Pars Defect Injury (Spondylolisthesis or Spondylolysis)

It may sound confusing because the word fracture is not in this condition’s name, but a Pars Defect injury is simply a stress fracture or fracture in one or some of the bones in your lower spine. In your spinal vertebrae there is a thin portion called the pars interarticularis and this is where the bone injury happens. A pars defect injury usually occurs on only one side of the spine, however if there is a stress fracture, or even a complete fracture, of both sides of the same vertebrae that is then referred to as Spondylolisthesis or Spondylolysis.

A Pars Defect injury often develops after a period of repetitive stress or overload of a specific sport or activity. Its more common in younger male athletes aged 11-17 as at this age they haven’t reached full bone development yet. It is important to get on top of this injury early as prolonged stress on the vertebrae can lead to possible movement of the affected vertebrae (and conditions like Spondylolisthesis or Spondylolysis) and these are both bigger rehabilitation journeys.

Pars defect injury symptoms commonly present as pain through the lower back region, but sometimes there is associated pain in the buttocks too. Muscles around this area may also feel stiff and tender for some athletes, and this gets worse the more they play their sport or do their activity (rather than improving with warm up). In some cases, you may also experience numbness, tingling or a weakness feeling in the legs as well.

Imaging can be used to assist findings and is normally taken as an XRAY or MRI. Differential diagnosis includes lumbosacral disc or facet injuries, lumbosacral radicular nerve pain or lumbosacral muscle strain injuries.

In the initial stages, treatment of a pars defect injury starts with planned rest, activity modification and the creation of a progressive rehabilitation plan, but this all depends on the severity of the bone injury (note: the size and number of stress fractures, or fractures, found on imaging is very varied). It is vital that activities causing the pain are avoided to allow the area to settle and the bones to heal sufficiently. Physiotherapists, working in conjunction with a Sports Physician or GP, are key in building a plan with the client and their family in phases. After the initial deloading phase, your physiotherapist will be integral in managing the reloading phase as you gradually and safely return to your chosen activities or sports without bone reaggravation. In this time manual therapy will be helpful treatment via massage or joint mobilisations to help improve muscle length and tension, but most importantly there’ll also be an individualised movement, flexibility and muscle strengthening treatment plan to build and progress weekly. This specific exercise program should be prescribed to target core, glute, and back muscles to promote a successful return to sport.  

If you are worried this condition could be sneaking into your athletic teenager, or someone else in your life, please do not delay them in presenting to an Optimal Health Lab physiotherapist ASAP for assessment. You can book by 9431 5955 or you can on our Client Portal via our website.