Managing Young Athletes with Mild Spondylolisthesis

Spondylolisthesis is a condition where one vertebra slips forward over the one below it. While it can affect individuals of all ages, young athletes—especially those involved in gymnastics, football, weightlifting, and other sports that place stress on the lower back—are particularly susceptible. Managing mild spondylolisthesis in young athletes requires a balanced approach to ensure continued participation in sports while minimising the risk of progression or discomfort.

Understanding Mild Spondylolisthesis in Young Athletes

Mild spondylolisthesis (Grade 1) is often asymptomatic or presents with manageable lower back pain, tight hamstrings, or stiffness. It typically results from repetitive hyperextension of the spine, which places excessive stress on the pars interarticularis, leading to defects that allow slippage.

Key Management Strategies

1. Activity Modification

While complete rest is not always necessary, modifying activities that involve excessive spinal extension, rotation, or heavy axial loading can prevent further irritation. Coaches and trainers should adjust training routines to reduce stress on the lumbar spine.

2. Strength and Stability Training

Developing core stability is crucial for young athletes with spondylolisthesis. Strengthening the deep abdominal and spinal stabilisers can help reduce excessive movement in the affected segment and provide better support for the lower back. Key exercises include:

• Core stabilisation: Dead bugs, bird-dogs, and planks

• Glute and hip strengthening: Glute bridges, clamshells, and hip thrusts

• Postural control: Exercises focusing on maintaining a neutral spine

3. Flexibility and Mobility Work

Tight hamstrings and hip flexors can exacerbate lumbar stress, so incorporating flexibility routines is beneficial. Stretching the hip flexors, hamstrings, and quadriceps while ensuring proper pelvic positioning can relieve tension in the lower back.

4. Chiropractic and Manual Therapy

Evidence-based chiropractic care, including soft tissue therapy, spinal mobilisation, and individualised rehabilitation exercises, can aid in symptom management. Chiropractors can also guide young athletes on maintaining optimal spinal mechanics to prevent worsening of the condition.

5. Sport-Specific Considerations

Athletes should work with coaches and healthcare providers to modify techniques that minimise spinal stress. For example:

• Gymnasts should focus on controlled movements rather than excessive hyperextension.

• Football players should avoid drills that require repetitive back bending.

• Weightlifters may benefit from alternative lifts that place less strain on the lumbar spine.

6. Monitoring and Gradual Return to Play

Regular monitoring of symptoms and periodic imaging, if necessary, can help track the progression of spondylolisthesis. Once pain and stability improve, a gradual return-to-sport program should be implemented, ensuring the athlete can tolerate increased loads without pain or compensation.

When to Seek Professional Help

Persistent or worsening pain, numbness, or weakness in the legs may indicate nerve involvement and should be evaluated promptly. Early intervention with a healthcare professional, such as a chiropractor at Epoch Health, can help young athletes manage their condition effectively while staying active in their sport.

Conclusion

Mild spondylolisthesis does not have to sideline young athletes if managed appropriately. With a combination of activity modification, strength training, mobility work, and professional care, athletes can continue to perform while reducing the risk of progression. If your young athlete is experiencing lower back pain, consult Epoch Health to develop a personalised management plan.