Low back pain and lumbar spondylolysis. How to assess, use imaging and effectively manage lumbar bone stress injuries

Low back pain in your athletes and active patients can be due to a bone stress injury of the lumbar spine or sacrum. Lumbar spondylolysis (LS) is a bone stress injury in the posterolateral vertebral arch, around the pars interarticularis. Patients with lumbar spondylolysis can have a gradual or sudden onset of pain, leading to them being unable to play sport or run. Activities that include or combine extension, rotation and lateral flexion movements, like bowling in cricket, serving and overhead shots in tennis, jumping and landing in extension in gymnastics and dance, will often be painful.

If you miss the early stages of lumbar spondylolysis or manage your athletes incorrectly, they are likely to progress to a chronic non-united lesion of the vertebral arch and have ongoing pain.

Explore the latest research, and find out exactly how to identify, assess and treat lumbar spondylolysis patients. You'll understand the anatomy, the bone stress continuum and the different stages lumbar spondylolysis goes through. You'll discover the imaging your patient needs, exercises they can perform, activities they need to restrict at each stage, and how and when they can return to sport. Get yourself ready for a shock when you find out when your patients are safe to get back to sport and activity (hint: "You can get back to sport when you're painfree" is a trap you don't want to fall into!)