When an adult has low back pain, it is usually a muscle or joint problem that settles with time and movement. When a teenage athlete has back pain that keeps coming back, the picture can be different, and it is worth knowing why.
In young athletes, one important and often missed cause of persistent low back pain is spondylolysis, a stress fracture in a small part of the spine. Here is what spondylolysis is, why it is more common in young athletes than adults, what tends to help, and when a young person's back pain deserves a closer look.
In this article
What is spondylolysis?
Spondylolysis is a stress fracture in a small bridge of bone in the lower spine called the pars interarticularis. It develops from repeated loading rather than a single injury, particularly movements that arch the back and twist, done over and over in training.
Because it is a stress reaction in growing bone, it behaves differently from the everyday back strain most adults experience. Recognised early, it generally responds well to a period of load management and guided rehabilitation.
Why is it more common in young athletes?
Young athletes are more prone to spondylolysis because their spines are still developing and they often play sports that repeatedly load the lower back into extension and rotation. Common examples include:
- Cricket, especially fast bowling with its arch-and-twist action
- Gymnastics, dancing and diving with repeated back-arching
- Football codes, particularly positions that involve a lot of extension
- Any sport with high training volumes and rapid increases in load
The combination of a growing spine and repetitive extension load is what makes this a young-athlete problem more than an adult one.
How often is it behind a young athlete's back pain?
This is the part that changes how seriously a young person's back pain should be taken.
Early recognition matters
Recognised early, spondylolysis is generally managed well with a period of load management and guided rehabilitation before a staged return to sport.
In plain terms, a lingering back pain in a teenage athlete is far more likely to involve a bony stress problem than the same complaint in an adult, which is why early assessment matters.
What does it feel like?
Spondylolysis in a young athlete often shows up as:
- Low back pain on one side that has built up gradually over weeks
- Pain that is worse with arching backwards or twisting
- Pain that eases with rest and flares with training or competition
- Back pain that keeps returning rather than settling for good
If a young athlete has back pain like this that is not settling, it is worth getting assessed rather than pushing through.
What helps spondylolysis?
The encouraging news is that many young athletes recover well with a clear, staged plan. Care usually focuses on calming the stressed bone, then rebuilding strength and control before a graded return to sport. This often includes:
- An assessment, and where needed appropriate imaging arranged through a doctor, to confirm the diagnosis
- A period of relative rest from the aggravating loads, such as fast bowling or repeated back-arching
- Progressive core and trunk control work to support the lower spine
- A gradual, monitored return to training and competition
- Guidance for coaches and parents on managing training load
A physiotherapist can coordinate this and work with the young athlete, their family and their coach. If you would like guidance, our team offers physiotherapy with a physiotherapist in Mount Gravatt for young athletes and families across Brisbane's southside.
When should you seek help?
Consider getting assessed if
A young athlete has low back pain that has lasted more than a couple of weeks, pain that is worse with arching back, or pain that keeps returning with sport. Seek prompt medical review if there is leg weakness, numbness, changes to bladder or bowel control, night pain, fever or unexplained weight loss, so more serious causes can be ruled out and the plan tailored to them.
Helping You Perform at Your Best
At ACE Sports Medicine in Upper Mount Gravatt, our physiotherapists provide personalised assessment and rehabilitation for young athletes with back pain, for families across Brisbane's southside. We will assess the back, coordinate any imaging through your doctor if needed, and build a staged plan and return-to-sport pathway.