Child Orthopedics

Frequently Asked Questions

Our 15-year old son is hoping to be an Olympic diver. He's currently training at the U.S. Olympic training center in Colorado. We just found out that he has a condition called spondylolysis. The team physician says it may be related to his diving and he has to wear a brace and stop training for a time. How long will this take? Can he go back to diving?

Spondylosis is a defect in the pars interarticularis of the vertebra of the spine. Some experts say it's a stress reaction or stress fracture of the bony support of the spine. Children, teens, and adults can have this condition.

Stress reactions of this area of the spine have been reported in many athletes. Gymnastics, diving, football, and rowing seem to have the highest number. It's likely that loading the spine over and over while in a position of extension and rotation is the cause of the condition.

Bracing is used to immobilize the spine. Healing can occur, especially if the stress reaction or fracture is only on one side of the vertebra and it hasn't separated. Once the fracture separates, then the main body of the vertebra can slide forward over the bone below. Many more problems occur with this situation.

Expect a healing time of six to eight weeks. Your son should start to have less pain and improved spinal motion by the end of this time. Hamstring spasm will decrease as well. He will be allowed to start back with activities under the supervision of a physical therapist (PT) and the team sports physician.

Your son should be advised to continue with the specific exercises prescribed by the PT as long as he continues to train and dive. The muscles around the lumbar spine must be strengthened to maintain stability at each segment around the spondylolysis.

Follow-up X-rays and/or CT scans will help keep an eye on any progression of the condition. Any recurrence of symptoms should be reported immediately. Early treatment is really the key to avoiding further problems and complications. With the proper treatment and training, he should be able to go back to a full training schedule.

Ralph Cavalier, MD et al. Spondylolysis and Spondylolisthesis in Children and Adolescents: I. Diagnosis, Natural History, and Nonsurgical Management. In Journal of the American Academy of Orthopaedic Surgeons. July 2006. Vol. 14. No. 7. Pp. 417-424.

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