Parents Sports Medicine Doc's "return to practice" letter and instructions

[misshoneybee]

Hi everyone, I have not been on in awhile. My dd tweaked her back doing something other than gymnastics. It hurts when she bends backwards....she took a couple of weeks off and of course I took her to her sports medicine (pediatric doc) doc and they did an xray and it was negative. The doc said that she also needed a bone scan because 50% of all stress fractures don't show up on xray's. She did give us an order for PT.

My dd has pain when she goes back into a bridge but that is it. The doctor gave me a note for her coaches and it was vague. She said that she can return to practice, letting pain be her guide, and she said "no back extension". and then told us verbally that there are alot of things that she could do still, sit ups, leg lifts, core strength, upper body, she said she can swing on a bar, etc.. I gave the note to her coaches and they didn't want her in the gym at all and implied that she should come back after she finishes her PT (which could be weeks) and is cleared by the doctor to return to practice. He gave me a very long list of questions that he wants answered before she comes back. Like how high can she jump, how far can she jump, how much weight can she lift, can she do a handstand, can she do abdominal exercise, can she stretch her hamstrings...etc.....

• Is it common for coaches to tell a gymnast to leave practice and come back when she is "better" - which could be 3 months?
• When you have dealt with injuries what level of detail have you had to provide to the coaches regarding modification and activity levels in the gym?

First of all, I don't want my daughter to become more injured, but mentally she really needed to be there even if it meant she did not do what all of the other girls were doing.

I need help figuring this out.

 

[Deleted member D3987]

unfortunately, it sounds like they don't want you there anymore. and please, don't shoot the messenger.

 

[misshoneybee]

That is what it sounds like to me too, I just wanted another opinion in case I was off base. Very sad, my dd works so hard, is so committed, never gives anyone any trouble, I don't bother anyone over either.

Makes me want to cry actually. She loves gymnastics more than anything.

unfortunately, it sounds like they don't want you there anymore. and please, don't shoot the messenger.

 

[MaryA]

Really? To me it sounds like the HC is afraid of dealing with a back injury and wants to have all of his bases covered so that you can't come back and sue his butt if something happens. I know that gymnasts and coaches have to deal with injuries all the time, but back injuries are the scarriest (other than maybe head injuries, but the head has fewer moving parts). What makes you think, based on this post, that this gymnast is being given the boot? Just curious... not necessarily disagreeing.

 

[misshoneybee]

Mary maybe you are right, he has made us feel unwelcome a few times prior to this incident. That is why I kinda felt that is what he was saying too.

 

[dmytv]

This is kinda strange. All the gyms we have been to have had a manditory show up rule. They all asked for a doctors note. Mostly the kids come in for extra conditioning or work on skills they are allowed to do. I kinda agree with dunno. Just don't lose hope though. My dd has now been through 3 gym switches. She is at her 4th gym and when she made the switch this year she visited 7 gyms and made a really detailed chart grading the gyms in all sorts of catagories. I think we have finally made the the right choice and found the best fit for her. Alot of her problems have been fixed because head coach is a judge, they have playback cameras and they really spend alot of time talking to her. Oh and don't just go off of score. Sometimes dedication and drive can help overcome alot. My dd was a terrible level 5. She scored a 31 uugg. But last season she got 35s at level 7 even with bar issues and a beam fall.She is doing level 8 this year and hc has high hopes for her. I am sure your dd will find her groove.

 

[bogwoppit]

When my dd had back pain and was restricted by her doctor she was not able to go to the gym. One coach said she shouldn't go as she couldn't do what the rest of her group was doing, the other just let her sit there and didn't care whether she did anything. They said they were not going to allow her to do stuff the other girls weren't dong. So she stayed home.

It is a bit like constructive dismissal from a jb when you are sick. They do nothing to help, or hinder. But it makes you feel very bad for your child. Bad enough to be in pain, restricted from doing something you love, without being rejected and looked down n.

It didn't take long for my dd to stop loving gym under those conditions as she felt one coach just didn't care and the other had no imagination to help her.

Not easy, and back pain is terrible.

 

[Gymdad2]

Did you have the bone scan that the dr. recommended? Back injuries are very serious and might affect you dd's future health. Whatever the coach's motive are, you need to listen to the dr. and protect her heath. Gym is temporary but her back is for life. Good luck.

 

[Flossyduck]

Unless there is additional information I have missed I didn't read it that they don't want her to come back. I took it at at value - that she can go back when she fully fit to work the skills her class are doing.

I don't necessarily agree with that response, because it seems if the PT says she can be there and allow pain to be her guide, assuming she is ok with, many coaches seem to prefer the gymnast to be in the gym - to do what conditioning they can and to keep up contact with the place.

However a couple of things might have caused what might seem a frustrating over-reaction:

firstly you said that the note was vague and when it comes to a back injury and a note which isn't very clear, the coach might very well feel that it is much better to wait until they have much better instruction or the injury is gone.

Secondly you said that she hurt it doing something other than gymnastics. If it were in the gym the mechanism of injury might have told the coach a lot and they might feel more comfortable making a judgement, but if it happens elsewhere they are dealing on say-so and a vague note... which would definitely make me anxious.

Backs are such complicated things - my daughter took a slight shove from the coach, going over the vault (not at this gym) and over-arched. She could barely walk the next day, but a couple of days later it was all fine, but equally there's a girl in her group who twisted awkwardly on a dismount and is still having PT after six weeks. She is in the gym though doing most things but not back extensions, and the coaches work with that.

I might be wrong, but I would take the coaches list to the PT and try and get some answers and then go back and discuss what she can do with the coach.

If they want her to leave over this then to be honest I'm stunned and devastated for your daughter! Good luck

 

[bookworm]

I also agree with Dunno that it seems like they just want you out because it is very rare that a coach will not want you in the gym AT ALL, even with an injury...they always want you there "working on something or conditioning"..kind of like what dawnmytv said about the "mandatory show up rule". I think your instincts are correct, you've felt unwelcome in the past and I think that the gym is taking this opportunity to have you leave (under the guise of injury so it's not them)....

 

[Moxiegrl83]

Is it common for coaches to tell a gymnast to leave practice and come back when she is "better" - which could be 3 months?

At our gym, once the Dr. says it's okay to come back, however limited it is, they are encouraged to do so. Even if it's just stretching and/or conditioning. Exception would be a kid who wouldn't listen to those limits. Sometimes if it doesn't hurt that moment, they forget or try them anyway.


When you have dealt with injuries what level of detail have you had to provide to the coaches regarding modification and activity levels in the gym?


We haven't had any injuries thankfully, but recently a little girl on PT sprained her shoulder. When she first came back with Dr's clearance, her dad told us she could do anything but use that arm. A few weeks later, after her next Dr's appointment, she could do light work with it, as long as it didn't hurt. No impact, light bar work, etc. He didn't give a detailed list or anything, but enough information for the coach's to safely work with.

 

[Kiwi]

My DD was asked by the gym to take a break from gym for a while to try to let her ankle injury heal. It was competition season and everyone else was competing except her. They gave her a list of conditioning to do at home. I think the gym owner thought it was the kind of injury that would heal in a few weeks if it wasn't trained on, like a sprain. However, it is a kind of injury that can be ongoing (kind of like Sever's and Osgood-Schlatter's, but in her ankle). We saw a sports physician the gym owner was happy with and eventually the gym did let her come back, but the injury still needs to be managed. The physician sent a fairly specific letter about how to manage it. She is training almost normally now, but she has to limit the repetitions of high impact activities (vault, dismounts, jumps, tumbling).

I don't think the gym was trying to get rid of us. I do think the owner was concerned about gymnasts training with injuries and the pressure this put on coaches trying to manage it and the concern about the responsibility of the gym if something went wrong, etc.

 

[gymmomtoo]

At our gym, you are encouraged to go to the gym every practice--injured or not, and just condition, if nothing else. I can't imagine our coach telling a girl not to come back until PT was over entirely! Is this a new coach that possibly hasn't had a girl with an injury before??

 

[BlairBob]

Yep, sounds like BS. Some coaches just get fed up and don't want to deal with gymnasts that are on the sidelines. However, a lot of these kids come in, do some training, end up having to do a lot of work on their own and just can't really train on events. I can see how some coaches tire of it.

Personally, I'd rather see them in the gym working around the injury perhaps on limited hours (not a full practice).

To note, I had 3 back injuries in 2011. One was during training while the one after that I think I tweaked my back spotting after it was recovering from the first one. Both still left me mobile enough to walk around and do rehab and coach.

The third crippled me though. I was barely able to get out of bed, into a chair, or on the couch without having it be a 3 minute process either up or down. Standing actually was better than sitting and laying could be alright so long as I didn't move a bit. For awhile, I was moving worse than my dad pushing 60 who has hip problems from some serious hip injuries.

Don't screw with your back. I know there were times during that I wonder if any training was over for me much less a small jump up and down or kneeling, anything. After about 2 agonizing weeks I was finally able to move around. Luckily it was just a really bad muscle strain in a muscle attaching to my tailbone. I think it had to do with overtraining as I had just started training again after 6 weeks off and was into week 4 of Lifting and CrossFit.

I still have a right hip lower back injury that I have to manage. It's fine for the most part but I do need to watch the pounding (especially running) and manage adjusting it and doing prehap stuff (stretching tight muscles, mobility and PT stuff).

Reverse Hypers were a godsend for the first 2 minor back injuries which were simply just tweaking my back and having it get ridiculously tight while it healed. You might know them as superman leg lifts while laying on a table, block, or pommel horse. Lots of reps, slow and controlled (no weight). Hanging and support pikey swings on rings and parallel bars.

 

[profmom]

I would say it's time for an honest talk with the coach. My DD had a broken arm, not a back injury, but she was in the gym doing conditioning at every practice not too long after the accident and the coaches were checking in with us about her recovery. When her group was doing things she couldn't do, she worked on flexibility (with some tips by her coaches on how to modify things so they'd work for her) or did her physical therapy exercises. Her coaches seemed almost as happy as she was the day she got the green light to go back to weight bearing.

It's tough for highly motivated kids to sit out and wait to get better, but in my experience with my daughter and other injured kids in our gym, compassionate and supportive coaches can make a huge difference in how the passing time feels to the frustrated gymnast.

 

[misshoneybee]

Thank you so much for all of your thoughtful replies. My DD had her bone scan Monday and we saw the doc today and her back looks great on the bone scan, no fractures and no pre-fractures. The doc thinks she has soft tissue pull/inflammation that is causing pain and said she could go back to the gym and gave us a list of things she could and could not do (I made the list - she filled in the blanks). Her back is stiff in the lower lumbar area and if she goes to PT and modifies in the gym she should be okay. We see the doc again in 3 weeks. Her back still hurts her only when she bends really far backwards - and the pain is lessening.

Our gym has a mandatory show up rule too which is why I was so confused. I think they are trying to "fire" us, if that is possible.

I guess what I don't understand is what to do now? Look for another gym? How does that work with an injured gymnast? Do I pull the plug on gymnastics all together? I am getting mixed signals from different coaches. 4 out of 5 of her last coaches have told me that she is one of the hardest working gymnasts in the gym. She is not gifted, but she is talented.

 

[Quadqueen]

did you ever switch gyms? a couple of months ago you posted about looking for a new gym but I wasn't sure what the outcome was of that.

 

[misshoneybee]

We never switched. It became really complicated at the last minute.

 

[Deleted member D3987]

you should've........

 

[BlairBob]

Get off the crazy train. Don't delay...ever. Good rule about life as well.