Parents Back injury seeking advice (not medical)

[Daphne Banks]

My daughter (level 9) just got an MRI that shows "swelling in the pars interarticularis and extending into the transverse process at L4". The Dr. said this is not yet a stress fracture but the start of one. She was told 8-12 weeks off. Absolutely no extension. She wants to go to the gym part-time to do what she can do avoiding extension so that she doesn't lose all her strength. I'm wondering if anyone else has had a back stress fracture or "almost" stress fracture and if they took complete time off or modified? The Dr. said let PT guide you back in but we can't get a PT appointment for a month! Working on that...

 

[katrid11]

Can the Dr get the exercises from PT? Does the gym have a PT contact that can get the exercises for you?

I would be extremely hesitant to even think of sending my child back into the gym part time with a back injury that is leading to a stress fracture.

She maybe worried about losing strength but she'll miss more months with a stress fracture (or end her gymnastics career). Yes she will lose some strength but it is better to come back needing to improve that in 2-3 months than to injure it worse trying to stay highly fit.

 

[Mish]

My daughter had that in lv 7. The doctor compared it to a rubber band that was stretched to it's limit but hadn't snapped yet (ugh). Had to shut down for a while (at least 6 weeks but I don't remember exactly) but continued to go to the gym and worked on strength and conditioning. She was also able to do some things that did not require any stress to her back. It has been over a year and a half since this injury, but interestingly enough she said her back was hurting her last night.

 

[Geoffrey Taucer]

I'd be very cautious about this, and follow the instructions/restrictions given by a PT to the letter.

The thing to keep in mind with any injury -- but especially a back injury -- is that an athlete stands to lose very little from being overly cautious, but stands to lose a great deal from not being cautious enough.

 

[JBS]

She was told 8-12 weeks off. Absolutely no extension. She wants to go to the gym part-time to do what she can do avoiding extension so that she doesn't lose all her strength.

At Level 9 I would absolutely want her in the gym to stay connected to the team. As a head coach I would need a note from the Dr. that states that she can be in the gym to do her PT. I would have her in around 1 hour per workout as many days as she could wanted to be in the gym. Depending other things this could progress into 1.5 hours.

Also... we have added in this machine as part of our high level training...

https://www.roguefitness.com/westside-scout-hyper

From the description of the machine...

Regular use of the Scout Hyper can provide safe traction, pressure/tension relief in the lower back, and strengthening of the posterior chain. “We spend hours sitting or standing at home, work or at school,” Louie Simmons says. “These simple yet everyday occurrences place significant pressure and torsion on our lumbar spine leading to mild or even severe daily discomfort. That's where the Scout steps in. A daily prescription of three to five sets of 15 reps on this machine could be the difference from painful to pain-free lumbar health.”

If anyone has questions about this machine and how we are using it and the benefits that we are seeing from it... let me know... I'll start a new thread for it.

 

[gymgal]

Others had similar advice to what I would say. I would add to try to get a PT who has experience with gymnasts. You really need one who understands the dynamics of the moves and body stresses. We have been to some who have no knowledge and really couldn't offer any feedback as to how quickly to come back. Thankfully we found one who was a former gymnast and was able to walk my dd back from injuries gradually and safely.

 

[JBS]

Here are some things to think about during the break...

Think aggressively about every turn and figure out which things were causing the issue.

In the case that I dealt with there were several things all lining up together...

1. Two highly aggressive NEW skills at the SAME time - We had 2 new highly aggressive skills being learned at the same exact time. The athlete wanted to get these new skills very very badly... they were fun skills... high reps are easy when someone really wants something to happen.
2. Lower fitness level - We had just returned to the gym after being shut down from Covid. The gymnasts really lost nothing over break... we were all very excited over this. We should have taken more time ramping back up... should have built up our general fitness and core strength more.
3. Growth - And not that I'm going to give you an exact example here... but I am. When an athlete grows... their tap may have to change on bars. It may have to have more "shapes"... resulting in a harder and more forceful "jerk" at the bottom of the swing. If you are training a double layout on FIG... you may need to pick a new dismount... or change your bar setting to a larger setting so the "shapes" don't have to be so hard. Everyone thinks that low back is from BWO & BHS and impact on tumbling. Don't underestimate the power of bars... it will destroy the low back if you are not doing things right. We eliminated the dismount and it will not be returning. That is just one example... "growth" in general makes everything change... be aware.

Remember... I am a head coach... I know the numbers and things that my upper level athletes are doing... I was the one that helped figure out where the issue was coming from. You may need help from the coach to help figure things out.

On the "return to play" remember #2 from above. An athlete will need another couple of months after they return to get back to the fitness level of before the problem... they will then need a higher core fitness level than before so it does not happen again.

There you go... some of you totally understand the attention to detail that high level coaching takes... others of you are probably...

 

[JBS]

Also... we have added in this machine as part of our high level training...

https://www.roguefitness.com/westside-scout-hyper

Wanted to clarify... we use this machine when our athletes are NOT injured as part of our regular training. This is NOT something we would use for an athlete with a spine injury unless assigned by a Dr. / PT as part of their rehab.

 

[NutterButter]

My DD has had stress fractures (sophomore year) and an almost fracture (senior year, different vertebra). The sophomore year injury was a little more serious but both times my DD took a complete break from gym for a period of time. For the 10th grade injury this meant not even going into the gym for 8 weeks (they stopped billing during this time) and for the 2nd injury she did light conditioning the entire time. The 10th grade injury gave my DD time to take Drivers Edso she had something else to focus on in the short term.

@JBS gave some great input and I'll add some additional thoughts. My DDs gym has had a ton on back injuries (over a dozen!). The conditioning program was poorly designed to properly strengthen the core, coaches are not always mindful of reps of skills or landing techniques and the team trainer was woefully inept (for example to this day she doesn't believe in tiger paws!). Because of this, my DD had to take on all of the advocacy for her body and my DDs recovery had to be adjusted to fit with the gym's shortcomings. We kept her out of the gym for longer than the others did with their back injuries. She worked with a PT with a gymnastics background and she safely returned my DD to sport. When my DD faced pressure by the coach or trainer to change the plan her PT established, my DD had to step up and say 'no'. The PT helped my DD phase back into tumbling and taught her new landing stances to alleviate stress on the back.

@Daphne Banks - if your HC is more like @JBS you are lucky in that you have a true partner in your DDs return to gym! If your gym is more like my DDs, you will want to be more vigilant on what happens when she returns to the gym.

 

[PeanutsMom]

We are literally in the midst of this right now.
My daughter, level 7, 13 years old, started with hip pain in September. We did PT, we did stretching and when it didn't get better we went to an orthopedic. They found a complete break of the bone that holds together her L4 and L5. She was immediately put on inactive status, no gym, no stretching, no anythign until we could get an MRI of both her lumbar spine and her hip. We got those images done January 14th. January 24, we had a follow up with a different orthopedist who sees children. He immediately said, Brace her and get her to a surgeon as she has impingement of the nerves (hence the hip pain). We finally got to the local Children's Hospital to see the surgeon and she has Spondyolothesis, Spondylitis, and pretty significant compression/degeneration of the disks at L4. He said she doesn't need surgery (yet) as they do not recommend surgery for anything less than 50% impingement (she is at approximately 15%) and he said shes could go back to bars only for now. The break he said was maybe going to heal, maybe not as where it is is all the places shes moves just walking etc. She has to do PT of core and back (we don't have that first appointment yet) and she can slowly ease back into full gymnastics (though likely at a lower level not trying to make level 10 and will likely do XCEL Diamond to be able to have more options like level 9 bars and level 7 floor). She also has to go back for full scans in July. If the compression/degeneration of that disk (the doctor's real concern) is worse, her gym career may be over.

 

[MuggleMom]

I haven't had experience with this but my answer would completely depend on how you think your DD coaches will approach this. Are they conservative when it comes to injuries or push the envelope? Will they make your DD feel bad for not "wanting" to do more? Do they have anything valuable to add to the conditioning (helpful exercises that they have seen work for similar athletes)? If they can't enhance her recovery with their compassion an experience she may be safer staying out of gym and rehabbing on her own/with PT.

 

[ReluctantGymMom]

@JBS can you give more details on what kind of things on bars are hard on the back??? We have removed BWO, FWO and bridges completely, but my kid gets pushed hard on bars. When she had a no impact restriction, our coach wouldn’t let her do stalders on bars either and bar restrictions were hard for her. But even our spine ortho who knows gymnastics doesn’t give restrictions for bars, only beam, floor, vault

 

[JBS]

@JBS can you give more details on what kind of things on bars are hard on the back???

I'll just start off with this... everyone thinks it's only the extension. Can't you hurt your back by bending over and lifting something heavy? Well... there are movements like this on bars... like a Maloney throw.

-----------------------------

At a high level... tons of stuff is now being talked about. In-bars stalders are a big one (read the comments on that thread)...



No one can really pinpoint it... is it the arch going in... does it have something to do with the position at the bottom of the circle... or is it the extension out?

We have had issues with kids when they start working Maloney's... and this is before they were catching and doing the huge reverse tap after the catch. Pain during the throw. This basically told us to stop and figure out what we needed to do. More core and posterior chain strength was what has really made the difference for us.

The reverse taps out of Maloney's and such. We have never had any issues with this one. The bigger issue seems to be when it is required for all gymnasts to learn whip tap front giants... definitely not the right technique for everyone.

Catching the low bar in an arch... like a pak. However... the same issue can happen with bails / overshoots or even straddle backs. It's not that hard to get in a weird position before the hand impact the low bar.

Also... the arch that can happen during the catch of a release skill... especially if they catch close.

Another huge one that we have seen is when coaches insist on the "narrow hand grip" on bars. This does not work for athletes with tight shoulders. When the hands are close... the shoulders do not open as much on a tight shouldered athlete and the forces migrate to the low back. There is no reason for narrow hands on bars... just slide them on top during the weightless time right before the pirouette.

Also... some athletes have more mobile hips in a straddle position. For this reason we teach all of our athletes to straddle tap at some point. They do not have to use it... but it may be beneficial for some.

Another one is mistakes on release skills where they for some reason do not let go. Like a Tkatchev that the athlete just jerks and kind of drifts over in a huge arch.

I would add some of the popular "timer" drills into that category above. Tkatchev timer to a big arch while hanging onto the bar... Jaeger into a hugely strange arch while hanging on the the bar... don't like either one of those drills.

At a low level... really not much... mainly just things done improperly. The movements at a low level usually aren't as aggressive. Bad casts come to mind... especially when athletes are pushed to do all straight body casting when they are not strong enough.

Not sure what I missed there or what I even typed... but there is some of it.

 

[JBS]

I'll just start off with this... everyone thinks it's only the extension. Can't you hurt your back by bending over and lifting something heavy? Well... there are movements like this on bars... like a Maloney throw.

I totally wrote that wrong… I was thinking correctly. Should say… everyone thinks it’s only when the athletes are in an “arch”.

Basically I’m trying to say that the loads coming out of the pike position before they even hit the arch can be an issue to.

 

[Deleted member 25901]

Totally follow the advice you are given unless you want it to get worse.