To compensate, the large torque producing global muscles are used to stabilize the spine.In one study, patients are taught to train the co-contraction of deep abdominal muscles and lumbar multifidus in static postures, functional tasks and aerobic activities. This technique was shown to reduce pain and functional disability when compared to other conservative treatments. These results also had a long- term effect in reducing levels of pain and functional disability. This is because motor programming eventually became automatic, and conscious control was no longer needed to contract the deep abdominal muscles during activities. Activity restriction
Activity restriction of spondylolysis is advised for a short period of time once the patient becomes symptomatic, followed by a guided physical therapy program. Once spondylolysis has been diagnosed, treatment often consists of a short rest period of two to three days, followed by a physical therapy program. There should be restriction of heavy lifting, excessive bending, twisting and avoidance of any work, recreational activities or participation in sport that causes stress to the lumbar spine. Activity restriction can help eliminate and control a patients symptoms so they are able to resume their normal activities. Activity restriction is most commonly used in conjunction with other rehabilitation techniques including bracing. Bracing
Acute spondylolysis is most commonly treated through the use of an antilordotic brace (Boston brace) to control and limit spinal movement, and reduce stress on the injured spinal segment. Bracing immobilizes the spine in a flexed position for a short period to allow healing of the bony defect in the pars interarticularis.
The process is relatively non-invasive, performed through small incisions and has a high success rate. Laminectomy: Often performed when spinal stenosis occurs in conjunction with spondylolysis. The procedure surgically removes part or all of the lamina from the bony ring of the vertebra to reduce the pressure on the spinal cord. The laminectomy is commonly performed on the vertebrae in the lower back and in the neck. Implications for rehabilitation
Spondylolysis can have a huge impact on a young athletes career, and may impede their future ability to perform. It is important to understand how social and psychological factors may affect rehabilitation of an injured athlete. Frustration, anger, confusion, fear and depression are some of the psychological factors that injured athletes experience, therefore a debilitating injury can have a large impact on an athletes mental well-being. These psychological factors can also affect recovery and return to sport as fear of re-injury often prevents athletes from adhering to rehabilitation and returning to their sport at full intensity.Social factors can also impact the cognitive, behavioural and physical responses to injury. More specifically, social isolation from the team can have a profound psychological effect. This makes it essential to provide social support through supportive listening, emotional support, personal assistance, and reality conformation.It is also critical to educate the athletes on the rehabilitation process so they know what to expect. For instance, explaining what activities to avoid and will cause pain as well as the duration of the treatment process.