Spondylolysis / Spondylolisthesis
What is Spondylolysis and Spondylolisthesis?
Spondylolysis is a stress fracture in a part of the vertebrae in the spine (pars interarticularis). Spondylolisthesis occurs when the vertebra slips forward due to instability. These are common in young athletes, especially in sports requiring repeated back extension (gymnastics, football, weightlifting).
Common Symptoms
Low back pain worsened by extension or arching
Hamstring tightness
Stiffness or fatigue in the lower back
In advanced cases, pain radiating into the legs
Physical Therapist Diagnosis
A PT evaluates pain with extension movements, palpates the spine, and assesses posture and mobility. Imaging (X-ray or MRI) is often used for confirmation.
Why it Happens
Repetitive extension and rotation stress the spine, leading to stress fractures. If untreated, vertebral slippage may occur.
Why it Doesn’t Always Heal on Its Own
Stress fractures require activity modification and guided strengthening. Without intervention, symptoms persist or worsen.
Ideal Physical Therapy Treatment
Rehab emphasizes stabilization, strengthening and gradual return to activity.
Key strategies include:
Activity modification to limit painful extension
Manual therapy for hip and spinal mobility
Dry needling for muscle spasm in lumbar or hip muscles
Core and glute strengthening to support the spine
Gradual progression back to sport
Expected Outcomes
Most athletes recover fully with conservative rehab. Severe cases may require bracing or surgery, but PT remains essential.