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Answer to your Health Question


I have been taken out of hockey for 4 weeks due to a L5 stress fracture and want to know if I can come back.

I am almost pain free but I still get shooting pains down my legs and my back is agitated a little when I bend backwards.



Dear Madyhikop,

A stress fracture, medically known as Spondylolysis, is the most common overuse injury of the lower back in sport.

The most common site for Spondylolysis is the bottom-most lumbar vertebra, called L5, where the mobile lumbar spine meets the fixed pelvis.

This is because this vertebra is subject to most stress during sports.

The continuous hyperextension common in sports such as hockey is one of the causes of L5 stress fracture.

When your pain decreases to the level that you can start physical therapy, rehabilitation focuses on strengthening and stretching the abdominal muscles, the lumbar spine muscles, and other core muscles.

Return to play hockey can take several weeks to many months.

Some doctors do not wait for x-rays to show complete healing of the region, but rather they slowly allow the player to get back to play hockey as his symptoms improve and he can tolerate the demands of the sport.

You can play hockey as long as you do not have pain.

You may need to change hockey to one sport that does not involve hyperextending the back.

If your doctor thinks the break is new and that the bones could heal, he or she may recommend wearing a brace for one to three months.

Spondylolysis is a chronic problem. It is very important to keep your back in the best possible physical condition.

Do not become overweight.

You can best prevent these conditions by having strong back and abdominal muscles and by avoiding being overweight.

If you have spondylolysis you may be able to prevent progression to spondylolisthesis by doing back exercises and by avoiding forced back extension activities.

It is important to have strong abdominal muscles when the structures of your spine are weakened. These exercises help build strong stomach muscles.

The goal of rehabilitation is to return you to play hockey as soon as is safely possible.

If you return too soon you may worsen your injury, which could lead to permanent damage.

Everyone recovers from injury at a different rate.

Return to play hockey will be determined by how soon your back recovers, not by how many days or weeks it has been since your injury occurred.

In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

It is important that you have fully recovered from your low back pain before you return to play hockey or any strenuous activity.

You must be able to have the same range of motion that you had before your injury.

You must be able to run, jump and twist without pain.

Do you have any other questions? Enter your health question

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