THis may seem concerning, but in most cases, they will not cause pain in the long term. Generally speaking, pars fractures will not re-unite, and they rarely progress. ![]() There are other mechanical and pathological considerations, but they are too great to cover here. This is important in deciding the approach to restriction in activity. Is the teenager playing representative sport or just club sport on a weekend. Is there any forward slippage of the vertebra and if so, by how much? (there are some surgical techniques that may be employed for minor slippages to assist with healing).ĥ. This impacts recommendations for care and restricted activity.ģ. Is the fracture on one side or both? This is important, again because an MRI will show if there is a developing lesion on the other side, called a stress lesion. It will also tell you if the fracture is recent or old.Ģ. Was the fracture diagnosed from x-ray or MRI (An MRI can tell you if the lesion is currently active and whether pain is likely to be from the lesion or not). It is important to obtain some additional information in order to provide suitable advice.ġ. Progressive functional exercise that emphasise total body movements.Correct retraining of deep core muscles.single leg eyes closed – used for proprioception) 4 point arm and leg lift (used for strengthening muscles deep in low back).Half curl ups (used for strengthening of abdominal muscles).Front planks/ side planks (used for muscular endurance).Seated core activation progressions on Swiss ball (for postural control in seated position).Such exercises that might be beneficial include: Ideally, see someone with a Real Time Ultrasound to use to assess proper activation of these muscles – this is gold standard.Īdditionally a focus needs to be functional exercises (exercises to mimic daily activities or sport specific exercises etc.) these incorporate exercises with multiple planes of movement, whilst helping to improve posture and body awareness. See a physiotherapist or exercise physiologist with specific training in spinal rehabilitation to get help with exercise prescription and training variables. In these instances depending on the time since injury retraining of the deep core muscles is important (especially transverses abdominis and lumbar multifidus) as research has shown these muscles reduce in activation and size (hence strength) during low back injuries. Strengthening of core muscles is vital for optimal recovery and to protect the healing process of the fracture. A stress fracture to the pars interarticularis AKA Spondylolysis is a very common condition especially in adolescents and particularly in sports like cricket, gymnastics and rugby.
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