PTOTSLPCase ReportInternational journal of sports physical therapy2021

Inter-Disciplinary Conservative Management of Bilateral Non-United Lumbar Pars Defects in a Junior Elite Golfer.

Simon L Brearley, Orlaith Buckley, Patrick Gillham and 2 others

PMID 33604152

WHAT IT FOUND

A 15-year-old golfer with bilateral lumbar pars fractures avoided surgery through a 12-month interdisciplinary exercise program.

He returned to competitive golf and accepted a college scholarship, remaining asymptomatic 18 months post-intervention.

Key findings

01The athlete remained asymptomatic and returned to pre-injury golf volumes 18 months after the intervention, with no further inter-vertebral slippage.

02Significant improvements in strength and trunk work capacity were observed after 12 months of rehabilitation, with deadlift loads increasing from 40Kg to 110Kg.

03The case highlights the benefit of graded exercise-based rehabilitation over the typically prescribed 12 weeks of rest alone for this condition.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

This is a single case report, so it cannot establish cause and effect or generalise to other patients. The intervention was multi-disciplinary, making it impossible to isolate the specific contribution of any single component, such as the physiotherapy exercises versus the golf swing technique changes. Follow-up was limited to 18 months, and long-term outcomes regarding bone healing or recurrent injury are unknown.

Declared interests

The authors report no conflicts of interest.

The easy way to misread this

Do not interpret this single successful case as evidence that conservative management always avoids surgery for bilateral pars defects. The outcome depended on a complex, multi-disciplinary intervention including specific golf swing changes, which may not be feasible or effective for all patients.

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