Spondylolysis is a stress fracture of the pars interarticularis (back bone). A fairly common condition, around 1 in 20 people suffer from spondylolysis. The spine consists of 31 stacked bones that house the spinal cord. The spine is a very robust, resilient, and mobile structure with several joints at each level. A back fracture sounds scary; however, this condition is relatively common in the asymptomatic population and return to sport outcomes are very positive.
Because spondylolysis is actually quite common in the asymptomatic population, it is not correlated well with pain, meaning you could have a spondylolysis without even being aware of it. People may report pain after continuous use of muscles in the back either from day-to-day life or from participation in sport or athletic activity.
The most common cause of spondylolysis is typically repetitive stress with or without the presence of an energy deficit. Pain is typically experienced with extension (bending
backwards) and/or rotation of the spine.
Spondylolysis vs. Spondylolisthesis
Spondylolysis refers to a stress reaction or fracture to the pars interarticular is (stress fracture of the spine/back) while spondylolisthesis refers to slippage of one vertebrae on the one below it, which may occur as a result of a spondylolysis.
Spondylolysis Symptoms
The most common symptom of spondylolysis is pain that is specific to a certain area of the back and that is typically experienced with extension (bending backwards) and/or rotation of the spine. Pain may also be felt with activities that load the spine, such as running, jumping, and lifting.
Spondylolysis Causes
The most common cause of spondylolysis is typically repetitive stress with or without the presence of an energy deficit. Repetitive stress may include excessive running, jumping, or rotation movements such as throwing, swinging a baseball bat, or hitting a volleyball or tennis ball.
Sports Where Spondylolysis Commonly Occurs
Spondylolysis can be present in any population, athlete or non-athlete. However, symptoms most generally are reported among those who participate in sports such as:
- Gymnastics
- Volleyball
- Baseball
- Football
- Tennis
- Weight lifting
- Wrestling
- Swimming
- Golf
- Hockey
Spondylolysis Treatment
Unfortunately, there is no cure for spondylolysis. However, physical therapy can help you to manage your symptoms and remain pain-free while performing everyday or athletic activity. Herlong Sports Physical Therapy can help you manage these symptoms to get you back to participating in sport or athletic activity at a high level.
Treatment for spondylolysis typically consists of activity modification with a break from high impact/sport activity. PT may begin immediately after diagnosis where we will start by working on core stability and full body exercises with a neutral spine, followed by a gradual reintroduction of core strengthening in functional ranges of movement.
Once you’ve cleared the previous hurdles with minimal to no pain reported, we will gradually help you return to impact activity such as running, jumping, and sport activities. The spondylolysis recovery process/time spent in physical therapy usually lasts about 12 weeks, though this timeline may vary from person to person.
Bracing and/or surgery may be recommended in more severe cases.
Spondylolysis Rehab Exercises
Early Stage: Plank
This is a great exercise for spondylolysis recovery in the early stages.
Perform this exercise by…
- Hold a push-up position, with palms flat on the floor and toe tips holding up your lower body.
- Squeeze your abs as if you are bracing for a punch to the stomach.
- Attempt to hold this position for 30 seconds
- Perform 3 times per day.
NOTE: If you are unable to hold the planking position or if you experience pain with this activity, try performing this same activity with your hands elevated such as on the first, second, or third step of a stair-case. If you still are experiencing back pain after making these adjustments, seek advice from a medical professional.
Mid Stage: Prone Superman
This is an exercise often performed during the mid stages of recovery from spondylolysis.
Perform this exercise by…
- Lay on your stomach with arms straight above your head (you should look like superman).
- Lift both arms and both legs up toward the ceiling
- Hold for a 3 second count, then control your arms and legs back down.
- Repeat for 10 repetitions.
- Repeat this exercise 3 times per day.
