Gymnastics is a tough sport and aches and pains often come with the territory, but how do you know when it’s something that can be treated with icing and ibuprofen, or when it’s time to take your child to see a doctor? Many gymnasts are used to training through discomfort and may even have a higher threshold for pain than most people, so they don’t always speak up as soon as something hurts. Parents and gymnasts may worry about missing training or missing out on a big meet and put off seeking treatment out of fear of being sidelined, but ignoring an injury is likely to lead to a longer recovery time.
When is it time to see a doctor?
“For a chronic injury I recommend seeking treatment if the pain has gone on for longer than five days in a row, or if the gymnast has experienced the pain every other day for more than two weeks,” says Dr. Elspeth Hart, DScPAS, PA-C, MPAS, ATC, LAT.
The founder of the nonprofit, Gymnastics Medicine: Education and Research, Dr. Hart runs a Boston-area clinic treating gymnastics injuries with the goal of getting athletes back to their sport.
“The sooner you seek treatment, the better,” says Dr. Hart. “The hardest thing is when a gymnast comes in with something like three to six months of back pain. Usually, it will take at least that long to be able to return to the sport.”
Pay attention when your child begins complaining of pain and check back in to see if it is continuing. Things like stretching, massage, or physical therapy all may be part of the recovery process, but only after you have gotten a medical diagnosis.
How long will recovery take?
Recovery time depends entirely on the diagnosis. Minor injuries may only require a few days or a few weeks of modified training, while a serious chronic injury requiring surgery could take up to twelve to eighteen months to fully heal. No gymnast ever wants to miss out on training, but with the proper diagnosis and treatment Dr. Hart finds that most kids are able to get back into the gym.
“Most kids do recover from their injuries. Ninety percent of the time kids are able to get back to gymnastics,” she says.
However, Dr. Hart warns that it’s important to follow the treatment and recovery plan and not rush back into training too soon, which can lead to a ripple effect of further injuries.
“The biggest thing we see is that gymnasts want to compete and perform. They don’t want to miss training, so they sometimes try to go back too soon. Rehab is an important piece. It takes time to build back up. For example, I tell gymnasts that three weeks in a boot equals three weeks to get back to regular training,” Dr. Hart says.
The best plan is for your gymnast to wait to return to training until he or she is fully cleared, continue with any PT that has been prescribed, and back off if pain returns.
What are the most common gymnastics injuries?
According to Dr. Hart, research shows that the most common gymnastics injury is an ankle sprain, while the second most common is knee internal derangement (either a meniscus or ACL tear), however, these aren’t the injuries she sees most often among the gymnasts who come to her for treatment. Below are the top three most common injuries Dr. Hart sees in gymnasts:
Low back pain is the number one complaint among gymnasts because the sport requires repetitive hyperextension and twisting of the spine. It’s also the symptom that seems to scare parents the most. Facebook groups and gymnastics forums are full of questions from parents seeking advice about their child’s back pain, often looking for reassurance that back pain may be nothing serious. The key is seeking a medical diagnosis as soon as possible. The doctor will perform a physical exam and may order imaging. X-rays sometimes detect a spinal fracture, but often an MRI or a CT scan is required. In cases where there is no sign of a fracture your doctor may prescribe physical therapy, massage, or a brief period of rest. If your child does have a spinal fracture, it does not necessarily mean the end of gymnastics.
Spondylolysis is a stress fracture or defect in a vertebra, while Spondylolisthesis is the slipping of all or part of one vertebra forward on another vertebra. Treatment for both typically includes a period of rest and may include the use of a back brace. Surgery is sometimes needed for patients with spondylolisthesis with severe or high-grade slippage or more than fifty percent displacement. Physical therapy is usually required to help prevent further injuries to the spine. With proper treatment most gymnasts are able to return to the sport.
Gymnast wrist can occur when athletes with open growth plates perform weight bearing or pounding exercises on their hands, which leads to injury and inflammation of the radial growth plate. Gymnasts may have tenderness on their wrists at the site of the growth plate, decreased motion, and pain when bearing weight on their hands. Typically, gymnast wrist is diagnosed with a physical exam, x-rays, and possibly an MRI. Treatment depends on the severity of the case. Some gymnasts may recover after rest, immobilization in a brace or cast, and physical therapy, but more severe cases may require surgery.
Osteochondritis Dissecans of the elbow
Often referred to as OCD, this joint condition occurs from repetitive impact that leads to a lack of blood flow to the bone and cartilage. In gymnasts Osteochondritis Dissecansis most commonly found in the elbow. Symptoms include swelling at the elbow, tenderness at the elbow with rest or movement, loss of motion in the elbow, and gymnasts may experience the feeling that the elbow is locking or catching. Non-surgical treatment typically requires bracing, physical therapy, and somewhere between three to nine months of rest. Surgical treatment is needed if the condition is unstable and will not heal on its own. According to Dr. Hart, surgery for OCD of the elbow often requires surgery with up to a year to a year and a half to fully recover.
If your child is experiencing chronic pain, the best bet is to seek treatment as quickly as possible so that they can get on the road to recovery and return to the sport they love.
Jen Kula is a Massachusetts based writer, and mom to two gymnasts. She has published one novel, has worked for several magazines and websites including; MetroSports Boston magazine, Appalachian Mountain Club Outdoors Magazine, and Babyzone.com, and has an MFA in Creative Writing from Emerson College.