Teen Athletes and Back Pain: Is It Routine or Pars Stress Fracture?

If your teen athlete is suffering from back pain, you might shrug it off as a normal part of sports participation. But for 30 percent of young athletes, it might be something more serious: spondylolysis, also known as pars stress fracture.

This lumbar spine condition occurs when the back is hyperextended or rotated continuously. It can adversely affect the growing bones of young athletes by fracturing the bony arch that connects the spine’s facet joints – the pars interarticularis – hence the name pars stress fracture.  

Which Sports are Risky for Pars Stress Fracture?

“I see it with offensive and defensive linemen, gymnasts, volleyball players, and cheerleaders,” says Orthopedic Specialists spine surgeon Taylor Beatty, DO. “It can occur on one side of the back or both.” Other sports in which this routinely occurs is diving, pole vaulting, high-jumping, ballet, weightlifting, and wrestling.

Repeated injuries don’t allow proper healing and can lead to cracking in the pars. Untreated, these stress fractures can cause spondylolisthesis, in which one vertebra slides over an adjacent vertebra.

Diet Can Worsen Pars Stress Fracture?

Teens, especially busy athletes, are not known for having the healthiest of eating habits. The tendency to skimp on nutrition while training vigorously is known as Athletic Energy Deficit (AED). A nutritional deficit during adolescence, a period of rapid bone growth, can make pars stress fracture worse. It can lead to slower bone growth, an increase in stress fractures, and early osteoporosis.

AED is particularly pronounced in sports that emphasize low body weight, such as gymnastics and skating.

Symptoms of Spondylolysis

Common signs of pars stress fracture include pain and stiffness in the lower back that is aggravated by activity and subsides with rest. However, parents should also look for other signs, such as discomfort in the neck, legs, or shoulder; muscle include pain and stiffness in the lower back that gets worse with activity and improves at rest. Other symptoms include

• Muscle spasms or weakness
• Headache
• Numbness or pins-and-needles

How is Pars Stress Fracture Treated?

In addition to making dietary changes, adolescent and teen athletes need to incorporate adequate rest into their training routine. “Once pars stress fracture is identified, we recommend three to four months of rest – minimum – to allow bones to repair,” says Orthopedic Specialists orthopedic and sports medicine surgeon Scott Brotherton, MD.

Adds Dr. Beatty: “Lumbar bracing is also commonly indicated to allow healing and minimize motion at the fracture site.”

Young athletes and their parents should also work with their coach to focus on stretching and strengthening, particularly stretching hamstring muscles. "Hamstring stretching is important to take the pull off the pelvis," says Dr. Beatty.

Young athletes should also focus on modifying their form to prevent overextension in the future.

If you are concerned about backache in your young athlete, make an appointment with our youth sports medicine specialists in Palm Harbor at 727-496-2391.