Parents Back issue: Edema in the L4 left pedicle

[BStephenM]

We just received some bad news regarding ou daughter. One week before her 1st level 8 competition this year she was diagnosed with "Edema in the L4 left pedicle". I will place full MRI diagnosis at bottom. She is supposed to wear the BOB brace for 4-6 weeks and begin PT immediately.

https://www.bostonoandp.com/products/scoliosis-and-spine/boston-overlap-brace/

Naturally she is devastated. I am looking for any advice, guidance, tips etc.

Anyone have experience with this brace? Any suggestions on getting her more comfortable in it? She hates wearing it.
Obviously we are falling a Drs guidance.

thanks in advance,


1. Edema in the L4 left pedicle extending into the bases of the left superior articular and transverse processes, likely reflecting stress reaction. No
fracture line is visualized.
2. Mild edema of the bone marrow of the spinal process of L5.
3. Mild posterior bulging of the intervertebral disc of L4-5 resulting minimal narrowing of the neural foramina, slightly more evident on the left.

 

[BStephenM]

sorry..that should say following Dr's guidance. Forgot to mention she's a 14 year old.

 

[NutterButter]

My DD had two rounds of back issues (stress fractures in L4, L5 the first time, stress reaction in L3 the 2nd time). She was never prescribed the brace. Several of DDs teammates also had back issues and only 1 was prescribed the brace. Most of these kids saw the same ortho so I don't believe it was simply a physician treatment preference otherwise you'd think more than one would have had the brace. If you DD hates it - it might be worth a call to the Dr to see if she absolutely needs it. Or maybe it's not quite fitted correctly if it's a comfort thing and a different size is all she needs. I seem to recall that there was some 'controversy' within the orthopedic profession on whether the brace is even necessary for stress reactions/fractures. I'm not a medical professional and not at all suggesting that she doesn't need it but there is a wide variety of protocols out there on whether to brace, how long gymnasts need to be out of the gym, the time it takes to rehab and regain skills, etc, etc.

 

[BStephenM]

thanks, curious where your DD is now with her gymnastics? how was her recovery from the back issues?

 

[NutterButter]

My DDs first back injury was early in the competition season her sophomore year. She was a first year L9. Given the severity of her injury (2 stress fractures and a bulging disc) and the fact that she was one of many with back problems in her gym we took a very conservative approach to recovery as it was obvious we could not rely on her gym's strength/conditioning program to keep her back healthy. She was out of the gym all together for 10 weeks which was longer than the ortho said was necessary. Her PT was the one who was really in charge of progressing her return to sport. Very slow. She didn't even do basic tumbling until the end of the summer/start of fall. A couple of times my DD had to say 'I'm not doing that right now' to her coaches as their knowledge in back stuff was grossly outdated/wrong. She came back though and had a great season her junior year.

Senior year she started experiencing pain again at the beginning of comp season. This time on the other side. Caught it early enough so not a full fracture. She was supposed to take a 4 week break from the gym but was still hoping to compete at the last meet and/or petition into post season. Covid happened and her break from the gym turned into a few months. By this point she committed to a D3 team and her PT suggested that she work with a specific trainer to get her back ready for college gym in the fall. He was amazing and very talented in coming up with a plan tailored for her specifically.

DDs college coach suggested that backs 'tends to get better' in his gym due to differences in NCAA training and resources and event specialization. This was true for my DD. Ultimately though an achilles injury ended her gymnastics career her sophomore year.

My advice for anyone dealing with a back injury is to seek out medical professionals who have experience with high level gymnasts. If that's not an option in your area someone who works with dancers is a good option too. Also recognize that each one has a specific job. Bones heal in a certain amount of time which drives the guidance that orthos will tell you. But if you don't fix the underlying problem, it will come back. PT's will help strengthen the back but not all of them know for example that some kids need to change their mechanics in how they land out of tumbling. Etc, etc.

Also - I'm so sorry this happened to your DD. It's rough. But she will get through it.

 

[Coach Kate]

I absolutely agree with seeing all the specialists first and then I'll add that I struggled with back pain throughout my late teen years and into college (pole vault). I was in a minor car accident the year after I graduated and one thing led to another and I got involved in yoga. Gentle inversions like legs up the wall pose held for longer periods of time helped me so much. Then the really crazy thing happened and I started working with a teacher trained in deeper back bends. It led to me training circus arts and contortion, again, with very qualified teachers. We spent more time doing strength exercises and working on moving and controlling through our whole core than deep crazy bends you might be picturing, and my back was healthier than ever

 

[BStephenM]

Thanks everyone for all the advice...her Dr is a former D1 gymnast who specializes in treating gymnasts, so we feel like we are in good hands.

Elspeth Hart, DScPAS, PA-C, MPAS, ATC, LAT | Boston Children's Hospital

www.childrenshospital.org

She also has great coaches who fully support her. Her main coach has said her health is priorrity 1 and that she can test out of level 8 over the summer and thereby stay on track to be a level 9 in her sophmore year. That has been out daughter's biggest concern...falling behind the other gymnasts.

All of this is assuming she heals well.
The toughest part of all this is getting our daughter to advocate for herself...meaning eating better, sleeping better, etc.
BTW, what is DD

 

[NutterButter]

DD = Dear (or Darling) Daughter

Awesome! for having both solid medical care and a supportive coach. Not everyone has that or even is aware of what to look for. I hope the next several weeks go by quickly for your DD and she has an easy time returning to the gym. The whole advocating for yourself thing is a process.