Document Type

Case Report

Department

Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2019

Advisor

Laura Frey Law

Abstract

Background: Spondylolysis is a stress fracture occurring in the pars interarticularis of the vertebral arch. Due to the nature of their activities and immature skeletal system, adolescent athletes are highly susceptible. Nearly 50% of those experiencing low back pain in this cohort can be attributed to spondylolysis. Currently there is a large knowledge gap in the literature in effective physical therapy management of young athletes with a spondylolysis. Case Description: The patient was a 16-year-old female dancer diagnosed with an L5 spondylolysis. Interventions: Treatment of the patient consisted of a 3-phase progression. Phase 1 consisted of soft tissue mobilization and non-weightbearing core and hip extensor/abductor strengthening. Phase 2 added weight-bearing and plyometric activities. Phase 3 was a maintenance period while the patient returned to her sport. Outcome Measures: The 3 primary outcome measures assessed were: Modified Oswestry Low Back Pain survey, manual muscle testing, and percent of return to sport. Following 8 weeks of physical therapy, the patient demonstrated a 20% improvement in her Oswestry score, full strength and endurance of musculature tested, and returned to 100% of sport specific activities Discussion: The patient had made a complete return to dancing following 8 weeks of immobilization and 6 weeks of physical therapy, with an additional 2 weeks of continued physical therapy. This aligns with the time frame of return to sport average established in the literature of 3.7 months. This case demonstrated the safe use of a progressive, phased rehabilitation approach to return the patient back to dancing activities.

Keywords

Spondylolysis, physical therapy, return to sport

Pages

9

Copyright

Copyright © 2019 Ryan Hermsen

COinS
 

URL

https://ir.uiowa.edu/pt_casereports/91