It's most often that young athletes experience a stress fracture in one of their lower vertabrae, a condition called spondylolysis. The wrong jump, jar or twist in gymnastics or football, for example, leads to a crack in one of these small back bones — usually the fourth or fifth lumbar — resulting in pain in the lower back. You may feel radiating sensations through the buttocks and legs, muscle strain and extra pain when moving, but less with rest.
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While young athletes are most commonly afflicted because their spines are still maturing, the condition can affect just about anyone who experiences repeated stress to the low back. In most cases, spondylolysis isn't a life sentence, but resolves with treatment, rest and time.
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Your physical therapist may assign you specific exercises to relieve pain, prevent excessive hamstring tightness and reduce stiffness.
One of the reasons your vertabrae were vulnerable to injury is a delay in engagement of your deep core muscle, the transverse abdominis. This exercise trains this muscle to engage on impact or when twisting, thus supporting your trunk — especially your lower back.
Perform the draw-in: Lie on your back on a mat or other supportive surface. Bend your knees and plant them about hip-distance apart. Rest one hand on your abdomen. Inhale and as you exhale, pull your bellybutton in and push your back toward the floor. Hold for several seconds, release and repeat. Alternatively, perform the draw-in from all-fours and hug your belly button toward your spine without overly arching your back.
The dirty dog teaches you how to brace your core while your limbs move. This is valuable in sports or daily life. It's an easy exercise, but requires some body awareness to ensure you don't overly tilt your pelvis.
Perform a dirty dog: Get onto all-fours. Brace your abdominals and, keeping your knee bent at 90 degrees, lift your leg out to the side. Prevent your hips from dropping to one side — envision a cup of water resting on your lower back. Do at least 10 on one side, then switch.
Bird dogs continue the process of retraining your movement patterns, so you're more stable through your core. Just like with the dirty dog, keep your pelvis level and your core tight.
Perform bird dogs: Get onto all-fours. Brace your abdominals and level your pelvis. Inhale and extend your right arm forward and your left leg back. Do your best to straighten the knee and elbow joints and keep the limbs parallel to the floor. Hold for a count or two, release and switch sides. Alternative for 10 to 15 rounds.
Hip bridges train your glutes and abdominals to support your spine.
Perform hip bridges: Lie on your back on a mat and bend your knees, planting your feet about hip-distance apart. Inhale and raise your buttocks up off of the floor. Hold for 1 to 3 seconds and replace them down. Repeat 10 to 20 times, using control.
To advance the move, raise one leg while your buttocks are lifted. Reach this leg toward the front of the room at an angle; the knees should remain parallel. Repeat on both sides for the duration of the set.
Medicine balls and stability balls assist you in your rehab from spondylolysis. These train your trunk muscles to move with control and proper engagement to support your spine. Possible options might be plank holds with your legs on a stability ball, reclined twists on a stability ball and standing rotations holding a medicine ball.
Remember to clear exercises with your physical therapist or doctor first, and that dynamic activity usually comes later in your therapy. Also, whether or not these are appropriate for you depends on the nature of your injury and your rate of healing.
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