Spondylolysis is a stress fracture to the pars interarticularis, a narrow part of your vertebrae.  The most common low back injury in children and adolescents, it affects 3-7% of this population.  In athletes, it is typically due to repeated and forceful extension at the lumbar spine.  Football lineman, hockey players, gymnasts, dancers, swimmers, and cheer athletes are most prone to these injuries.  Spondylosis can lead to spondylolisthesis, which occurs when both sides of the vertebral ring fracture and the vertebrae begins to slip forward.

In athletes, “spondys’ are typically caused by repeated, forceful extension. There is preliminary research indicating that some people may have a genetic predisposition, causing a thinner layer of bone at the pars interarticularis – less material, able to tolerate less stress.  In the elderly population, spondys can be due to age-related degeneration of these bones.

Repeated forceful extension.

– Sport type.

– Growth spurts. 

– Poor mobility. 

– Core/hip weakness. 

– Genetic predisposition.

– Pain in the lower back, especially with extension (leaning backward).

– Loss of range of motion.

– Muscle spasm.

At Home Diagnostic Tests

– Extension Test (video).

– Valsalva Maneuver (video).


At Home Care

– Avoid irritating positions (extension). 

– Comfort care:  ice, heat, NSAIDs.

When to Seek Help

If your child or teen athlete is experiencing low back pain, they should see a physical therapist as soon as possible. Your physical therapist will be able to determine if medical imaging is necessary and provide symptom relieving treatment all in the same session.

Inspired Athletx Treatment

At Inspired Athletx, we take a proactive approach to the treatment of spondys.  Many orthopedic providers will recommend 6-12 weeks of rest in a spinal brace prior to beginning physical therapy, but this only increases the severity of contributing factors, like hip flexor tightness and core weakness.  We liken this treatment method to putting an ACL repair patient in a cast for 4 weeks – while it is something we used to do, we now know that early rehab creates much better outcomes.  Early PT will focus on manual therapy to improve the hip and thoracic spine mobility impairments that create excessive stress at the low back (paper clip video), improving your low back and pelvic posture, and core and hip stability.  As you progress, these basic tenants are integrated into strength training and sport specific exercises. This method typically gets athletes back in the game before they might even be out of their brace with a standard treatment protocol.