Non-Operative — Spondylolysis / Spondylolisthesis — Conservative Management (Youth Athlete)

Massachusetts General Hospital · MGH Brigham Pediatric Sports Medicine

Weight-Bearing

N/A

Key Restrictions

Cessation of athletic activity recommended >=3 months; AVOID lumbar extension (Phase I-III); bracing per physician to limit extension and rotation; bracing may be discontinued once pain-free with ADL; close physician collaboration required for phase progression; discharge: 0% Micheli Functional Scale, full pain-free ROM all planes, pre-injury performance

Timeline & Phases

Phase I (0-6 wks, 2-4 visits): active rest, avoid lumbar extension, TA/MF isometrics in spine-supported positions, hip strengthening, aerobic (treadmill/bike/Nu-Step); Phase II (6-9 wks, 4-6 visits): neutral trunk stabilization (plank, dead bug, bird dog), hip strengthening, closed chain LE, aerobic progression; Phase III (9-12 wks, 4-6 visits): anti-rotation exercises, squat/deadlift progression, plyometrics, return-to-run; Phase IV (12+ wks): sport-specific, full return to play with monitoring

Notes

06/2024; key distinction from postural back pain: lumbar extension strictly avoided Phases I-III; athletics cessation >=3 months; bracing may be recommended; Micheli Functional Scale outcome measure; close physician collaboration; pars interarticularis stress fracture considerations. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2025-11-15.]

Surgeon / Author

MGH Brigham Pediatric Sports Medicine

Published

2024-06