Spondylolysis: A Concern for young gymnasts

Spondylolysis is a common diagnosis with a high prevalence in children and adolescents complaining of low back pain. It may be caused by either a defect or fracture of the pars interarticularis commonly due to mechanical stress. It occurs at the L5 vertebrae between 85 and 95% of the time due to its anatomical position and stress during repeated motions, specifically hyperextension. Due to the occurrence of this happening with hyperextension, gymnasts experience this the most. Spondylolysis can progress to spondylolisthesis, which is defined as anterior displacement of the vertebral body in reference to the vertebral bodies above and below. 

Spondylolysis is typically asymptomatic and may be found incidentally on radiographic imaging. If you have this diagnosis, there may be low back pain present and it will become worse with back extension. 

Treatment: 

Depending on the severity of the spondylolysis and symptoms, it may be treated either conservatively or surgically, both of which have shown significant success. 

Conservative treatments such as bracing and decreased activity have been shown to be most effective with patients who have early diagnosis and treatment. There is also research that supports strengthening the core may help alleviate some of the symptoms. 

Surgery may be required if conservative treatment, for at least six months, failed to give sustained pain relief for the activities of daily living.

Reference: 

Paul Gagnet, Kent Kern, Kyle Andrews, Hossein Elgafy, Nabil Ebraheim, 

Spondylolysis and spondylolisthesis: A review of the literature,

Journal of Orthopaedics, Volume 15, Issue 2, 2018,

Pages 404-407 ,ISSN 0972-978X, https://doi.org/10.1016/j.jor.2018.03.008.