Spondylolisthesis


Learn more about spondylolisthesis, its signs and symptoms, and how you can recover safely with Restore Physiotherapy.

What is Spondylolisthesis?  

Spondylolisthesis is a condition where one of the bones in your lower back (called a vertebra) slips forward over the bone beneath it. This can put pressure on nearby nerves and cause pain or stiffness in the back.

We often see this condition among individuals who’ve had stress fractures on both sides of the lower spine, especially young athletes involved in sports that require a lot of bending or twisting, like gymnastics or football. It can also be caused by muscle degeneration as we age.

Some of the typical symptoms of spondylolisthesis are lower back pain, tight hamstrings, leg pain or numbness, and stiffness. Fortunately, spondylolisthesis can usually be managed without surgery, and we see many people (including professional athletes) train and perform at a high level with the right management and guidance.

By focusing on core and lower back strengthening, patients can stabilise the spine, reduce pain, and get back to life as normal.

Spondylolisthesis

Symptoms of spondylolisthesis 

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Low back pain and stiffness, often worsened by activity
Poor-Posture
Pain that may radiate into the legs

Fatigue
Tightness in the hamstrings

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Discomfort when arching the lower back (lumbar extension)
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Tenderness when pressing on the lower spine, sometimes with a noticeable "step" or dip in one of the spinal bones
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A sharp, catching pain when returning to an upright position after bending forward

Recovering from spondylolisthesis with Restore Physiotherapy 

Shoot your best hoop yet

Restore Physiotherapy has helped many patients recover from spondylolisthesis with an accurate assessment and the right physical rehabilitation strategy. The first step to treatment is understanding the cause of spondylolisthesis, whether it's degeneration or a stress fracture.

With an accurate assessment, our team will help you recover through a comprehensive exercise program that involves strengthening core muscles, improving flexibility, and addressing posture issues.

Physiotherapy case study: Returning to cricket after spondylolisthesis

Spondylolisthesis

Scenario

A 20-year-old male cricketer visited our team with ongoing lower back pain. We conducted a detailed clinical assessment by reviewing his bowling technique, training load, and activity history. An MRI also confirmed stress fractures and a Grade 1 spondylolisthesis. 

Solution

We started rehab with four weeks of relative rest, including basic core activation exercises. At five weeks, the patient started with low-impact activity on a stationary bike and began lower limb strength work. This was initially done using his body weight, which then progressed to gym-based exercises that avoided spinal loading. Core strengthening was also done through our in-house pilates program. 

By 12 weeks, he had regained sufficient strength and mobility to begin a gradual running program. Over the following eight weeks, we progressed his speed and volume. At five months, he resumed technical work with a bowling coach, focusing on low-impact walk-throughs to refine technique and reduce spinal strain. 

Bowling was reintroduced as part of his training at six months, as we carefully monitored and adjusted his frequency. By eight months, he began bowling in matches under strict load monitoring. 

Results

After 10 months, the athlete returned to unrestricted bowling and successfully rejoined the First Grade Sub-District Cricket tournament. He remains symptom-free and continues to follow a tailored home exercise program to reduce the risk of re-injury and maintain his performance. 

Book an appointment 

Better mobility starts here. Book an appointment online or contact Restore Physiotherapy to speak to our care team.

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Frequently asked questions

We use both clinical assessment and imaging to confirm a diagnosis. If a lumbar stress injury is suspected, we often ask the patient to undergo an MRI, X-ray, or CT scan to help us determine if there is spondylolisthesis and how severe it is. 

Most cases of low-grade spondylolisthesis can be managed naturally with rehabilitation exercises that focus on core strengthening and building stability through the small muscles in the lower back. We can do this through our clinical exercise or pilates program, as well as a home exercise program. We also recommend taping or bracing the affected area to provide support and reduce discomfort.

Tight hip flexors and hamstrings can contribute to spondylolisthesis by affecting posture and increasing pressure on the spine. We usually focus on treating these areas and will only recommend surgery for high-grade slips or if nerve-related symptoms persist.

In the early stages, our advice is to avoid movements that extend or compress the lower back (i.e. backbends or barbell squats). Instead, focus on core and abdominal strengthening exercises (e.g., single-leg bug, roll-downs, hundreds). Additionally, bodyweight and Theraband exercises can also improve spinal stability without aggravating symptoms. 

Spondylolisthesis can be a demotivating condition. We believe that confidence comes from patients seeing their progress and knowing they can move safely again. Our team is here to help you rebuild your strength gradually, starting with gentle exercises that don’t cause pain and progressing to more challenging ones. 

By retraining movement patterns and strengthening the core, lumbar spine, and legs, we reduce pressure on your back and help you regain trust in your body. 

Yes definitely! We work closely with GPs to diagnose the initial pain, administer pain relief, and perform imaging. We also refer to spinal specialists for symptoms that are severe, persistent, or involve nerve compression.

For athletes, we typically liaise with their strength and conditioning coaches to ensure they can safely return to sport.