A Lower Back Fracture You May Not Have Heard Of….

A condition you might not have heard of that affects girls playing/participating in gymnastics, cheerleading, and volleyball specifically, but also men and women playing competitive sports is lower back pain created by a fracture.  This particular kind of fracture is self-limiting, but it’s important to have it looked at if your child is playing in a competitive sport because waiting too long to get treatment can dramatically affect your own or your child’s ability to play sports now and in the future.  What these sports have in common with your child involves repeated back extensions done over weeks, months, and years of training resulting in this fracture.
Spondylolisthesis is a lower back condition in which a part of the vertebrae is fractured (referred to as a pars defect or pars interarticularis fracture) due to overuse and repetition.   Spondylolisthesis are graded from I-IV depending on the severity and the amount of forward slippage of 1 vertebrae relative to the one below it.  Most Grade III and IV do require surgery for stabilizing the spine as neurological symptoms and deficits can arise in these most notably (but it is also possible, although minimal to have neurological symptoms in Grade I and II depending on the exact nature of the fracture). Typically, your son/daughter presents with pain made worse with activities (especially bending back), buttock pain, and lower back muscle spasms.  Diagnoses of this condition can be accomplished by physical exam, but a definitive diagnosis is made when X-rays, MRI and/or Bone scans are performed.
For conditions such as this, contact sports or competitive sports must be stopped immediately or the athlete increases the risk of further injury to his/her lower back.  Currently, the Modified Boston Brace is the most effective way to allow an athlete to recover as it only has to be worn for 3-6 months (up to at least 80% of the athletes who wear this will return to competition after this time frame).  Also, strengthening both their core and gluteal muscles are critical for lessening the risk of re-injury once the diagnosis is made.
So the next time your son/daughter tells you of lower back pain, be aware this may be lurking, but make sure you see a health care professional to have it evaluated so he/she doesn’t have to miss more time because of their injury.
Stay tuned to next month’s blog… In the meantime, as summer is now here, get outside and do something you enjoy!
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