Multiple Pars Interarticular Stress Fractures in a Male Collegiate Soccer Goalkeeper

Advisor Information

John Bartle

Location

Dr. C.C. and Mabel L. Criss Library

Presentation Type

Poster

Start Date

4-3-2016 10:45 AM

End Date

4-3-2016 12:15 PM

Abstract

An NCAA division I male soccer goalkeeper (21-year-old, height=184.15cm, mass=80.8kg) complained of pain in low back on December 2, 2014. He indicated a dull ache around his L4 and L5 vertebrae and just lateral of the spine. The pain was noticeable upon kicking, back extension, sitting and standing for a long time. He had palpable tenderness to the left of the spine at his L4 and L5 vertebrae. Bone imaging single-photon emission computerized tomography and computed tomography indicated stress fractures through the right L4 pars and the left L5 pars. A team physician and back specialist instructed him to rest 10 weeks. After the rest, the specialist recommended limiting activities. After the period, the athlete began a rehabilitation protocol. The physician prescribed vitamin D3 4000-5000 IU and calcium 500mg once daily. He received soft tissue mobilization using Gua Sha® tools and passive muscle contraction through electrical stimulation. He returned to soccer practices 13 weeks after initial diagnosis. Fractures of the pars in adult soccer players are uncommon, compared to other sports and adolescent athletes. Moreover, the presence of multiple concurrent fractures is unusual. Clinically, lumbar stress fractures are also difficult to assess and diagnose. Pars stress fractures are uncommon in collegiate soccer athletes. However, athletic trainers should be reasonably suspicious in goalkeepers with excessive lumbar hyperextension. Furthermore, patients who report persistent non-specific back pain should be referred for further evaluation.

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Mar 4th, 10:45 AM Mar 4th, 12:15 PM

Multiple Pars Interarticular Stress Fractures in a Male Collegiate Soccer Goalkeeper

Dr. C.C. and Mabel L. Criss Library

An NCAA division I male soccer goalkeeper (21-year-old, height=184.15cm, mass=80.8kg) complained of pain in low back on December 2, 2014. He indicated a dull ache around his L4 and L5 vertebrae and just lateral of the spine. The pain was noticeable upon kicking, back extension, sitting and standing for a long time. He had palpable tenderness to the left of the spine at his L4 and L5 vertebrae. Bone imaging single-photon emission computerized tomography and computed tomography indicated stress fractures through the right L4 pars and the left L5 pars. A team physician and back specialist instructed him to rest 10 weeks. After the rest, the specialist recommended limiting activities. After the period, the athlete began a rehabilitation protocol. The physician prescribed vitamin D3 4000-5000 IU and calcium 500mg once daily. He received soft tissue mobilization using Gua Sha® tools and passive muscle contraction through electrical stimulation. He returned to soccer practices 13 weeks after initial diagnosis. Fractures of the pars in adult soccer players are uncommon, compared to other sports and adolescent athletes. Moreover, the presence of multiple concurrent fractures is unusual. Clinically, lumbar stress fractures are also difficult to assess and diagnose. Pars stress fractures are uncommon in collegiate soccer athletes. However, athletic trainers should be reasonably suspicious in goalkeepers with excessive lumbar hyperextension. Furthermore, patients who report persistent non-specific back pain should be referred for further evaluation.