Objective: To describe a novel approach in treating a teenage athlete with spondylolysis of the L5 vertebrae using Dynamic Neuromuscular Stabilization principles.
Clinical Features: A 15-year-old female softball pitcher presented with progressive low back pain following a tournament. MRI revealed acute bilateral pars interarticularis fractures at L5 with bone marrow edema pattern, without anterolisthesis.
Intervention and Outcome: She was treated with therapeutic exercises, spinal manipulation, and soft tissue therapy over 8 weeks. Therapeutic exercises were organized according to Dynamic Neuromuscular Stabilization principles, focusing on optimizing core stabilization during functional movements. She experienced significant improvements in pain (reduction from 7/10 to 1/10 on the Visual Analog Scale), increased pain-free range of motion, and safely returned to her sport.
Conclusion: This case suggests that interventions combining manual manipulation, soft-tissue therapy, and therapeutic exercise based on Dynamic Neuromuscular Stabilization principles may be beneficial in conservatively managing pars interarticularis injuries in adolescent athletes.
Author keywords: Dynamic Neuromuscular Stabilization; Spondylolysis; Conservative Care; Chiropractic; Manual Therapy; Pars interarticularis
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