Pars Stress Fracture - Here's another one

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Me_and_my_big_mouth

witty softball quote
Sep 11, 2014
437
18
Pacific NW
Just got the dreaded phone call after a CT last night: stress fracture, L5. It's stable and we caught it early, so that's a good thing. We won't know until Monday what the course of treatment is, but from everything I've read and heard, the treatment is zero activity for at least 8 weeks. Try looking into the eyes of a 13 year old pitcher and dropping that bomb at the start of the season, without welling up. I dare you.

My dd went outside to be alone, and is "processing" right now. And me? I am stuck in a loop of, "What could I have done differently?" I know it doesn't do any good to do that to myself, but I keep thinking back to those days - and one tournament in particular - where I knew her back was hurting. I went to Walgreens and got Icy Hot, Advil, and an Ice Pack and was so proud of my dd because she was SO tough and played hurt! What in the heck were we thinking?? My parent of the year award is getting taken down off the mantle today! :mad:

I can second the sentiments of others on this board when I say: 1) Warm them up properly 2) Make them rest 3) Recognize that stress fractures are common (it's been estimated that as many as 30% of athletes between the ages of 11-17 will get them) and are primarily caused by OVERUSE. And when I say rest, I mean at least 6 weeks of zero activity during the Winter. We went just as hard all Winter as she has this Spring, and in hindsight I would've just put on the brakes and said NO WAY.

My heart is broken for my kiddo. She just got onto a team that she adores and couldn't wait to play with. She had one tournament with them, and now she's sidelined. Will she be fine? Yep - because setbacks are just life, and we know that she'll take this in stride and bounce back - but I sure wish I would've known when she began pitching at 11 how important those rest periods are. I know now, and it's a crappy lesson to have served up at the beginning of the season. If we had recognized the symptoms and gotten the tests done back in September, she would've been healed and ready to rock right now.

Hope this helps others out there who might be wondering whether or not they should pursue further treatment. You will be told it's muscle tightness (that was her pediatrician). You will be told it's poor mechanics (that was a well-meaning coach who wanted her to use H/E style instead). You will be told it's facet syndrome (that was her orthopedist). You will be told she needs to strengthen her core because it's probably weak (that was PT). You will told she needs yoga (that was my weird step-mother). Who really knows? It goes back to overuse - and rest.

I chose to listen to bucket pinata and not screw around. Thanks to his story, I think I was able to get ahead of this and be my dd's advocate in the face of everyone else telling us we were crazy when we suggested a fracture. Thanks, man.

I will echo what everyone else says: DEMAND THE DANG CT.
 
Jul 16, 2013
4,659
113
Pennsylvania
My heart is broken for my kiddo. She just got onto a team that she adores and couldn't wait to play with. She had one tournament with them, and now she's sidelined. Will she be fine? Yep - because setbacks are just life, and we know that she'll take this in stride and bounce back - but I sure wish I would've known when she began pitching at 11 how important those rest periods are. I know now, and it's a crappy lesson to have served up at the beginning of the season. If we had recognized the symptoms and gotten the tests done back in September, she would've been healed and ready to rock right now.

I hope your DD has a quick and completely recovery. Based on the circumstances, it sounds like you are handling the situation very well. There are many people out there that would benefit from your advice. It is too easy to think "it won't happen to me". My DD has just recently returned from an elbow injury that kept her out of HS practice for over a month. As a freshman, this delay/setback was brutal to her, but she has come back strong, and showed a great deal of maturity throughout the recovery process. So, yes, it can happen to anyone. And as you have stated, setbacks happen, but pitchers can be very resilient. Good luck!!
 
Dec 7, 2011
2,368
38
Know that you are one of MANY MANY pitcher parents going through this or have gone through this.

2-3 years ago I documented here in DFP all the trials & tribulations of my DD and our family went through in getting through her pars break which led to an aggravated SI joint that finally all went away. But that was after almost 2 years of health & game impact to DD.

It's incredibly tough on your DD AND on you. I have been there. If it's any consolation, in our case, it has produced a young lady who I believe has learned she can conquer ANYTHING and has matured her well beyond others her age. I trust this will be a result for you too. But being in the middle of it right now sucks,....I know.... (DD & I have the song "what doesn't kill you makes you stronger" as our anthem from this experience)

You did not do anything wrong. You were providing an avenue for your DD to express her skills and competitiveness. All us parents, if we knew this was going to be a result, would steer our DD's away from the risk. But the softball community AND the medical community does NOT know what the true risks and facts are with pars breaks in pitchers. You can't protect your children from what you do not know about.

The only "fact" I took away from the whole experience is a simple one => every 12 months a young pitcher (10-18yrs old) should take roughly 7 weeks off with NO torso-tourque. This is the only way to ensure that the pars bones get a chance to repair any micro-fissures.

Best wishes to you & your DD
 
Feb 17, 2014
551
28
Question for you guys that have gone through this before or are going through it.

How much do other sports play into this?

Here's DD's story and why I am asking.

I'm not sure if DD specifically has a pars stress fracture because the doctor didn't use those terms. He did say DD has a stress fracture of the S1. Friday we go back to the doc after 4 weeks. I know she's not getting released to play. I assume he's going to tell her she doesn't have to wear the brace any more.

So, DD pitched all through the winter, at least once a week at lessons. Some weeks twice a week, with an occasional 3 times in a week. She also took hitting lessons every week, once per week. Her team also had indoor practice every Saturday. DD made to most of them unless she had a basketball conflict.

As far as basketball goes, she plays travel basketball as well as school basketball. Before school ball started, she practiced for travel twice a week. They played 1 game every Saturday and 2 every other Sunday. Once school ball started, they practiced every day unless there was a game. No travel practice, but they did keep the weekend schedule since there wasn't a conflict with school ball.

And to top it all off, she would go to strength & agility classes at the high school if she was free that night.

The doctor said the injury was caused by overuse. It is a fairly common injury in kids her age that play lots of sports. DD is 12 years old.

Since he said it was an overuse injury, I asked him what the risks were if she followed the same regimen this coming winter and he said there was no risk. He has never had a patient with this injury have a recurrence of the injury.

I've seen this injury mentioned a lot with pitchers. I know of 1 other girl in our area with the same injury and she is a pitcher. On this forum, I believe I have only seen it mentioned with pitchers.

The plan going into this winter once she recovers it to keep playing basketball, but take December & January off from pitching & hitting lessons to give her a body rest from softball activities.

Any other advice is very welcome.

EDIT - one other thing, DD started having back pain sometime around with bucket pinata mentioned his DD's issues here. That thread made DW & I take DD to the doctor much sooner than we would have without it. So, thanks, bp!
 
Oct 22, 2009
1,781
0
Spleen, my DD had (2), one on each side. Doctor said the same thing, overuse. She played no other sport. She was 14.

Hers was about as serious as it gets. Couch rest all summer. When fall started and she went back to school, no carrying anything. She had to have someone take all her books to her coaches class, and then he had someone take her books to each class. By winter she was allowed to carry books and have light activity. She did go back to pitch in Spring, because she begged to pitch for the high school team, and I agreed but made her also take that summer off. --so that was (8) consecutive months of no pitching and two summers off.

Her injury did not reoccur and she went on to play 4 years of college as the main pitcher all 4 years.
 
Oct 4, 2011
663
0
Colorado
My DD suffered two bulging discs and two stress fractures this past fall during HS season. In my research into the injury, I found a high prevalence with pitchers (SB and baseball), golfers and basketball players.

DD had zero activity for about 4 weeks, then she started PT. No softball at all for 4 months, then gradually working back into swinging a bat and pitching. She pitched 7 innings over two days this past weekend, which is the most she has pitched so far. She is 8 months into her recovery.

I might be careful about basketball, but listen to your doctor and see how your daughter feels. I let my son play basketball five weeks after a collar bone break because he was starting to get a little depressed. I figured his mental outlook on life was more important than the possibility of re-breaking his collar bone. Keep an eye on your DD's mental outlook; though my experience has been that with these types of back injuries complete rest is usually the best course of action.
 
Last edited:
Dec 7, 2011
2,368
38
I'm not sure if DD specifically has a pars stress fracture because the doctor didn't use those terms. He did say DD has a stress fracture of the S1.

Is it a pars interarticularis break or some other? It IS important to define what kind of spine break it is. Pars are from repetitive torque-stops of the twisting toreso (for the most part - even though some feel/say it is furthered by the impulse on the kinetic chain from the plant foot). Other breaks can be from other sources is all I am saying.
 
Dec 7, 2011
2,368
38
Is it a pars interarticularis break or some other? It IS important to define what kind of spine break it is. Pars are from repetitive torque-stops of the twisting toreso (for the most part - even though some feel/say it is furthered by the impulse on the kinetic chain from the plant foot). Other breaks can be from other sources is all I am saying.

Oh - and my daughter was in volleyball, as a hitter, and I think that lent to it too.
 

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