 While these injuries are common in the adolescent population there is very little research to guide treatment of these patients, particularly with rehabilitation. Conservative standard of care with the treatment of spondylolysis and spondylolisthesis injuries are to rest from sport, brace the lumbar spine, and begin physical therapy and return to sport as the patient is able. There is some evidence to show that patients should rest for 12 weeks prior to returning to sport, otherwise there is an increased risk of injury El Rassi, 2013. There currently is no research to suggest when to begin physical therapy. Physical therapy for rehabilitation and return to sport is a part of standard of care, but recommendations for beginning therapy vary widely and are not supported by evidence. A concern for beginning physical therapy too soon is that the fracture will not have adequate time to heal and re-injury can occur. While a concern for waiting too long to begin therapy is increased muscle atrophy, high fear avoidance beliefs, and unnecessarily long avoidance of activity. 