what is a lower back stress fracture?
a lumbar stress reaction or stress fracture, medically known as spondylolysis, affects the pars interarticularis, a small bridge of bone at the back of the spine. it most often occurs at the l4 and l5 levels.
we see it regularly at newcastle physiotherapy, most often in adolescent athletes aged 12 to 19 who have started a new sport, changed surface, or increased how often, how hard or how long they train. it often coincides with a growth spurt.
how it happens.
bone is constantly broken down and rebuilt in response to load. with repetitive load and too little recovery, repair falls behind breakdown and a stress reaction develops. if the loading continues, a stress reaction can progress to a stress fracture and, in some cases, a forward slip of the vertebra known as spondylolisthesis.
what it feels like.
where the pain is
- a dull ache in the lower back
- pain that may radiate into the buttock
- symptoms that come on gradually rather than from one injury
- pain that intensifies during activity, often becoming sharp
triggers & relief.
makes it worse
- leaning backwards (hyperextension)
- twisting or rotating the spine
- sports such as cricket, gymnastics, football and tennis
- continuing to train through the pain
usually helps
- rest
- reducing training load
- avoiding backward bending
how we treat it.
we start every journey with a thorough assessment, the right diagnosis is the foundation of successful treatment. depending on what we find, we typically combine several of the following:
- an initial period of rest to offload the spine, which varies with severity and sport
- bracing or taping to limit lower back extension
- manual therapy for hip flexor and hamstring flexibility and mid-back mobility
- exercise rehabilitation for range of motion, flexibility, core stability, strength and kinetic chain control
- an individual, gradual return to play programme with aerobic conditioning and sport-specific rehab
- advice on pain management, sporting technique and posture
treatment length depends on the sport and the severity of the injury. most athletes return to sport within 4 to 6 months, and more severe cases can take longer. if you think your child may have a lumbar stress reaction or fracture, call us on 0191 217 1929.
faqs.
do i need a gp referral?
no, you can book directly with us. if you’re using private medical insurance (aviva, vitality, wpa, axa and others) your insurer may require a referral; check your policy before booking.
how many sessions will i need?
most patients resolve acute issues in three to six sessions. chronic or complex cases can take longer. we’ll give you an honest timeline at your first assessment.
what should i bring?
something you can move in, shorts and a t-shirt for lower-limb work, a vest for shoulders. we have changing rooms if you’re coming straight from work.
how soon can i be seen?
we always strive to have same-day availability, and evening and saturday morning slots are available.
