We teach front tumbling a specific way that reduces upper extremity impact as well. I've never thought of it as a wrist saver until now... but it definitely is. If anyone is interested in that... just let me know... but that's a whole other topic.
Parents Question about Tiger Paws
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I'd love to hear more about this!
Are these kids with wrist pain also seeing a doctor or PT for an eval? I think wrist strengthening is important, but so many cases of gymnast wrist are actually caused by shoulder and lat issues that a PT should be addressing. Rest won't fix those issues, so the wrist pain returns as soon as the activity is resumed. I see this with some of our most talented kids who are extremely young and strong, but not blessed with great shoulder flexibility. They have wrist pain before they are even competing (these are devo kids who delay compulsory competition and do TOPs-type training instead).
This is my thinking as well. Wrists are not ankles! Same is true with the elbows, which is why coaches, parents and gymnasts (who are old enough to be responsible) need to be aware of what gymnast wrist and OCD of the elbow are so that they can prevent them from ever occurring. Teach and follow the 3-day rule on pain. No pain goes unchecked if it persists for more than 3 consecutive days.
We have worked with on-site PT for years.
I do not agree with this at all. It's caused by overuse. The issue is definitely not caused by shoulder and lat issues most of the time. If they stopped gymnastics... would their wrists still hurt? Training must be highly modified for athletes with tight shoulders. My daughter has tight shoulders and ran the TOPS program as well as the devo invite camps. My wife is the state TOPS manager. I am very familiar with that world. I have seen more overtraining / overuse injuries in that world than any other in gymnastics.
Also... doctors and physical therapists definitely aren't the only way to address situations. They are just one step of multiple that should usually be taken. In our team program... doctors and physical therapists are currently running 65% wrong according to our team stats. That makes them 35% right. I'm not saying that people shouldn't go to the doctor... I'm saying that the medical field is not an exact science.
Doctors are wrong all the time... in fact... my doctor was wrong about my shoulder. How did I know he was wrong? He stated that his first diagnosis was "wrong".
One thing to remember is that if a doctor is not familiar with your teams training style... they will struggle to use their experience from other athletes/gymnasts to diagnose things. We have a doctor that has treated so many athletes from other local clubs that this doctor has historically referenced things that are nothing like our training style. Now that I have met with him and discussed our training style... we get much better results.
Our training style is very different than many clubs... very similar to others... but not similar to any club near us.
Our training style is very different than many clubs... very similar to others... but not similar to any club near us.
Just to add to myself... how many kids would have spoke up to a doctor? That is a big issue with gymnastics and the medical field... we are dealing primarily with very young athletes that struggle to explain what is happening with their body.
How many times did you do this skill? I don't know.
When did it start hurting? I don't know.
How many hours do you do gymnastics? I don't know.
Sound familiar with some of the athletes?
Many times the coaches can help the doctor figure out what is going on and what direction to look very quickly. If you don't have a doctor that is at least willing to look at videos that a coach wants them to see... then you have the wrong doctor. After all... the coach should be controlling what the athlete is doing in their training... right?
Very true, but IME it's the doctors and PTs who have little to no experience (or interest) with gymnastics. The ER and urgent care doctors miss fractures all the time, and we have one sports med doctor near us who is mostly wrong IME. He even diagnosed a kid's pain as a sports injury and prescribed PT when it turned out to be pain from constipation, lol. Even the PT right away knew he was wrong. I think it's our job as the coach to sift through and find the good ones and work with them with our athletes. I have found a handful of exceptional ones in my neck of the woods and haven't seen a case where they were anything but helpful. In one case their colleague, the ortho surgeon, was very wrong though, which is why I still would always get a 2nd or third opinion if surgery might be required.
YES!
I believe it is my job as head coach to track injuries. If I am seeing a large amount of the same thing... well... it's my program.
I’m a peds nurse practitioner (and former gymnast and mom of gymnast). What you are saying about children’s history abilities is so true! I see this with my patients all the time (lack of awareness of their body and injury/pain timeline). Your comments on this thread are so interesting and helpful to me, particularly as a mom of a gymnast with a lot of potential. And no, most of us in general peds do not have an understanding of the specific mechanics of various sports to adequately make recommendations for serious young athletes.
Agree with doctors being wrong all the time. I am currently dealing with peroneal tendonitis that was misdiagnosed by 3 doctors before I got the right diagnosis.
#1 diagnosis - We are reasonably sure that probably don't have a hairline or stress fracture, and it's most likely a soft tissue injury.
RX = ace bandage and rest it for a few days and alternate heat and ice. (The hemming and hawing about a possible fracture was because we couldn't get my foot flat enough to see one that might show up if I was weight bearing for the xray).
#2 diagnosis (based on what the first x-rays showed) - since x-ray showed nothing, it is probably a "fallen" arch. RX = RICE and tape my arch when I go back to working out ... and as much as possible, workout on a padded surface.
#3 diagnosis - We didn't see any fracture (These x-rays were even worse because my toes and heel were all that were touching and my foot was very arched in the "flat foot" xray). It is just arthritis. RX = take my arthritis meds.
#4 diagnosis - Severe peroneal tendonitis (and the arthritis dx was laughable because where my pain is, there are no joints). Of course, now that I have the right diagnosis, this doctor seems to be an idiot in how she wants to "treat" it. RX = Soft cast for 3-7 days, RICE, an ankle brace (after the soft cast), custom orthotics, and never work out barefooted.
The custom orthotics is where the issue comes. They took a mold of my foot by having me sit in a chair and putting each foot, one at a time, lightly onto the stuff... but they pushed on my foot to get the impression.
Issues:
1 - I walk on the back outside of my feet and always have and that wouldn't show up with them not letting ME press down. Hell, they could have asked to see the bottom of my Crocs and seen the wear pattern.
2 - They had seen me 3 times, always in Crocs, but they NEVER said I couldn't wear the orthotics with Crocs. I was just told to wear them for 1 hour that day and increase an hour each day. Crocs have a molded in arch support. Adding the orthotic FORCED me to overpronate even worse. When i called to tell them this, that was the first time they said they couldn't be worn with Crocs ... and that I would have to remove the insole of whatever shoe I put them in.
3 - They asked if I had any other shoes I could wear them with, and I told them that my only other shoes the orthotics would fit in also had a built in arch support. They insisted that the arch support was in the insole, so removing that would also remove the arch support. If it was glued in, I should "just rip it out." Excuse me ... you want me to ruin my $84 shoes to put in your orthotics ... on that chance that I am wrong and the arch support is NOT molded in (which I wasn't - the bottom of the shoe shows the arch, and inside, the glued down insole was actually flat when I checked). I do have a pair of booties that I would have tried, but the orthotics are wider than the boot, so that's a no-go. And I have a pair of (genuine Army Issued) combat boots, but there is no way I am going to work out in combat boots.
This is why we were so grateful to have a PT who was a former high level gymnast. She actually knew what my daughter was talking about and was able to provide real meaningful, gymnastics related exercises/rehab/prehab. The drs generally are clueless about gymnastics related injuries, particularly those that are nagging, not from a specific action/fall.
We actually don't teach roundoff hands... we only fix them if they are wrong. Like below is how we want them...
Turning the second hand back to point where you came from creates a huge amount of stress on the wrist for certain athletes if you are teaching the athletes on a straight line.
Most athletes overturn their roundoff anyways... this puts both hands pointed somewhat back where you come from.
Also... look at men's vault... the Kasamatsu. Turning the hand back around could actually break the wrist. I see women's coaches teaching Tsuk's this way all the time. Below is a video of a Kasamatsu (the vault at 2:00 minutes in the video)... notice the second hand position...
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