Pars stress fractures are common in athletes, especially in those who participate in high-impact sports such as gymnastics, running and soccer. The fracture occurs due to repetitive stress on the pars interarticularis, which is a portion of the vertebral arch in the lower back. Over time, the stress causes small cracks in the bone that can eventually lead to a complete fracture. The pathophysiology of the injury is related to the repetitive stress on the bone, combined with poor bone density and inadequate recovery time. To treat a pars stress fracture, we focus largely on reducing stress on the affected area, promoting healing through movement and even the use of Shockwave therapy, and improving the athlete's overall strength and stability. Dynamic core work, sled pushes/pulls, and specific exercises to improve hip stability can help achieve these goals. A specific return-to-sport plan would be tailored to the individual athlete and could involve a gradual progression of activity, as well as a focus on proper technique to prevent further injury and ease back into competition.
