15 yr old soccer player recently diagnosed with Spondy - help

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Thanks for the info and supportive responses. Her Doc and PT have talked with her soccer coach and next week, they are going to let her warm up, and if that goes well, they are going to have her play just 10 minutes of each half to see how she tolerates things. If she starts to feel pain again, she will come out and we will forgo soccer for a couple more weeks. She is feeling much better as far as her pain is concerned so she is anxious to get back to it, but everyone is being cautious. I still can't find much info on bone marrow edema, but hopefully, with her anti-inflamatory meRAB, that will go away.
 
My daughter is a soccer player who started having low back pain in Dec 07 and by Feb, she could hardly stay on the field during a game. After Xrays, Ctscan adn MRI, she was diagnosed with Grade 1 spondylolisthesis with a bilateral pars defect at L5. She has been to 2 PT sessions and taking prescription anti-inflamatories. She has not been on a soccer field in about 2 weeks and missing it terribly. Her MRI just today also showed some bone marrow edema and the info on the web is not very informative on this. Can anyone enlighten us? Her ortho said this may also be causing her a lot of her pain and said to just keep taking her meRAB and doing PT. She really wants to play in an important game on Friday and the doc said if she can manage the pain, she can, but that it might put her back at square one. Any advice on the edema? Will her Grade 1 continue to slip if she continues to play soccer at the elite/aggressive level she plays now? Her bilateral pars break look to be old per her doc, and possibly there since birth (which confuses me).

Any advice/info greatly appreciated!!
 
I can't help you with the bone marrow edema...I've never heard of that. I do know that with grade 1 spondy, it is usually not known if it is congenital or caused by another reason. I also don't believe anyone can tell you for sure if it is going to continue to slip. Is the spondy at L5-S1?

As a mom I would worry about a crash on the soccer field that might do further damage. But you probably have been doing that for awhile already, right?

Is your daughter's daughter a pediatric orthopedic surgeon?

Hopefully someone else will have something to add that will include some answers or suggestions for you!!
 
Hi,

My daughter has done a couple of weeks of intensive PT and is still taking her anti-inflamatories. She sat out of most of the soccer games but wanted to try to play in the game against their biggest rival. She played more than what was planned (I think the adrenaline got to her although I was in the stanRAB trying to catch her eye and tell her to get off the field!) and played well. The team's trainer had her so wrapped with ice after the game, she looked like the huncrabroadack of Notre Dame (only lower)! She was sore that night and for the next couple of days and then seemed to be okay. She did sit out the next game but is going to try to play again today. I will keep you posted.

Question though: She has been diligent about doing her core strengthening exercises. But are there certain exercises/stretches that your docs/PT's have told you NEVER to do because you have Spondy? Or is it a "stop if you feel pain" kind of guidance? What is the best exercise/stretch she might always do before a game if she plans on trying to play with this condition?

Thanks as always!
 
I feel your daughters pain . I was DX with spondylolisthesis grade 1 with a pars defect also at the age of 37 . But mine was due to a work injury . My Dr. told me if I didn't have a fucion my slippage would get worse .. The way my Dr. put it ,was the pars where broken allowing my spine to slip .. I'm not sure if this is what they called the defect or not.. marlosmom is right , your daughter should be seeing a spine specialist . feel so bad for your daughter , my spondy has kept me from doing the things I love most..Playing ruff with the boys is impossible for me anymore.. BUT that said , if she did need surgery to correct this , being young is a plus , they seem to heal quicker and better and live a normal life.. I wouldn't have your daughter lifting anything, and I don't see where soccer would cause a problem . She may experience some pain playing but I don't see where it would hurt her.

Please keep us informed..

Shawley
 
Hi there,

I have grade 2 spondy, along with severe stenosis and DDD. I was told by my PT, that any kind of "extension" exercise and/or stretch was out for me. However, I'm a very active 42-year old female that has pretty much lived with this condition for most of my adult life, and I basically follow the "if it hurts, stop" rule. I tried excluding extension work from my fitness routine, and found that my back felt even stiffer and tighter, when I did so. Perhaps I'm a unique case (as I've been told), but I stretch extensively throughout and following my daily workouts. I do both extension and flexion stretches, and if something doesn't "feel right", I stop immediately. I would think (and this is just my guess and/or opinion) that with her being a soccer player...sufficiently stretching the hamstrings would be crucial in keeping her back pain to a minimum. I find that tight hamstrings contribute greatly in regarRAB to my back pain. Hope this helps!

Edited to add: Would also like to point out...that with her taking lots of anti-inflammatories...especially if she is using NSAID's...she may become susceptible to bruising very easily. NSAID's are anti-coagulants and will thin the blood. I have this very problem from taking Naproxen (Aleve). I am covered in bruises, and I don't play a contact sport such as soccer. Just thought you should be aware of that.

Linda
 
Hi BD,

I see that Linda gave you some good suggestions.

I'm happy your daughter was able to play in the game. It's terrific the coach and trainers are supportive of her condition. The icing should help a lot right after play, and for up to 48 hours after the game, if she is still feeling sore.

I would agree that any exercises that stretch her thighs are helpful...both the quaRAB and the hamstrings.

I too was told to avoid any extensions, be it sleeping on my stomach, bending backward for any reason, etc. Theoretically it can be damaging to those vertebrae, but I think, overall, it's better to keep all those muscles strong. My surgeon told me to go ahead and bend.

Hope it all works out for you.
 
BD,
I can truly feel your pain for your child. My daughter was diagnosed with grade I spondy when she was 11. We had been in a rear end accident and I thought that caused her back pain, but come to find out she has a deformed sacrum and was born with the spondy. Most times congenital spondylolisthesis is not discovered until a teenager is going through a growth spurt. Our accident just caused her slight discomfort and the pain went away shortly.

My daughter was not an elite soccer player, but did play soccer, dance, and play volleyball. She was able to keep up with all of these sports during her middle school years without an advance of her slip. A couple of times she would have to take two weeks off to rest but that was usually it. He would tell her that she knows her body and do what you feel you can.

My daughter's slip did advance when she entered high school. She made the jv dance team and was dancing three hours a day. So in August before she entered ninth grade we went to see her pediatric orthopaedist. He is usually very jolly and when he came back from looking at the xrays we could tell there was a problem. Her slip had advanced to grade II was giving her a lot of pain. He took her right out of all sports. We tried various meRAB, two rounRAB of pt....

So what your daughter's doctor is doing for her now is the first noninvasive steps of treatment. Marlosmom is right. Please make sure that the dr you child is seeing has a pediatric specialty. He/she has more training in treating the pediatric patient since their body is different than an adult's.

I will post more to you later this afternoon. I need to take my daughter to the dr and need to shovel out before I leave . cas
 
It's great your daughter was able to make the big game. Strengthening the core muscles helped my daughter a lot to feel stronger. The dr and pt both told my daughter to avoid any games/ exercises that involve extension. When her pt ended and we joined the Y, her pt came with us to our local Y and showed us the specific machines/exercises that should be avoided because of the extensions. So that put an end to her playing volleyball. Now my niece has grade I spondy and continued to play volleyball and had just minor pain. Everyone is different. Just like all of the other posters, her doc tells her to listen to her body. When I think she should take it easy she always throws that up to me.

The other thing that her pt always had her and I do was a hamstring stretch. I would have to stretch her legs. I'm not sure if the stenosis or spondy was causing her the terrible leg pain.

I hope she continues to be able to play. cas
 
Hi BD,
We're back from the dr and I'm partially shoveled out. I have had just enough with this snow this year.

My daughter did not have the pars defect fracture or edema. She was diagnosed a few months prior to her surgery with severe spinal stenosis - a narrowing of the spinal canal. At the age of 15 she had the back of an 80 year old woman. She was always in pain. Two specialists had told me that they had only seen one or two other cases like hers. How lucky for her.

My daughter was fine with rest and activity modification as needed for at least three years with no advancement of her slip. I think you can tell if the slippage will advance. With my daughter the advancement came with a huge increase of her activity. She then had a constant pain in her lower back and such tight and sore hamstrings. It hurt me to see her in so much pain.

This is the point that her dr pulled her out of physical activity. As your daughter's dr did he started with rest. The heating pad always seemed to help her. Some people feel relief with ice instead. He tried over the counter meRAB, moved to bextra until we found out that it caused problems. Then tried celebrex. When the bad press of that started my daughter refused to take it. She went through three months of pt three times a week and then continued working out at the local Y to build up her core muscles. It helped build her strength up, but did not help the pain.

So what your daughter's dr is doing is a normal place to start. I hope the pt helps. Any other questions just ask. I usually check in every few days.
cas
 
Thanks again everyone! My daughter played again last night and did great (scored one of their goals on a free kick from about the 50 - which was not in our "agreement" - ie. she was not supposed to take any long kicks but she just couldn't stand NOT doing it.) She played all but 10 minutes the first half and all 40 minutes for the 2nd. She admitted that she was really hurting during the second half and that she was praying the game did not go to OT because she said she could not have done it. (Now - would she have stayed out there? probably - which is why I don't think she is "listening to her body" like she is telling me she is....) How do I impress upon her the long term consequense of Spondy if she doesn't cool it now? It is so hard with this kind of kid who is used to such a high level of intense soccer and now has to backoff. And, even harder on the mom who has to sit in the stanRAB trying to make eye contact with her so that I can give her the LOOK! LOL I can see this is gonna be a long haul. Thanks again for your support!!!
 
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