Back in Play: Dr. Farah Musharbash Helps Young Athletes Heal from Pediatric Pars Fractures
Back pain in young athletes isn’t always “growing pains.” Persistent symptoms may indicate a pars fracture.
Most people think of back pain as an adult problem. But for young athletes, it can signal something far more specific and often overlooked.
Dr. Farah Musharbash, an adult and pediatric spine specialist at Atlantic Brain and Spine (ABS) in New Jersey, sees this all too often: a teen gymnast whose performance suddenly declines or a young wrestler who winces through every drill.
Back pain in teens and children is often written off as “growing pains,” but it can reflect something deeper – a small stress injury called a pars fracture, also known as spondylolysis.
“When detected early, pars fractures heal well,” explained Dr. Musharbash. “When ignored, they can lead to chronic pain and long-term consequences for a developing spine. It’s important to take young patients’ pain seriously.”
Watch Dr. Musharbash explain treatment options
Understanding Pediatric Pars Fractures
The pars interarticularis is a thin section of bone that connects the upper and lower joints in the spine. It acts as a stabilizer, absorbing the strain of movement. When that bone weakens or develops a small crack, the condition is known as spondylolysis.
Pars fractures are very common, occurring in roughly 3-10% of children and adolescents. Nearly 40% of young athletes with persistent lower back pain lasting more than two weeks receive a diagnosis of spondylolysis. Spinal stress fractures are especially frequent in sports requiring repeated bending or twisting, such as:
- Dance
- Diving
- Football
- Gymnastics
- Weightlifting
In more advanced cases, the fracture causes one vertebra to slip forward over another, a condition called spondylolisthesis. Left untreated, it can lead to significant pain or nerve damage.
“The physical demands on young athletes’ bodies are incredible,” said Dr. Musharbash. “When we combine growth with intense training and repetition, the spine can develop stress points that need real attention.”
Recognizing the Signs of Spondylolysis in Young Athletes
For parents and coaches, it can be hard to tell the difference between fatigue and something more serious. But there are a few clear warning signs that deserve closer attention.
- Persistent lower back pain, sometimes radiating into the buttocks or legs
- Stiffness or tight hamstrings that limit flexibility
- Difficulty arching the back or performing extension-based moves
- Unconsciously avoiding certain positions or movements
- In more advanced cases, tingling, numbness, or weakness in one or both legs
Unlike a muscle strain, pain from a pars fracture tends to persist beyond a few days and may flare with specific movements like backbends or kicks.
“When a young athlete says their back hurts, it’s not something to push through,” said Dr. Musharbash. “Their body is telling us something important.”
Why Expertise Matters in Diagnosing Pars Fractures
Pars fractures can be difficult to identify with early imaging. Evaluation by an experienced spine surgeon can mean the difference between healing without surgery and prolonged pain.
At the Spine Center at ABS, diagnosis begins with a detailed physical exam to identify pain patterns, flexibility, and muscle strength. Imaging may include CT scans or MRI to identify breaks or detect early-stage inflammation before the fracture line appears.
As an orthopedic spine surgeon specializing in both adult and pediatric spines, Dr. Musharbash understands how growth plates and developing bones develop under stress.
“During growth spurts, children’s spines are more vulnerable to overuse,” he explained. “Early diagnosis helps prevent permanent issues later in life.”
Treatment Pathways: Healing Without Setting Kids Back
The majority of young athletes recover with conservative treatment if their condition is caught early, although more advanced cases may require surgical intervention.
Non-Surgical Care
Initial treatment focuses on rest and activity modification while maintaining safe movement with low-impact activities like walking or gentle cycling. Physical therapy helps restore strength and flexibility, particularly in the core and hamstrings. Braces can provide certain patients with additional support.
Two-thirds of children with early-stage spondylolysis heal within four months with activity modification. With proper rest and rehabilitation, most athletes can return to their normal sports performance within three to six months.
When Surgery Becomes Necessary: Robot-Assisted Pars Repair
If pain persists despite conservative care, or imaging shows spinal instability or nerve irritation, surgery may be required. Traditional fusion surgery stabilizes the spine but limits flexibility – a tradeoff many young athletes want to avoid.
Atlantic Brain and Spine offers an alternative: minimally invasive robotic pars repair, a technique introduced into the region by Dr. Musharbash. This advanced motion-preserving approach stabilizes the fracture while maintaining the spine’s natural movement.
Dr. Musharbash performed the first outpatient, minimally invasive pediatric pars repair at Atlantic Health, underscoring his commitment to innovation and faster recovery for young athletes.
“The goal is to get kids back to what they love while protecting their spine for life,” he noted.
When Surgery Is Needed:
What Recovery Can Look Like
For the right patient, robotic pars repair can restore stability while preserving motion—helping young athletes return to sports safely and efficiently.
✔ Back to sports within 3 months
Precision with Purpose: The Benefits of Robotic-Assisted Pars Repair
Using 3D navigation and robotic guidance, Dr. Musharbash places small titanium screws to repair the fracture and stabilize the spine. The system maps each patient’s anatomy in real time, allowing for unmatched precision while minimizing trauma to the muscles and tissue.
Key benefits of robotic-assisted surgery are:
- Same-day or outpatient procedure
- Lower risk of complication
- Less pain and minimal scarring
- Faster recovery and return to activity
- Preservation of natural spine motion
“The robotic-assisted, motion-preserving approach represents the next generation of pediatric spine surgery,” Dr. Musharbash explained. “We’re using cutting-edge technology to give kids back their mobility, safety, and confidence.”
Long-Term Outlook and Prevention
With timely diagnosis and the right care plan, the outlook for young athletes with pars fractures is excellent. Most heal completely and return to full activity, and those who require surgery often resume sports before the season is over.
After recovery, continued physical therapy and conditioning help rebuild strength and coordination while lowering the risk of re-injury. Preventive steps include:
- Building strength in the core and hamstrings
- Cross-training to reduce repetitive stress
- Practicing proper technique in extension-heavy sports
- Allowing rest between seasons or competitions
“Prevention begins with awareness,” emphasized Dr. Musharbash. “When parents, coaches, and athletes recognize the early signs of back pain and act quickly, we can protect young spines and keep kids active for years to come.”
Choosing a Pediatric Spine Specialist
Pediatric spine care requires a different perspective. Children aren’t just smaller adults – their spines are still growing and adapting.
Dr. Musharbash’s experience with adult and pediatric spines gives him unique insight into spinal development, allowing him to identify early patterns in young athletes that might lead to chronic problems later. As one of the top pediatric spine specialists in New Jersey, he works with a multidisciplinary team of neurosurgeons, physiatrists, and rehabilitation specialists to deliver treatment plans that support both immediate healing and lifelong spinal health.
“When treated early and appropriately, a pars fracture doesn’t have to define a young athlete’s story,” Dr. Musharbash said. “It can be a chapter of resilience, teaching them to listen to their bodies and come back stronger.”
If your child is experiencing persistent back pain, don’t wait.
Early evaluation can make all the difference. Schedule a consultation with Dr. Farah Musharbash at Atlantic Brain and Spine to explore all the options that help young athletes heal safely and return to what they love.
