> Spinal Physiotherapy > Spondylolysis Physiotherapy
Spondylolysis (spon-dee-low-lye-sis) refers to a painful stress fracture of a
section of the lumbar spine; most usually is the fifth vertebrae of the spine. The
injury can occur on the left, the right, or both sides of the vertebrae.
Spondylolysis occurs in up to 11.5% of the general population in the
United States, and is most frequently seen in young males. Spondylolysis
is a common cause of low back pain experienced in late childhood and
Highly active teens, both boys and girls who engage in
activities that require lifting heavy loads, repeated backward bending
of the back, or twisting of the trunk, are most at risk for
spondylolysis, including athletes participating in activities like
Fortunately, only a small percentage of cases
of spondylolysis require surgery, and 85% to 90% of young patients
recover in 3 to 6 months with proper treatment.
Spondylolisthesis (spon-dee-low-lis-thee-sis) describes the forward
slippage of a vertebrae over the vertebrae beneath it. Because the
mechanism of injury, age of the patient, symptoms, and treatment are
similar for both conditions, spondylolysis and spondylolesthesis are
often described together.
Our senior physiotherapists provide
to aid healing for patients with these
conditions. We can help you increase your spine and
leg flexibility, strengthen your core muscles, and return to your sport,
work, and recreational activities without a recurrence of symptoms.
What are Stress Fractures of the Lumbar Spine?
Spondylolysis is a stress fracture of the pars interarticularis,
part of the bony ring that connects the front part of the spinal column
to its back portion.
Specifically, the fracture occurs between the
spinous process (bony protrusion that sticks out the back of the spine)
and the transverse process (bony protrusion that sticks out of the side
of the spine). Excessive strain on the lumbar vertebrae due to
repetitive activities in a growing child can cause injury to the
vertebrae, resulting in low back pain.
Spondylolisthesis is the forward slip of a defective, unstable
There are five grades of slips, with grade I being the
smallest amount of slip and grade V being a slip of 100%. Nonsurgical
management is most successful with patients who have a defect on only 1
side of the vertebrae and those patients with a grade II or less slip.
Young athletes whose adolescent growth spurt has not yet occurred are at
greater risk for continued slippage and are monitored until they stop
Key points to understand about spondylolysis and spondylolisthesis:
- Early detection and proper diagnosis of these conditions is
important because return to sport or an active lifestyle can occur
within 3 to 6 months with early diagnosis. With prolonged symptoms and a
delayed diagnosis, healing may take up to a year.
- The majority of symptoms resolve with rest, with or without the use of a back brace or activity modifications.
- Surgery may be indicated when conservative treatment of greater than 6 months fails and debilitating symptoms persist.
- Spondylolysis and spondylolisthesis need to be ruled out in a young
athlete who is experiencing low back pain for more than a few weeks.
Active young athletes who participate in sports, such as football,
hockey, gymnastics, and dance are at the greatest risk of developing the
conditions, especially while growing.
- A negative x-ray reading requires additional imaging to rule out
early injury to the vertebrae if clinical exam findings suggest a high
probability of spondylolysis.
- Spondylolysis and spondylolisthesis are not a major cause of low
back pain in adults, except in high-level athletes engaging in high-risk
Signs and Symptoms
Spondylolysis may be present if you are experiencing:
- Low back pain with or without buttock or leg pain (If leg pain is
present, it radiates into the thigh, but generally not below the knee.)
- Muscle spasms in your low back, buttocks, and thighs
- Difficulty or pain with walking or prolonged standing
- Symptoms that are relieved by sitting, slouching, or bending forward
- Pain with sports or manual labor
- Pain with bending backwards, twisting the spine, or with throwing
- Decreased flexibility of the leg muscles
How Is It Diagnosed?
Our senior physiotherapists will conduct a thorough evaluation that includes taking your health history.
We may ask:
- How long you have had the pain, and whether it came on suddenly or gradually
- If the pain occurs with activity or at rest, or during the day or night
- What activities or positions make the pain better or worse
- If you engage in high-risk activities that may cause injury to your vertebrae
- If you can point with 1 finger to the area on your back that is painful
- If you are having any other symptoms, such as fever, chills, or night sweats
- If you have difficulty maintaining control over your bowel and bladder
Additionally, we will perform objective tests
and measures to identify movement, flexibility, or strength factors that
may be contributing to your pain. Specifically, we may watch
you walk, have you bend forward to touch your toes, bend back as far as
you can, stand on 1 leg and bend back, and turn your trunk from side to
We will assess your leg and spine
flexibility as well as your core strength, and ask you if the testing
changes your symptoms. We may gently press areas of your
back to see if they are painful. All the information gathered helps
determine the cause of your pain and the best treatment to resolve your
Diagnosing spondylolysis and spondylolisthesis can be challenging.
stress fracture is suspected, we will refer you to an
orthopedist or sports medicine physician familiar with back injuries.
The physician may order further imaging tests to confirm the diagnosis
and rule out other spine conditions.
how our senior physiotherapists can help you
In the beginning, when you are in pain and having difficulty performing your normal daily routine, we can:
- Show you how to rest the injured vertebrae, use lumbar bracing, modify your activities, and avoid painful movements
- Help you reduce and manage your pain symptoms
- Help you maintain fitness while healing, through pain-free cross-training, such as aquatic therapy
- Initiate symptom-free hamstring stretching and activation of your core muscles, either in or out of a back brace
When you are pain free, and the healing of your injured structures has begun, your physical therapist can help you:
- Improve the flexibility of your hip and leg muscles
- Improve your core and leg strength
- Improve your spine flexibility
- Prepare for a return to sport or work activities by improving your overall fitness levels
- Begin a gradual progression of higher-risk movements, such as back extension and trunk rotation to reduce the chance of reinjury
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Phoenix Rehab physio Services
Phoenix Rehab Group works with specialist
physiotherapists and rehab therapists who are highly
trained, qualified, experienced and passionate to provide high level of
expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
HAND THERAPY & SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, and requires Hand Therapy to increase the function of their hand
following injuries or post-operations as well as custom made hand splints.
Commonly treated hand pain injuries includes
CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on posture,
core stability, balance, control, strength, flexibility, and breathing. It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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