One of the Most Common Low Back Injuries in Youth Athletics!

Even though they hardly slow down here in Florida, youth sports are soon to be in full swing again! Weekend long soccer tournaments, all-day gymnastics or swimming meets, and baseball triple-headers are just around the corner in Jacksonville and St. Johns county (or have already started.

With this rapid increase in activity levels, this unfortunately means that there will be an increase in injuries & pains throughout these different sports. We often think of sports injuries in the youth and teenagers occurring to the knees, ankles, and shoulders and we often think of spine injuries mainly happening in adulthood. Though low back pain is extremely prevalent in adults, it is also way too common in adolescent athletes.

Low Back Pars Fracture Summary

What is a "Spondy?"

In this article, we want to highlight one of the most common causes of low back pain in youth athletes, which is called a “pars fracture” or “spondylolysis.” This is simply a stress fracture near where your vertebrae come together and form joints in your spine. The fracture can happen on one side of the spine (unilateral) or it can happen on both sides (bilateral). It often happens to athletes who plays sports that involve a lot of rotation, extension (bending backwards), and loading of the spine (1-2). Baseball, gymnastics, football, tennis, and weightlifting are the most common sports were athletes develop low back pain in the form of a pars fracture. Think of a baseball player swinging or a gymnast doing back handsprings as common mechanisms of injury.

These fractures are fairly common in the general public but are not always symptomatic. One study showed that almost 40% of those under 18 years old that had low back pain for greater than two weeks had a pars fracture (1). As a parent or athlete, a pars fracture or spondylolysis itself should not cause a great amount of fear or worry. This injury has a really good prognosis and statistically has excellent outcomes with conservative care (chiropractic & physical therapy, without drugs or surgery).

You do however, want to seek care for this injury because in some cases they can develop into a spondylolisthesis, which is when the fracture causes the vertebrae to slide forward (toward the abdomen). The younger the athlete, the more likely this is to happen. However, this does not happen at a high rate for ipsilateral pars fracture that are taken care soon after injury or that are asymptomatic.

To summarize: a pars fracture is not a scary diagnosis for any age group including youth athletes, but treatment for this type of low back pain should not be delayed.

Do I Have a Pars Fracture?

You won’t be able to tell if you or your child’s low back pain is a pars fracture unless you go see an injury specialist who can diagnose your condition, typically a chiropractor or orthopedic doctor who specializes in sports medicine. Your doctor should listen to you, gather information from you, and put you through a thorough physical exam that will clue them into a diagnosis.

A pars fracture typically has local pain (not widespread) along the low back and is reproducible with certain activities or movements. Ultimately an x-ray (radiograph) and/or a CT scan or MRI is needed to confirm this diagnosis. A Pars Fracture can also be referred to as a “Scottie Dog Fracture” because of its appearance on an x-ray.

Spine Location of a low back pars fracture
A pars fracture often happens in the low back of youth athletes involved in a heavy amount of extension and rotation.

What is the Best Treatment for a Pars Fracture?

No two cases of spondylolysis or a pars fracture are the exact same, so treatment would always be specific to the patient in front of us. However, research does heavily support the use of specific therapeutic exercise when it comes to this sports injury of the low back. Exercises designed to improve core muscle strength to create better intra-abdominal pressure and low back stability are recommended by the research (1).

This certainly does not mean that you should be out and do a bunch of sit-ups and crunches, but rather you should be taken through a progressive rehabilitation program to safely activate your core muscle to help stabilize your spine properly.

Dr. Speer giving treatment to a youth athletes
Dr. Grant Speer working on spinal stability, core activation, and hip strength with a youth athlete.

Other treatment can be directed to the hip and pelvis muscles as they often become tight and weak with this specific sports injury. Therapy should begin immediately after the diagnosis of a pars fracture is even suspected. 95% of patients achieve excellent results with conservative management within 3 months of initiating treatment (1).

Spinal manipulation (chiropractic adjustment) are completely safe for a pars fracture, as is soft-tissue therapy, and specific rehab exercises.

What We Do At St. Johns Chiropractic & Performance

At St. Johns Chiropractic & Performance, we specialize in many sports injuries and low back aches and pains. We have seen and had success with athletes playing baseball, football, gymnastics, tennis, soccer, cross country, and weightlifting that have had this specific low back injury or one very similar.

All patients, athletes, and injuries are different, which requires a specific approach that is unique to you. However, all of our appointments start by taking the time to listen to you and to get to know you. We then take you through a detailed assessment and sport specific screening to help give us our diagnosis and tell us why you have the pain in the first place.

We then utilize a combination of techniques including manipulation, rehab exercise, stretching, soft-tissue muscle therapy, and other techniques such as sport cupping and taping to give you the results you need! It is not our goal to make you sit out and rest from your sports. Our goals is to get you back on the field as quickly and as safely as possible!

Aside from low back injuries, we have helped other patients and youth athletes recover from foot and knee pain, plantar fasciitis, ankle sprains, headaches, shoulder and elbow pain, muscle strains, and tendonitis! It is our goal to get you out of pain quickly and rehabilitate your injury so that you can get back to enjoying the sports that you love with your teammates!

If you know someone in the Saint Johns, Florida area (Durbin Crossing, Aberdeen, RiverTown, Julington Creek Plantation, Beachwalk, Silverleaf) who is not able to live the active lifestyle that they want because of an injury or pain and could benefit from our thorough approach and comprehensive care, please share this post with them or send them our way!

We are conveniently located just south of Jacksonville in between CR 210 and Race Track Road, near where St. Johns Parkway and Longleaf Pine intersect! Right across the street from Patriot Oaks Academy in the 32259 zip code! Only 4 minutes from Durbin Park! We are committed to offering the best chiropractic care near you!

We help active adults & youth athletes get out of pain quickly & rehabilitate their injuries so they can get back to doing what they love pain-free!

We are a proud supporter of the Creeks Baseball Club, Patriot Oaks Academy, Swiss Point, Freedom Crossing Academy, and other youth sports programs!

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001669/pdf/JSM2020-9235958.pdf
  2. Movement Over Maxes by Zach Decant

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