Brearley Simon L, Buckley Orlaith, Gillham Patrick, Clements Bryan, Coughlan Daniel
Cranleigh School; England Golf; European Tour Performance Institute.
European Tour Performance Institute.
Int J Sports Phys Ther. 2021 Feb 1;16(1):236-247. doi: 10.26603/001c.18873.
The prevalence of spondylolysis amongst adolescent athletes presenting with low back pain has been reported as high as 47-55%. Youth athletes participating in sports involving movements combining compression, extension and rotation appear most susceptible. As such, young golfers are a high-risk group, particularly given the high shear and compressive forces associated with the golf swing action. This is compounded by a culture which encourages very high practice volumes, typically poorly monitored. Although non-operative interventions are deemed the gold-standard management for this condition, surgery is indicated for more severe presentations and cases of 'failed' conservative management. The case presented herein outlines an inter-disciplinary, non-operative management of a 17-year old elite golfer with a moderate to severe presentation. A 4-stage model of reconditioning is outlined, which may be of use to practitioners given the paucity of rehabilitation guidelines for this condition. The report highlights the benefits of a graded program of exercise-based rehabilitation over the typically prescribed "12 weeks rest" prior to a return to the provocative activity. It also supports existing evidence that passive therapeutic approaches should only be used as an adjunct to exercise, if at all in the management of spondylolysis. Finally, and crucially, it also underlines that to deem non-surgical rehabilitation 'unsuccessful' or 'failed', clinicians should ensure that (long-term) exercise was included in the conservative approach.
4-Case Report.
据报道，在出现腰痛的青少年运动员中，椎弓根峡部裂的患病率高达47%-55%。参与涉及压缩、伸展和旋转相结合动作的运动的青少年运动员似乎最易患病。因此，年轻高尔夫球手是高危人群，特别是考虑到与高尔夫挥杆动作相关的高剪切力和压缩力。这种情况因一种鼓励大量练习且通常缺乏有效监督的文化而更加严重。尽管非手术干预被认为是这种疾病的金标准治疗方法，但对于更严重的病例和保守治疗“失败”的情况，则需要进行手术。本文介绍的病例概述了一名17岁精英高尔夫球手中度至重度病情的多学科非手术治疗。文中概述了一个分4阶段的康复模式，鉴于针对这种疾病的康复指南较少，该模式可能对从业者有用。该报告强调了基于运动的分级康复计划相较于通常规定的在恢复刺激性活动前“休息12周”的益处。它还支持现有证据，即被动治疗方法在椎弓根峡部裂的治疗中，如果要使用的话，也只能作为运动的辅助手段。最后，至关重要的是，它还强调，要认定非手术康复“不成功”或“失败”，临床医生应确保在保守治疗方法中包含（长期）运动。
4 - 病例报告。
