WAG elbow dislocation/surgery & continuing pain

[pinklemonadeliz]

I know there have been several threads about elbow dislocation and associated surgery to reattach the medial epicondyle. I've responded to one with my kiddo's story & it's pretty typical (over-rotation of back tuck on tramp - put arm out when bailing - dislocation of elbow w/ surrgery to re-attach medial epicondyle w/ a screw). She bounced back quite quickly (accident in late Aug '15 & competing Jan '16) but...

She's been having some significant pain - especially lately - to the point that some nights after she's done a long bars rotation she literally cannot straighten her elbow until the next morning :-( She had a workout of over-doing it last Wed night & she's still in pain (had to scratch bars & fell on her bwo on beam because of it).

We've been to three sports med / ortho surgeons (including an elbow specialist) and all of them are telling her that the elbow has healed perfectly & there's absolutely nothing they can do about her pain (except to quit). She's in no way ready (either in her head or her heart to let gym go) so I'm feeling a bit desperate to find someone who can help her.

I know this is a really common injury in gymnasts so I'm sure she can't be the only one who has this problem - is anyone else familiar with the continued pain issue and if so, what did your docs do for you/your kiddo??

Thanks!!

 

[stacy]

I know there have been several threads about elbow dislocation and associated surgery to reattach the medial epicondyle. I've responded to one with my kiddo's story & it's pretty typical (over-rotation of back tuck on tramp - put arm out when bailing - dislocation of elbow w/ surrgery to re-attach medial epicondyle w/ a screw). She bounced back quite quickly (accident in late Aug '15 & competing Jan '16) but...

She's been having some significant pain - especially lately - to the point that some nights after she's done a long bars rotation she literally cannot straighten her elbow until the next morning :-( She had a workout of over-doing it last Wed night & she's still in pain (had to scratch bars & fell on her bwo on beam because of it).

We've been to three sports med / ortho surgeons (including an elbow specialist) and all of them are telling her that the elbow has healed perfectly & there's absolutely nothing they can do about her pain (except to quit). She's in no way ready (either in her head or her heart to let gym go) so I'm feeling a bit desperate to find someone who can help her.

I know this is a really common injury in gymnasts so I'm sure she can't be the only one who has this problem - is anyone else familiar with the continued pain issue and if so, what did your docs do for you/your kiddo??

Thanks!!

 

[stacy]

My daughter fractured right elbow and broke both bones in left forearm.We thought elbow was doing well until recent X-ray,and now getting a pin put in this week or next.Im definitely following your story.Hope for a good outcome for your daughter.Mine hasn't done any gym since the accident beginning of December.

 

[rsm]

Sorry she is still feeling pain. I don't have a good answer for you. DD had a dislocation in Oct, no surgery. The last x-ray showed that it had healed fine and she just had to get back full range in the elbow. She just got back to doing full practices two weeks ago. She can do what is tolerated, but if there is pain, she wouldn't do more with her arms. The first few days she did have some pain and swelling after practice. I kept her home the next day to make sure the swelling and pain were gone before doing more with her arms. Last week, she was able to do some consecutive practices and she is slowly working up to using her arms for more. We ice every day after practice and she doesn't try to straighten or bend much until the next day anyway. I would suggest cutting back on bars and vault for a little and taking the recovery a little slower. Vault actually seems worse than bars for this particular injury, and pounding when it's not straightening is not a good thing to do.

 

[GymRays]

My DD fractured her humerus just above the elbow. Needed surgery and pins. She's out of the cast now and pins have been removed. She isn't allowed to put weight on it yet but is doing PT to gain back range of motion. Also massage therapy from me (I'm licensed). She also has nerve damage so she is working on gaining back proper function of her thumb and index finger.
I would recommend seeing a massage therapist that is familiar with sports massage. So much happens to the soft tissue and muscles around injuries like these. Massage is a great way to improve range, decrease pain, and healing the soft tissue now that the bones are healed.

 

[NY Dad]

I can't help but I thought I would join the elbow support thread. It sounds like my dd's fracture was similar to WSCoachWL's dd (hers was supracondylar humerus at the beginning of Jan). I know each case is different but her PT said that mobility was the most important thing in the beginning. They don't want her focusing on strength until she's got her full mobility. She told me after school yesterday that she was doing her arm stretched at school. We still haven't been given the green light for gymnastics, still just conditioning. (And truthfully since we've been focusing so much on her PT she isn't really doing much of that either). I'm going to his comment to me when I asked about strength training (I didn't think I even implied gymnastics)

... she still does not have full range of motion and until total motion is restored she should not be doing advanced strengthening let along full on gymnastics. Therapy is an investment in her long term well being so that she doesn't return too fast and risk getting hurt again; her bone needs to continue to get stronger and learn to accept weight/compression, return of motion, restore full strength of grip, elbow, and shoulder, and re-coordinate her gymnastic specific skills

We thought elbow was doing well until recent X-ray,and now getting a pin put in this week or next

That doesn't sound right. Was she in a cast? Were you getting regular X-rays? We had been told that was likely going to happen and that there was no drawback in taking the wait and see approach regarding pinning. (But they were referring to the first 2 weeks). They X-rayed my dd weekly for the first 4 weeks. At week 3 they said that unless she fell the bone wouldn't just slip since (you'll have to excuse my lack of medical knowledge/terminology) the bone starts sticking to itself and the healing has started.
Sorry to hear about the setback.

 

[LizzieLac]

So sorry to hear this. Have the docs done a recent Xray or MRI? Maybe she has tendonitis or some other elbow issue not related to that injury. I would ask for some diagnostic tests or imaging to be sure about what is going on. Hope she feels better and it turns out to be nothing!

 

[stacy]

She

I can't help but I thought I would join the elbow support thread. It sounds like my dd's fracture was similar to WSCoachWL's dd (hers was supracondylar humerus at the beginning of Jan). I know each case is different but her PT said that mobility was the most important thing in the beginning. They don't want her focusing on strength until she's got her full mobility. She told me after school yesterday that she was doing her arm stretched at school. We still haven't been given the green light for gymnastics, still just conditioning. (And truthfully since we've been focusing so much on her PT she isn't really doing much of that either). I'm going to his comment to me when I asked about strength training (I didn't think I even implied gymnastics)



That doesn't sound right. Was she in a cast? Were you getting regular X-rays? We had been told that was likely going to happen and that there was no drawback in taking the wait and see approach regarding pinning. (But they were referring to the first 2 weeks). They X-rayed my dd weekly for the first 4 weeks. At week 3 they said that unless she fell the bone wouldn't just slip since (you'll have to excuse my lack of medical knowledge/terminology) the bone starts sticking to itself and the healing has started.
Sorry to hear about the setback.

 

[pinklemonadeliz]

So sorry to hear this. Have the docs done a recent Xray or MRI? Maybe she has tendonitis or some other elbow issue not related to that injury. I would ask for some diagnostic tests or imaging to be sure about what is going on. Hope she feels better and it turns out to be nothing!

The elbow never straightened to "0", it's probably at 5degrees, which is made worse by the fact that the other arm hyper-extends to probably -10degrees so there's a big difference between the two & she had to learn to do many skills all over again to accommodate the different length arms. At one point the PT thought the recurring pain might be tendonitis because of the short arm trying so hard to straighten out all the time & gave her a "strap" for it - seemed to help for a few days & then stopped working.

She had Xrays when we went back a few months again when the pain started coming back & it didn't indicate anything abnormal. She hasn't had an MRI (can she have one with screw in the bone?) - they've never mentioned getting one. We've seen two sports med surgeons (her original and a 2nd opinion) plus original consulted with an elbow specialist - they all pretty much said that "it is, what it is" & the only thing she could do to alleviate the pain would be to quit doing gym.

I know this is such a common injury (her coaches daughter on a college team told her many of the girls on the team had suffered the same injury & they all healed up fine) so I'm just having a hard time, not only watching her suffer, but accepting the fact that this is the best it will get.

 

[LLmom]

Get an MRI to be sure...but another thought...have you had her in a brace or tape to prevent hyperextension? Sometimes elbows look fine/normal for normal people. But gymnasts often hyperextended naturally or during specific skills. It could be that she lacks a few degrees (you said 5) but that when she uses the elbow at a high level it is being forced past and that's causing overuse-type pain. If you give it a little extra support to stay at zero or even missing the last 5 degrees it might make her feel better.

 

[pinklemonadeliz]

Get an MRI to be sure...but another thought...have you had her in a brace or tape to prevent hyperextension? Sometimes elbows look fine/normal for normal people. But gymnasts often hyperextended naturally or during specific skills. It could be that she lacks a few degrees (you said 5) but that when she uses the elbow at a high level it is being forced past and that's causing overuse-type pain. If you give it a little extra support to stay at zero or even missing the last 5 degrees it might make her feel better.

Originally, the doctor told her she wouldn't need a brace, but with the recent pain, she's been using a light support one (sleeve with wraps in both directions) - she says it doesn't seem to help any I emailed the Dr last night to see if he could get her in, so hopefully we can see what he can do (although the last words from all three previously was that nothing could be done ) Got a message last night from a super helpful parent whose kiddo had same issues and had screw removed which alleviated the pain - definitely going to explore that option also when we get in to see doc.

 

[Deleted member 14190]

It's not that common and i have lost kids and had kids come back. sorry to hear, But she needs to get her arm totally straight. scar tissue is build up.

 

[B&M's mom]

My daughter has had elbow issues and continuing pain issues so we've been down that road. In terms of the elbow flexation, that's difficult to recover the missing degrees. When my DD broke her elbow, they kept it moving because the ortho told us that if they lose flexation, they tend not to get it back. So, that may be a continual problem.

In terms of the continual pain issue, for my DD it was her knee. She had a couple of pins put in to fix an OCD lesion. She was never out of pain even after she was told that it was completely healed. She actually had another lesion in her other knee that didn't hurt as much as the repaired one. We ended up switching docs when the first refused to do anything about the repaired knee on the basis that it was healed. She was also told to consider quitting. The new doc did an MRI and found that the bone hadn't completely healed in the year following surgery. He thought it would be fine but kept an eye on it. Despite being cleared to train, her pain level got worse. Finally a second MRI confirmed that she had developed a cyst around the pins. So they had to go in and remove the cyst and pins. There was also some cartilage damage because of the cyst. The rehab was long and during the process she decided to retire from gymnastics on the basis that she needed her knees for the rest of her life. She still has pain occasionally. She's now diving and loving it.

There's no easy answer with this. Apparently things are never the same after surgery despite all the doctors saying otherwise. I know that we were really frustrated when she kept being told that it was fine and she could work out despite the pain. She really wanted to go back to gymnastics but frankly I was very relieved when she decided it was done.

 

[pinklemonadeliz]

It's not that common and i have lost kids and had kids come back. sorry to hear, But she needs to get her arm totally straight. scar tissue is build up.

I agree, the lack of straightness is probably contributing to the issue - she was in a tension splint for a good month & when in it she could zero out the elbow, but the problem is that the other arm hyper- straightens so she would never be able to get the injured elbow like the other.

 

[Deleted member 14190]

I agree, the lack of straightness is probably contributing to the issue - she was in a tension splint for a good month & when in it she could zero out the elbow, but the problem is that the other arm hyper- straightens so she would never be able to get the injured elbow like the other.

Just get it straight , or she will end up with tendon issues etc... She has to force it straight slowly every day.

 

[pinklemonadeliz]

I will have her start doing her PT exercises again - thanks!!!

 

[rsm]

We were told that DD needed to have her arm straight before tumbling and vault. She is about 2 degrees off and has just started tumbling on floor again in the last week. Her other arm does not hyper extend so both are pretty close. She started bars about a month ago and that has helped with the straightening and breaking up scar tissue. Also PT and daily massage and exercises helped with scar tissue and keeping it straight. We were very careful not to start too much before the arm was mostly straight, and I've heard from other parents in the same situation that swinging bars before other starting other events also helped to get back their extension.

 

[Deleted member 14190]

I will have her start doing her PT exercises again - thanks!!!

She needs to do it every day. Doing PT alone will not get it done .

 

[NY Dad]

When my DD broke her elbow, they kept it moving because the ortho told us that if they lose flexation, they tend not to get it back

When you say they kept it moving does that mean she wasn't in a cast? When did she start PT? Did she get reduction and/or pins? My dd was in a hard cast for 4 weeks (I was pushing for 3 but the ortho said it wasn't safe to take her out of the cast that quickly.

Our PT initially told us they tend to lost extension, but now that my dd has made huge progress on extension PT is focusing more on flexation.

 

[B&M's mom]

We worked with a sports ortho at our children's hospital. Even before the diagnosis had been confirmed, they had her start very very gentle PT to keep motion going in the joint. Fortunately, the bone was not displaced so they didn't have to do surgery. Her doctor, knowing that she was a gymnast, told us that she would not cast it because of the potential loss of motion. So my daughter was in a sling for 12 weeks. She wasn't allowed to put any weight on the arm for 8 weeks and then under the guidance of her PT she started gradually adding weight. Throughout the entire time she was in the sling, she had 2 PT sessions a week simply to preserve the flexibility. I have to admit watching those sessions was like watching paint dry. She'd sit there while the therapist moved her arm. I was really excited when she actually got to do the movements herself.

Years later, she had knee surgery and they used a CPM machine on her knee for 6 weeks. It did essentially the same thing, very gently move the joint to preserve motion.