Study: Young athletes need to avoid continuous repetitive activity to decrease risk of pars fracture

Young athletes today often participate in sports year round and with increasingly competitive club and school sports, it has become common to choose one sport to specialize at a young age. While this specialization may seem like a competitive edge, new Northwestern Medicine^® research suggests that repetitive activity in just one sport, high impact or not, may not be a great idea for growing athletes.

A Northwestern Memorial Hospital spine surgeon, Wellington Hsu, MD, recently conducted a study which suggests that young athletes, during the stages of skeletal maturity, should avoid continuous repetitive activity associated with low impact rotational sports, such as baseball, tennis and golf, to decrease their risk of a spinal injury known as a pars fracture. The research was presented at the 2014 annual meeting of the Lumbar Spine Research Society.

The pars bone is part of a vertebra that joins the facets of the neighboring vertebra together. This bone, which helps protect the spinal cord, is susceptible to injury during adolescent growth, which is a point of weakness in the spine. Adolescents who have not yet reached skeletal maturity have a higher rate of injury than adults. 

"Rotational sports that put repeated stress on the pars bone can result in a stress fracture in the spine, which is known as a pars fracture," said Hsu, who is the Clifford C. Raisbeck Distinguished Professor in the department of orthopaedic surgery at Northwestern University Feinberg School of Medicine. "This condition is found in 6 percent of the world's population, which equates to more than 430 million people worldwide with this injury."

A pars fracture, also known as spondylolysis, is usually isolated to one side of the lower back and symptoms arise during activities such as twisting, bending or stooping. This injury may not cause a high level of pain initially, but if left untreated can cause more severe back pain, including a pars fracture on the opposite side.

"If spondylolysis is caught early, it can often heal with just rest and immobilization and taking a break from the sport or activity which caused the injury," said Hsu. "When this injury is not caught early, it can lead to more serious conditions including a slip of a vertebra, narrowing of the spinal canal, or compression of nerve roots. These conditions may require physical therapy, cortisone injections, or in severe cases surgery to correct the injury. "

To protect young athletes' spines, Hsu recommends being active in a multitude of sports that include diverse muscle groups.

"Especially while a child's body is still growing, moderation of anything is a good idea to achieve physical fitness while being cautious," said Hsu. "By varying the sport adolescent athletes can develop different core and major muscles groups to stabilize their spines and reduce some of the repetitive stresses of certain rotational sports."