Lumbar Spondylolysis in Female Indoor Volleyball Athletes

Abstract Background: Spondylolysis is a common cause of back pain in adolescent athletes, though little is known about spondylolysis in volleyball. This descriptive study aims to compare historical, physical examination, imaging and treatment outcome differences between female volleyball athletes and female athletes from other sports Methods: Retrospective chart review of female athletes aged 10-20 years diagnosed with spondylolysis over a 17-year period were divided between volleyball and non-volleyball athletes was performed. Demographic, injury history, physical exam findings, diagnostic imaging findings, treatments, return to sport and duration of care information was collected and analyzed. Results: Volleyballers with spondylolysis are significantly older than non-volleyballers (16.0 vs. 14.75 years, respectively; p<0.001). Responses to history questions are similar between groups with exception of the report of lower extremity weakness. Physical exam findings were also similar between the groups except for pain with active and/or passive range of motion, which was present in 97% of volleyball athletes (vs. of other sports, 73.8%; p<0.001). Stork testing showed a significantly greater negative predictive value in volleyball athletes. Athletes playing the outside hitter position were significantly more likely to be affected, and more likely to suffer a unilateral left-side injury compared to other positions, and all injuries were in front row players. Duration of care was significantly shorter for volleyball players who were treated exclusively with home exercises compared to formal physical therapy and with non-bracing compared to bracing. There were no differences in duration of care between volleyballers and non-volleyballers. Conclusions: Several statistically significant differences exist between female volleyball athletes and female athletes from other sports. Athletes may be cleared to return to sport sooner if treated exclusively with home exercises and/or non-bracing instead of formal physical therapy and/or bracing. Outside hitters are at greatest risk for spondylolysis and are much more likely to have left-side injuries.