Your young athlete works hard to be at the top of their game. It can be difficult to know what aches are normal and what pains need a doctor's attention. If your child frequently bends or twists their back during sports and they experience frequent lower back pain, it might be time to ask their doctor about spondylolysis.
What is spondylolysis?
This injury is a stress fracture or defect in a ridge of a vertebra (small bones in your spine). It usually affects a vertebra in the lower back. Unfortunately, it's a common reason for back pain in teenage athletes.
What causes spondylolysis?
Although the cause is often unclear, some athletes may have an increased risk for the condition due to genetics or repetitive motions. "Spondylolysis most commonly occurs with hyperextension activities, especially when combined with rotation, such as in gymnastics, football and weightlifting," says Christopher Redman, M.D., a pediatric orthopedic surgeon at Children's Health℠ Andrews Institute for Orthopaedics and Sports Medicine. "Up to 47% of gymnasts and football lineman have evidence of spondylolysis."
Additionally, young athletes are at increased risk of spondylolysis because their spines are still growing. Growing spines may have points of weakness that make it more likely for children to have overuse injuries.
How can spondylolysis be prevented?
Your child can lower their risk for spondylolysis by building strong back and core muscles. They should also avoid activities that repeatedly cause them to hyperextend their backs (lean too far backward).
"This is not always possible in several sports," says Dr. Redman. "Patients diagnosed with spondylolysis may want to consider a change in sports."
What are spondylolysis symptoms and signs?
The most common symptom of spondylolysis is back pain. If your child has recurring back pain, it's important to seek medical help to prevent symptoms of spondylolysis from getting worse.
Over time, spondylolysis can weaken the vertebra and cause a condition called spondylolisthesis (slipped disk).
If your child has spondylolysis, they will need medical monitoring and care to ensure spondylolisthesis doesn't occur.
How is spondylolysis treated?
Most young athletes receive non-surgical treatment for spondylolysis. These treatments might include:
- Stopping activities that cause hypertension in the spine for at least eight weeks
- Taking anti-inflammatory medicines
- Wearing a back brace to support the spine
- Attending physical therapy sessions for several months
"Physical therapy is focused on reducing pain, increasing flexibility and strengthening muscles to support the injury," Dr. Redman says. "Once the symptoms are gone, patients should continue their home exercise program to prevent the pain from coming back."
Spine surgery is rarely needed to fix the defect, but may be necessary if your child's spondylolisthesis is severe or they have completed six months of physical therapy with no improvement in symptoms.
Most athletes return to their sports after completing treatment and the symptoms have gone away. However, they should continue home exercises, maintain back and core strength and increase flexibility to avoid another injury. By following their treatment recommendations, most athletes won't experience spondylolysis pain again.
If you are concerned about your child and spondylolysis, contact the Children's Health Andrews Institute Spine Center.