Spondylolysis is the term used for a fracture in the supportive posterior portion of the spine that keeps the vertebrae in alignment. Because the fracture is usually located in the pars interarticularis, smalls sections of bone that connect the vertebra to the spine, the injury is often referred to as a pars fracture or defect.
This type of injury is most often found in the L-5 vertebra, which is the lowest vertebra in the lumbar (lower) region of the spine and therefore receives the most pressure from strenuous activities.
Why is martial arts training particularly conducive to spondylolysis?
The training and practice in martial arts involves repetitive twisting of the lower back in punching, kicking, throws, and other practices. Striking and kicking heavy bags also creates stress in the lumbar region of the back as
Performing jumping kicks causes stress to the lower back both from hyper-extension of the spine when performing midair kicks and repetitive shock to the lower spine as the feet hit the floor during landing and the L-5 vertebrae absorbs the shock the weight of the entire spinal column pressing down upon it.
What are the symptoms of spondylolysis?
The L-5 vertebrae is the closest vertebra to the sciatic nerve, which is the longest nerve in the body and runs from the lumbar region of the spine to the feet. When a fracture occurs, the vertebra may come out of alignment and irritate the sciatic nerve.
This may cause intense pain anywhere along the path of the nerve, such as the buttocks, legs, or feet. It may also cause numbness or tingling in various parts of the legs or feet.
If the fracture is limited to one side, the pain or irritation will also be restricted to one side of the body. The symptoms can range from mild irritation to debilitating pain that can last for days or weeks before subsiding.
How can spondylolysis be diagnosed?
X-rays can be used to detect some fractures, but advanced imaging techniques such as MRIs can provide a much better picture of the extent of the fracture and the best path to healing.
Spondylolysis is often not found until an unrelated traumatic injury occurs or pain becomes consistent or unbearable, because the symptoms can be relatively benign for an extended period and mistaken for simple muscle aches.
How is spondylolysis treated?
Most fractures can be treated by limiting training and taking over-the-counter painkillers until symptoms subside
Core exercises, which strengthen the abdominal and lower back muscles that support the spine, are often beneficial in reducing the recurrence and severity of future issues.
These activities can be incorporated into regular training when it is resumed. Training should be gradually increased to its former level after a spinal injury. Competitions and heavy sparring (fighting practice) should be curtailed until symptoms are completely gone.
However, if a compound fracture occurs or a congenital defect is present, where the connecting bone is completely separated from the vertebrae, neurological services and treatment may be necessary.
In these cases, the vertebra may come out of alignment, irritating or damaging the spinal or sciatic nerves. Surgery may be necessary in these cases.
A neurologist can use titanium rods and screws to fuse the two lower vertebra together, keeping them in perpetual alignment. Surgery is always a last resort. Pain from scarring issues are always possible in back surgeries, and spinal fusion will limit the natural flexibility of the lower back.
Of course, when you have experienced an extended period of excruciating lower back or sciatic pain, a titanium rod in your back doesn't seem like a bad choice at all. Contact a professional like Mohsen M. Hamza, M.D. to learn more.Share
26 October 2016
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