, it doesn't feel very smooth and gradual. It actually feels more like there's this little lightning bolt rigidity and then a hyper curve, an extra curve. Maybe it's even deeper than that. And we call this little region, at least the two of us do, a step off. Because as I'm palpating down this region, it's like I'm here, I'm here, I'm here, and then my finger just falls off. And then I get more curve. Okay. So when I have that, if you watched my previous video, we talked about how these types of people with this issue aren't going to deal quite as well with compressive loads. Because they don't have the tissue integrity that will help them deal with all that. If I put something straight down here, it's just going to further exaggerate this step off. So instead, what I need to do is I need to get them into, believe it or not, some sort of ability to kind of straighten, that was unexpected, kind of straighten their spine a little bit. You see how this is less curved. Even, I might even need to learn how to pretty much flatten it. Because when I'm supporting a load, I want the bodies of my vertebra to be totally stacked on top of one another. The disc here in the middle, disc, there's our spinous processes there. The disc there in the middle deals pretty well with compression. It doesn't deal very well with this side to side back and forth twisting motions. That's what starts to wear it down. But if I just put a load straight down, like I'm holding a bar on my back, then a human body is pretty strong there. Pretty resilient. And so that's what I'm trying to get for my guy here is I'm trying to take some of this extra curve out of his back and trying to teach him how to make it a little flatter. Now, the way we're going to do that, and even, you know what, I didn't draw this very well, but he's even going to get a little bit taller too. Okay, that's a weird pelvis. He's even going to get a little bit taller because we're taking this curve out and we're stacking things on top of itself. Now, how am I going to get him taller? Well, I need to straighten the spine. How am I going to straighten the spine? Well, there's a lot of fluid around the spine that we can use. There are muscles on the backside. Let's be clear about this. There are muscles on the backside. I'm going to use this one now. And they go all the way up there and way down to even up to the base of the skull. And, you know, you've got these huge upper back muscles. We can use those as well. But for right now, we're going to look at just this one little section here that is his pelvis and his lumbar spine. So how can we flatten his lumbar spine? Now, we talked about those muscles in the back. If those muscles in the back shorten, they are going to further bend his spine forward. And that will further exaggerate the curve. That is not what we want. We don't want those low back muscles to shorten. We don't want a exaggerated curve. What we want to do is we want to take another marker color here and draw on some skin. So let's say the front of your body is there. And we'll just line the back of your body so you can kind of see it. What might happen, let's, you know, with this generally you're going to have a little bit bigger belly because it's just following suit. What we're going to do is we're going to take the muscles in the front here of the abdomen. And we're going to use those, you know, there's muscles that go all the way up there, your chest muscles and everything. We're going to take these muscles, these abdominal muscles that I love so much. And we're going to use that to bring this spine backward this way. Okay. And so what we're going to do is we're going to make these abdominal muscles tighter. We're going to make this, let's do this here. Abs tight. And we're going to use something else to, we're going to use the skin in the back. Feel back. Okay. So if you saw in a previous video, I talked about an exercise that I used for him. It was a wall supported squat. I put the wall on his back and I said, hey, take that steep part of your back and push it into the wall. That is a great cue for him. It's something that he can be very memorable or he can use as a memory to make sure he's doing it correctly. But it's also not the end goal. Like I'm not trying to make him the perfect wall squatter. I'm trying to make him better at living so that his back doesn't hurt and, you know, whatever else might hurt. So we're going to use the abs to push backwards and we're going to use the skin to feel and receive that pushing backwards. Now, what this does is this, this is a sensation, right? This isn't really changing a whole lot of what's going on here. When I turn these ab muscles on, I push this front part backward first and it doesn't necessarily change the spine. What changes the spine is this other color of body, which is, I should have used brown for this one, which is guts. Blue is good because guts are full of water. So I take these guts and those guts push backward onto the spine and then the spine can go backward into the skin back there and then backward into the wall and then sensation, proprioception, right? Now, what else happens here is I have lungs up here, which are also fluid filled, but with air instead of water this time. When I take the guts and I push them back this way, these guts are going to try to come up and this lung is going to push up and all of that is going to lengthen me. It's going to make me taller. So that is kind of the multi-step approach to this and that is why if you have somebody with a spondylolis thesis, this hyper curve in their low back, this extra curve in their low back is what's putting that pars interarticularis at such risk. I can take some of that away by making them taller. I can reduce some of the compression that they're feeling for one and two, I can make them better at dealing with it by stacking their joints a little bit more. Simply by turning the abs on and pushing everything upward.