Immediate physical therapy is beneficial for adolescent athletes with active lumbar spondylolysis: a multicentre randomised trial

Key Points

1. Immediate physical therapy did not increase the risk of less bone healing.

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BACKGROUND & OBJECTIVE

Low back pain is common among young athletes, and over 40% of those athletes will be diagnosed with spondylolysis (1). Common treatments for spondylolysis include rest, anti-lordotic bracing, electrical stimulation, and core stabilization (2).

A common treatment approach for spondylolysis is prolonged rest to allow bone healing, though full union occurs in only 68%-82% of these injuries.

The objective of this study was to compare the effects of initiating physical therapy (PT) for active spondylolysis versus resting until pain resolves to begin PT.

Low back pain is common among young athletes, and over 40% of those athletes will be diagnosed with spondylolysis.

Initiating physiotherapy immediately after diagnosis leads to faster return to sport and better functional outcomes without compromising bony healing, compared to delayed, rest-first management.

METHODS

• This prospective, multicentre, two-arm, parallel, randomized controlled trial recruited participants aged 10-19 years who were diagnosed with active spondylolysis via MRI and participated in organised sports at least two times per week at the time of diagnosis.

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