Back In Shape Podcast

Lower Back X-Ray Analysis: Retrolisthesis & The Flaws of Physical Exams


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In this Christmas Eve edition of the Back In Shape Podcast, we dive into a live clinical review of a subscriber's case to demonstrate why a physical examination alone is often insufficient for diagnosing chronic back pain. We discuss why standard orthopaedic tests (reflexes, strength, dermatomes) are designed to provoke pain rather than identify the underlying structural cause, often leading to vague diagnoses like "mechanical back pain" that offer no solution.

We then move to the X-ray analysis, revealing what the physical exam missed: a Retrolisthesis (backward slippage) of L5 on S1. Mike breaks down the biomechanics of this specific misalignment, contrasting it with the more common spondylolisthesis (forward slip), and explains how the loss of the natural lumbar curve (hypolordosis) compromises the spine's ability to handle load.

Finally, we issue our essential Christmas warning: The "Turkey Carry." It is rarely the heavy gym session that causes a Christmas flare-up; it is the awkward mechanics of carrying heavy roast trays across the kitchen while dodging toddlers. We break down how to apply gym-standard hip hinge mechanics to your household duties to ensure you stay pain-free into the New Year.

đŸ©ș Physical Exams vs. X-Rays: Why "ticking the boxes" on a physical exam (reflexes, sensation, strength) often gives a false sense of security, and why imaging is required to see the structural reality.💀 Retrolisthesis Explained: A visual analysis of the subscriber's X-ray, identifying the backward slippage of L5 and the straightening of the spine (hypolordosis) that creates chronic instability.🩃 The "Turkey Carry" Risk: Why household tasks during Christmas are high-risk moments for the lower back, and how to apply proper bracing and hinge mechanics to kitchen duties.

Chapters00:00 Introduction & Christmas Eve Greetings02:40 Patient Case Study: History (L5-S1)06:00 Why Physical Exams Don't Reveal Structure09:15 X-Ray Analysis: Identifying The Root Cause15:30 Retrolisthesis (Backward Slip) Explained28:00 Why "Instability" Is A Vague Term45:00 The Hip Mobility Connection01:07:00 The "Turkey Carry": Holiday Movement Hazards01:09:00 Conclusion & Sign Off

#Retrolisthesis #Chiropractic #BackInShape

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