What exercises are safe to do with moderate spondylosis of L5-S1, and can I do pelvic floor exercises for partial erectile dysfunction (ED) before getting Electromyography (EMG) test results?

Exercise Safety with Moderate L5-S1 Spondylosis

You can safely begin low-to-moderate intensity exercises now without waiting for your EMG results, focusing on flexion-based movements while strictly avoiding extension and twisting exercises, and yes, you can perform pelvic floor exercises for your ED. 1, 2, 3

Safe Exercises You Can Start Immediately

Recommended Activities

• Walking at a moderate pace for 20-30 minutes, 3-5 days per week, is one of the safest and most effective exercises for your condition 4
• Stationary cycling with an upright or slightly forward-leaning posture reduces axial loading on L5-S1 2, 5
• Swimming and water-based exercises provide excellent conditioning with minimal spinal stress 4, 5
• Flexion-based core strengthening exercises (bringing knees to chest, pelvic tilts, abdominal bracing) are specifically beneficial for spondylosis 2, 3

Target Exercise Volume

• Aim for at least 150 minutes per week of moderate-intensity aerobic activity, spread across 3-5 days 4
• Add strengthening exercises twice weekly, performing 8-15 repetitions per exercise 4
• Start with shorter sessions (10-20 minutes) and gradually increase duration as tolerated 4, 6

Pelvic Floor Exercises for ED

Yes, you can safely perform pelvic floor exercises (Kegel exercises) for your partial ED—these do not stress the L5-S1 region and can be done in any comfortable position. 4

• Perform pelvic floor contractions in lying, sitting, or standing positions that don't aggravate your back pain 4
• These exercises involve no spinal movement and pose no risk to your spondylosis 4

Exercises to STRICTLY AVOID

High-Risk Movements

• Extension exercises (backward bending, prone press-ups, cobra poses) significantly worsen spondylosis symptoms and should be completely avoided 1, 2, 3
• Twisting and rotational movements of the spine, especially dynamic abdominal exercises with trunk rotation 1
• High-impact activities including jogging, jumping, running, and explosive movements that increase axial loading 1, 5
• Heavy lifting, particularly with improper form or combined with twisting 1
• Spinal manipulation or high-velocity chiropractic adjustments carry risk of serious injury with spondylosis 4, 2

The Critical Distinction

A landmark 3-year study found that patients with spondylolisthesis doing flexion exercises had a 62% recovery rate versus 0% for those doing extension exercises 3. This evidence strongly supports avoiding any backward bending movements with your L5-S1 condition.

Regarding Your EMG Testing

You do not need to wait for EMG results to begin the safe exercises listed above. 4

• The EMG is diagnostic and will help identify any nerve involvement, but starting gentle exercise now is safe and beneficial 4
• Exercise is consistently shown to be safe in spinal conditions, with studies reporting very few adverse events when appropriate activities are chosen 4, 2
• Continue the safe exercises listed above while awaiting your EMG results 4

Managing Sitting-Related Pain

Since sitting worsens your pain, this suggests a flexion-intolerant pattern initially, but spondylosis typically responds better to flexion-based treatment long-term 2, 3:

• Take frequent standing breaks every 20-30 minutes when sitting 1
• Use a lumbar support cushion to maintain neutral spine position 1
• Perform gentle pelvic tilts and knee-to-chest stretches after prolonged sitting 2, 3
• Consider a standing desk or sit-stand workstation if feasible 4

Warning Signs to Stop Exercise

Stop exercising immediately and seek medical evaluation if you experience 4, 1:

• Progressive leg weakness or numbness (suggests nerve compression requiring urgent evaluation) 1, 2
• Loss of bowel or bladder control (medical emergency) 2
• Severe pain that significantly worsens during or after exercise 4, 1
• New or worsening radiating pain down the leg 1

Progression Strategy

• Begin with 10-20 minute sessions of low-impact aerobic exercise 2-3 times weekly 4, 6
• Gradually increase to 30-minute sessions 5 days weekly over 4-6 weeks 4
• Add resistance training after 2-4 weeks of successful aerobic exercise 4, 2
• Pain should guide your activity level—mild discomfort is acceptable, but sharp or significantly increased pain indicates you should modify the activity 4, 1

The key principle: flexion-based movements are therapeutic for L5-S1 spondylosis, while extension and twisting movements are harmful. 2, 3