Low back pain is a common in individuals of all ages. When back pain occurs in teenagers or adolescents, one of the causes may be Spondylolysis.
Playing through pain because you think “it will go away” may seem okay when you are a young active teenager. With spondylolysis, back pain is more than just a muscle strain. When the back pain gets worse with your activity and starts to impede on your performance, playing through it may no longer be the smartest idea.
Spondylolysis is a defect or crack in the boney ring that connects the front part of your spine to the back part. The defect can occur at the left side, the right side, or both sides of the spine. The crack specifically occurs between the boney protrusion at the back of your spine and the boney protrusion at the side of your spine. This defect weakens the bones and causes small stress fractures in the lower spine bones. As a result, you may feel low back pain, especially during heavy labor or activity. Spondylolysis is common in young adults ages 15-17, especially during their growth spurt. At this age, their spines are still developing and the bones are still weak. Individuals who are highly active and involved in sports such as football, gymnastics, wrestling, and dance are at a higher risk since these sports involve repetitive bending backwards, twisting, or lifting heavy weight. These activities place excessive strain on the lower spine.
When the crack or defect occurs at both sides of the spine, the lower spine bone can slip forward. This condition is a further progression of Spondylolysis and is referred to as Spondylolisthesis. With either condition, proper diagnosis and early treatment yield better outcomes and speed healing time. Conservative treatment such as bracing and physical therapy will help reduce symptoms and help return the athlete to their sport or activity safely.
Diagnosis
If Spondylolysis is suspected, your physician will recommend X-rays to help confirm the diagnosis or rule out other potential diagnoses. An MRI, bone scan, or CT scan may also be used to in order to see a more detailed picture of your spine if the X-ray is unclear. Once the diagnosis is confirmed, your physician may recommend you modify your sports activity and participate in physical therapy.
Symptoms
- Low back pain that can spread across the lower back or radiate down into a thigh
- Pain during or after playing sports or increased activity
- Muscle spasms in your lower back and/or thighs
- Increased pain when you bend backwards, twist, or during throwing
- Difficulty with standing or walking for a long period of time
- Relief with bending forward, sitting, or rest
- Tight leg muscles
How Can Physical Therapy Help Me?
Your physician may recommend nonsurgical treatment because most of your symptoms can improve after rest, bracing, and/or physical therapy. Your therapist will provide recommendations on how to modify your activities in order to rest your lower back, especially activities that involve repetitive backward bending. They will instruct you on what movements to avoid and how to manage your symptoms. Limiting your activities in the beginning will give your back a chance to heal. Once your back has calmed down, your therapist will included treatments such as:
Strengthening: Your therapist will prescribe exercises that focus on strengthening your core, hip, and low back muscles. These type of exercises will increase stability and support around your spine, helping you to move properly without adding excessive stress to your low back.
Stretching: Gentle stretching to improve the flexibility of your back, hip, and lower leg muscles will help decrease further stress on your lower back and ensure proper movement and posture during your sport or activities.
Hands on Therapy: Your therapist will provide hands on manual therapy to reduce pain and decrease muscles spasms in your lower back or hip.
Functional Training: Towards the end of your therapy, your therapist will initiate a careful progression of sport-specific movements. This type of training will allow you to safely return to your sport/activity. You therapist may also suggest changes in your technique or form during these activities to help improve your performance, reduce stress on your lower back, and prevent further issues.
If not taken seriously at first, Spondylolyis can eventually worsen and develop in to spondylolisthesis. This can mean a significant break from your sport/activities along with long term damage. Early treatment and maintenance are important. Your therapist can provide a home exercise program that will help you to maintain good core and hip strength and proper mobility. This will allow you to independently manage your symptoms and prevent additional stress on your low back.
For more information visit Total Performance Physical Therapy.
