Non-Operative — Lumbar Spondylolysis / Spondylolisthesis (Acute & Chronic Non-Operative)

UW Health Sports Medicine · Julie Sherry, DPT, MS; Marc Sherry, DPT, LAT, CSCS; Scott Tauferner, PT, LAT…

Weight-Bearing

Full WB; no sports/impact 4-8 weeks; impact loading Phase 4+

Key Restrictions

Acute: 4-8 weeks complete rest/no sports participation, no active or passive lumbar extension Phases 1-2; brace if still symptomatic after 2-4 weeks rest; reduce backpack weight; avoid sleeping prone; vitamin D and calcium recommended; Chronic: activity reduction then immediate stabilization exercise — no bracing or extended rest

Timeline & Phases

ACUTE (5-phase): Phase 1 (4-8 wks): complete rest, abdominal bracing, stretching, no lumbar extension; Phase 2 (+1-4 wks): static stabilization, bridges, planks, no lumbar extension; Phase 3 (+2-4 wks): dynamic trunk stabilization, single-leg bridges, resume lumbar extension in non-WB; Phase 4 (+2-6 wks): athletic enhancement, impact loading progression (2-foot → bounding → single-leg hop), running; Phase 5: RTS/maintenance program. CHRONIC (2-phase): Phase 1: dynamic stabilization + sport modification; Phase 2: athletic enhancement + impact loading; Phase 3: RTS/maintenance.

Notes

Single document covering both acute/progressive (5-phase) and chronic (2-phase) spondylolysis/spondylolisthesis protocols. Healing rates: ~70% unilateral early, 28% progressive/terminal; 85% good clinical outcomes by year 1 regardless of bone healing. Deep abdominal and multifidus core training is central throughout. Authors: Julie Sherry DPT MS, Marc Sherry DPT LAT CSCS, Scott Tauferner PT LAT. Updated 4/2022.

Surgeon / Author

Julie Sherry, DPT, MS; Marc Sherry, DPT, LAT, CSCS; Scott Tauferner, PT, LAT; UW Health Sports Medicine physician group

Published

2022-04