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Pars Fracture in Football Players

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Introduction

Football is a physically demanding sport that places significant stress on the spine. One injury that football players may encounter is a pars fracture. In this blog post, we will explore what a pars fracture is, its causes, available treatment options and rehabilitation techniques for football players dealing with this injury.

What is a Pars Fracture?

A pars fracture, also known as spondylolysis, is a stress fracture that occurs in the pars interarticularis, a small bony bridge connecting the vertebrae in the spine. The fracture typically affects the lower lumbar region, most commonly the fifth vertebra (L5). Pars fractures often result from repetitive hyperextension and rotation of the spine, which can happen during activities like football that involve repeated jumping, twisting, and bending movements.

Symptoms of Pars Fracture

Here are some common symptoms associated with pars fractures:

  • Back pain: Footballers with a pars fracture often experience localised back pain, specifically in the lower back (lumbar spine) area. The pain may be dull, achy, or sharp in nature. It can worsen with activities that involve extension or rotation of the spine, such as kicking, sprinting, or jumping.
  • Pain during exercise: The pain associated with a pars fracture is typically exacerbated during physical activity. Footballers may feel discomfort while performing movements that place stress on the lower back, such as bending backward or twisting the torso.
  • Limited range of motion: Footballers with a pars fracture may experience a reduced range of motion in the spine. They may have difficulty bending backward (extension) or rotating the torso freely due to pain and stiffness.
  • Muscle tightness or spasms: In response to the injury, the muscles surrounding the affected area may become tight or go into spasm. This can contribute to additional discomfort and further restrict the footballer’s mobility.
  • Radiating pain: In some cases, the pain from a pars fracture may radiate to other areas, such as the buttocks or thighs. This can be due to irritation of nearby nerves as a result of the fractured bone.
  • Aching or discomfort during rest: While rest may provide some relief, footballers with a pars fracture may still experience aching or discomfort in the lower back, even during periods of inactivity.

Causes of Pars Fracture

The main cause of pars fractures in football players is overuse and repetitive stress on the spine. Some contributing factors include:

  • Mechanical stress: Activities that involve repetitive extension and rotation of the spine, such as frequent jumping or excessive lumbar hyperextension, can lead to increased stress on the pars interarticularis.
  • Rapid growth: Football players going through the adolescent growth spurt during ages 14-18 years old are particularly at risk of pars fractures.
  • Sudden changes in training load: Sudden increases in training frequency or intensity can place excessive stress on the spine leading to pars fracture.
  • Muscle imbalances: Muscle imbalances, particularly weakness in the core and lumbar stabilisers, can result in excessive stress on the pars interarticularis.
  • Biomechanical factors: Biomechanical factors such as posture and movement patterns during football-specific actions may contribute to increased stress on the spine and the development of pars fractures.

Assessment of Pars Fracture

Accurate assessment of a pars fracture is crucial for determining the severity of the injury and planning appropriate management strategies. The assessment process may involve:

  • Medical history and physical examination: A thorough discussion of symptoms, previous injuries, and a physical examination to evaluate the affected area for tenderness, range of motion, and any associated muscle imbalances or postural abnormalities.
  • Diagnostic imaging: Imaging modalities such as X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI) may be used to confirm the presence of a pars fracture, assess its location and severity, and identify any potential complications.

Treatment Options for Pars Fracture

The management of pars fractures in football players typically involves a combination of conservative measures aimed at reducing pain, promoting healing, and restoring spinal stability. Treatment options may include:

  • Rest and activity modification: Avoiding activities that exacerbate symptoms, allowing the fractured pars to heal. Most pars fractures take between 3-4 months to heal but more severe cases may last 4-6 months.
  • Nutritional factors: It is necessary to have appropriate protein, calcium and vitamin D intake, as well as being in a positive calorie balance to optimise healing of a pars fracture.
  • Pain management: Pain levels can be managed with therapeutic techniques such as icing, massage, acupuncture or over the counter pain relief such as paracetamol.
  • Physiotherapy: A structured rehabilitation program focused on core stability exercises, flexibility training, and posture correction to address muscle imbalances, improve spinal stability, and prevent future injuries.
  • Gradual return to activity: As symptoms improve and spinal stability is restored, a gradual return-to-activity program should be implemented under the guidance of a qualified sports physiotherapist. This includes progressive reintroduction of football-specific movements, drills, and eventually full training and match play.

Products that may help

Voltarol Gel – Available here

This can be applied to the irritated part of the back to help reduce pain and inflammation.

Vitamin D Supplementation – Available here

Vitamin D contributes to normal immune, muscle and bone function. The body produces it naturally through exposure to sunlight. However during the autumn and winter months, most footballers Vitamin D levels will drop. It is therefore essential for footballers to supplement their diet during this period to protect their overall health as is it is not present in most foods. All SOCCER SUPPLEMENT products are rigorously batch tested under the Informed-Sport program.

Foam roller with mini bands – Available here

The foam roller can be used for self massage on the lower back and other muscle groups. The mini bands are useful for strengthening or muscle activation work.

Massage Gun – Available here

The massage gun can provide effective relief from tight and sore muscles in the lower back.

Muscle Stimulator – Available here

The muscle stimulator has a TENS machine setting which can provide pain relief for tight and spasmed muscles in the lower back.

Rehabilitation Techniques for Pars Fracture

The rehabilitation process for pars fractures typically involves the following techniques:

  • Core stability exercises: Strengthening the muscles of the core, including the abdominals, back extensors, and pelvic stabilisers, to provide support and stability to the spine.
  • Flexibility and mobility exercises: Stretching exercises targeting tight muscles, particularly the hip flexors and hamstrings, to improve overall flexibility and reduce stress on the spine.
  • Postural factors: Addressing any postural imbalances or faulty movement patterns that may have contributed to the development of the pars fracture.
  • Progressive strength training: Gradually introducing resistance exercises to strengthen the muscles surrounding the spine, focusing on controlled movements and proper form.
  • Functional training: Incorporating football-specific movements, such as agility drills and sport-specific exercises, to enhance overall performance and prepare for a safe return to play.

Conclusion

Pars fractures can be a challenging injury for football players, affecting spinal stability and overall performance. Understanding the nature of the injury, its causes, and appropriate management strategies are vital for successful recovery. Through a comprehensive approach that includes accurate assessment, appropriate treatment options, and a structured rehabilitation program, football players can effectively manage pars fractures.

It is essential to work closely with a qualified healthcare professional, such as a sports physiotherapist, who can guide the recovery process and ensure a safe return to the football field. Recovery time can vary depending on the severity of the fracture and individual factors, but it is typically expected to take 3-6 months for the injury to fully settle. Patience, adherence to the rehabilitation program, and gradual progression are key to achieving a full recovery and returning to football at peak performance.

Further Reading

Cheung et al, (2018) – Pars interarticularis injury in elite athletes–the role of imaging in diagnosis and management

Linton et al, (2022) – A review of treatment for acute and chronic pars fractures in the lumbar spine

Kukreja et al, (2020) – Spondylolysis and spondylolisthesis in the adolescent athlete

Mistiaen et al, (2020) – Case report: successful conservative treatment of a soccer player with multiple-level spondylolysis

Disclaimer

The information provided in this article is for educational purposes only and should not substitute professional medical advice. Always consult with a qualified healthcare professional for diagnosis, treatment, and personalised recommendations based on your specific condition. Some affiliate links may also be used in this article, these are from products we have specifically selected to display based on our own experience.

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