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Son has been dealing with what we thought was a tight muscle in his lower back for almost a month.  Unfortunately, learned yesterday the muscle was actually a symptom and the real problem was a Pars Fracture of the L4 vertebrae.  So far, the doctors have not indicated any concern about the healing process and expect a full “return to sport” recovery.  That’s the good news and son has a great attitude so far even though it means missing the key college recruiting months of June and July.  MRI is scheduled to verify the degree and if any other stress fractures exist so we’ll know more soon.  If anyone has insights, suggestions, or good resources to investigate, it would be greatly appreciated.

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I just saw this post, so sorry for the late reply. Before my son's sophomore year (2007) he had a similar issue. it is a repetitive motion injury also called spondylolysis, which is a defect in the pars interarticularis. My son's was with the (L5) and was bilateral (caused by both batting - hits left and throwing - throws right). 

This can be plenty debilitating and will not go away unless properly treated. Typically you need to see an sports orthopedic doctor who deals with children (sports pediatric orthopedics) and it is helpful if they have dealt with this type of injury before (not all will have). X-rays or an MRI will not typically show the injury, a CT scan almost always will (likely you will need to push to get a CT scan).

 

After healing, PT must follow to further develop the core and hip flexors prevent a return of symptoms, or they will likely return. We went through a very frustrating time with this injury until my son received the right type of PT. We actually had my son go to 4 different doctors before we found the right one. So, if you are not getting the answers you need, look elsewhere.

 

There is plenty of information on this if you look up spondylolysis on this site. As well, this post may prove helpful: http://asmiforum.proboards.com/thread/1100

 

The good news is my son totally recovered from this and is currently entering his senior year in college, as a D1 P/OF. He has had no further issues. 

 

Best of luck and please reach out using the dialog feature (PM) if I can be of help.

Last edited by birdman14

My son was diagnosed with spondylolysis 3 yrs ago.  We have struggled to find a doctor to take his desire to stay in the game seriously, even though we have been seen with a spine specialist at a top sports medicine facility.  His pars are clean breaks on both sides of his L5 & he shows some signs of progression to the spondylolisthesis.  3 yrs of 3 month stints in rehab, he was sidelined his entire junior year.  We started seeing a pain management doctor in May & he had the facet joint injections done 2 wks ago.  He actually feels better at this point than he has in a couple years.  Birdman... when you say totally recovered, do you mean that his pars have healed on their own?  We were told they would not heal by themselves & I am not sure if that is because his were complete breaks or not.  The injections are our last hope at keeping him healthy & back on the ball field for his senior year with high hopes of being able to continue at the next level. 

Thanks Birdman.  Glad your son's situation ended well.  We're dealing with only one pars, but it is a complete fracture (it was clearly visible on the x-ray). They also did an MRI to check for any other concerns.  They did not find any.  I suspect the combination of pitching, hitting, and weight training all contributed to the initial discomfort and the eventual fracture.  It is possible he has actually been dealing with this for over a year but, until the bone completely fractured, he was able to work through it.

 

Fortunately, our instincts about the first ortho doctor got us to a much better doc (pediatric and sports med) so I'll echo your suggestion (and those from your other links) about finding the right doc.  First doctor did not even suggest a brace until we asked for it and only limited physical activities to things that did not cause pain.  Not good protocol for an active 16 year old boy.

 

It has been 4 weeks and he's wearing the brace 23 hrs a day.  Yes, it does need frequent washing!  Physical activities are limited to walking and a recumbent bike at the YMCA.  We also purchase a CMF device (electromagnetic therapy) that he uses for 30 minutes a day.  The better doc used this for his son (also had a pars fracture).  Doc felt the CMF device improved the healing process and likely shortened the recovery period by 2-3 weeks for his son (took 16 weeks to "return to sport").  My son goes back for a follow-up next week.  Sure hoping for some good news, but realize it is still early in this process.

 

Thanks again for the reply, info, and advice.  

What I recall the doctor telling us was, that my son's fractures were not completely separated and the healing that occurred was fiburous (sp) healing. He did not use a brace and by the time we got him to a doctor and had a CT scan, it showed the healing had already occurred on the right side. We did not have anything significant (except edema (sp)). He was able to return to hitting very quickly, but throwing and pitching took significant time.

 

His injury occured in August 2007. He was able to throw off flat ground fairly quickly, but had difficulty pitching, or more specifically throwing from a mound, until this spring 2009. He went through a year as a position player only. I had talked to someone else on this site who's son went through a similar recovery time. 

 

Every situation is slightly different, and it sounds like both of your situations are different then my boy's. I just wanted to stress how important the PT was in my son's case. Hopefully both of your situations end up how ours did. 

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