Spondylolysis ( Back Stress Fracture.)

What is Spondylolysis?

Spondylolysis is a stress fracture within your back.

Commonly seen in children , adolescents and active young adults who report back pain.  It can occur at two distinct stages of skeletal development.

1) Early Childhood , when an infant is learning to walk

2) Early Adolescence , active sports people with immature bone structure.

It is clinically defined as  a non-displaced stress fracture of a spinal vertebrae. The majority of cases of spondylolysis occur at the L5 vertebral level.

Consulting a Manipulative Physiotherapist is a good start in directing a full recovery.


Symptoms of Spondylolysis?

§  Spontaneous onset,

§    Back pain – at the beltline , one sided pain reported.

§  Pain described as initially sharp. Described later as a dull ache.

§  Pain increases with standing , arcing activities and increased training. The pain may radiate to the buttock or thigh. Pain is eased with complete rest. Tight hamstrings and an exaggerated back arch is seen in most patients.


What Causes Spondylolysis?

§  Certain activities that are repetitive and require rotation of a joint and /or hyperextension.

There are plenty of sports which put you at a higher risk of a stress fracture these include but are not limited to :

§  Cricket  in particular bowlers

§  Gymnastics

§  Weightlifting.

§  Swimming butterfly

§  Golf

§  Ice Skating.



The diagnosis is made by your Manipulative Physio Melb CBD , based on your symptoms, a physical examination and X-ray or MRI  findings.

Call Elizabeth Street Physiotherapy on 96703996 for an appointment and advice on your condition.

Commonly with a physical examination low back pain is expressed by the Patient .In particular pain is felt with extension of the lumbar spine. Commonly hamstring tightness is found in approximately 80% of patients. Neurological symptoms are usually absent



Initially management is conservative aiming to reduce pain and assist healing.


Managing Your Pain & Inflammation

Pain is the reason why treatment is sought. The pain is experienced due to the associated inflammation of the area.

The management of inflammation  is of paramount importance in the early stages of recovery.

There is a range of treatments a Melbourne Physio can use to reduce inflammation and in turn reduce pain.

Ice is an obvious one , TENS machines , Ultrasounds, Interferential , Acupuncture , Soft Tissue Massage , Taping and /or a temporary use of a brace to deload the intervertebral joint. Bracing however is a controversial treatment option.

In addition, Inflammation and Pain can be reduced by avoiding those activities that cause the pain such as extension and sudden rotation movements.

Non-steroidal anti – inflammatory maybe prescribed and useful in reducing inflammation.


Progressing Treatment.

In the early stages of injury repair ,gentle freestyle or prescribed hydrotherapy exercises are beneficial. This allows for maintaining movement in the supportive water environment.

Running in water may also be of benefit to assist with maintaining cardiovascular fitness.

Regaining range of movement

With pain and inflammation settling, the restoration of normal lumbar joint range of motion is important and  your  city physiotherapist will help you through this process. Often stiff joints adjacent to the spondylolysis require mobilising .Leg and back and buttock muscles also benefit from stretching as they are often found to be tight. Hands on massage by an experienced Physiotherapist is often the best way of loosening those tight muscles without doing  damage to the healing fracture.

Physiotherapy Run Pilates is also recommended as a treatment option in regaining core muscle control and strengthening for those who have suffered from a stress fracture of the lumbar vertebra. It is important that the deep core muscles are activated and this has shown to be beneficial in recovery and restoration of normal functioning.


Physiotherapy Pilates can also be used to improve posture as often poor posture can exacerbate  symptoms.

Returning to your Sport.

The number one question is  “When can I return to my Sport ?”

The next stage of the rehabilitation process is to return to your sport. Generally a return to your preinjury condition may take 12 weeks or even longer , so patience and alternative forms of exercise should be guided and considered.

This period needs to be carefully managed by an experienced Manipulative Physiotherapist who has an in-depth knowledge of the spine , biomechanics and the demands the particular sport  you enjoy has on your spine.

The aim is to return to your sport safely and even though sport may have caused your injury an experienced Manipulative therapist will be the best Professional to guide your spine through recovery and prevention in a holistic manner , not just focusing in your sport or what caused your injury but also  on returning you to a pain free lifestyle.

A Manipulative Physiotherapist can adjust your technique , understanding the biomechanics of the sport you play AND understanding the intricacies of your spine to ensure a safe training and effective workload schedule.


The Prognosis for Spondylolysis.

Most people recover from symptoms within 6-12 weeks.

Conservative treatment successfully relieves pain in the majority of cases and the fracture heals. It is important however to address those risk factors that led to the injury so as to prevent a reoccurrence.


Preventing a Recurrence

Stress fractures , Spondylolysis, will recur if you overstress your lower back particularly if the graduated and completed rehabilitation has not taken place.  Back mobility and core strength and  control  will help in achieving your goals and return you to your sport safely and prevent a reoccurrence. Contact a Melb City Physio on 96703996 or email us on info@elizabethphysio.com.au