Parents Back pain... How long to wait?

[CLgym]

We did not get an MRI after the first doc visit, but after the second. Based on the initial exam and description of pain, doc was not particularly concerned about a stress fracture and wanted to try PT first. PT helped, but pain returned when we stopped PT so we made a second trip to doc. That's when the MRI was ordered. Doc was right and there was no stress fracture. We were seeing a pediatric orthopedic surgeon in the sports medicine dept of a nationally ranked children's hospital who sees many gymnasts in her practice -- I asked lots of questions but ultimately trusted her judgement. Definitely do your homework re: doctor and ask lots of questions including whether an MRI is appropriate now.

In some ways I was glad we had the MRI after the second visit instead of immediately. If the MRI results were negative initially, but then the pain returned, I think I would have been wondering "well is it broken now??" But in our case the entire process with both doc and PT was informative. It showed me what is "normal" for my not-so-bendy-back gymnast, and taught us how to manage it.

** Of course every case is different so push for that MRI if your gut tells you that's the right thing to do right now for your DD!!

 

[gymnastmom05]

My DD had back pain over a year ago. We took her to a sports med doctor that specialized in backs who also had a daughter that did T&T. He didn't want to do an MRI first. He had her take 2 weeks off of gym. No gym at all (thankfully we were going on a 10 day summer vacation because there were lots of tears in the car after that visit). She didn't have any restrictions outside of no gym, doctor felt anything that wasn't 20 hours at gym would be a huge reduction in her activity. He saw her back in 2.5 weeks, did some testing and cleared her. The rest was sufficient and (knock on wood) she hasn't had any issues since.

 

[Sk8ermaiden]

I took my daughter in after less than two weeks of minor back pain only while doing certain skills, and the doctor had drawn up the orders for imaging before he even got in the room - just after reading the words "gymnast"and "lower back pain" on her chart. He asked questions and examined her in the room before actually ordering them, but he knew she would probably need x rays and an MRI.

The OP's daughter is in severe pain with any activity other than sitting or walking, a month out from the initial incident. There is zero chance I would just wait and see or self-prescribe PT in that case.

Her case was treated SO easily and painlessly and the Ortho said it was because we did not wait to come in. Her coach (who we love and who does take injuries seriously) had said we didn't need to go to a doctor yet, just ice and rest. But there was no way I was going to "wait and see" because it's her spine. And it's a good thing I didn't.

 

[MUTigerMom]

Just to clarify... she has been resting since the soccer incident. Before that, we didn't realize it was still really bothering her. We knew she hurt it at that first meet. She skipped practice for a few days and said it felt better. We don't watch practice and she never really mentioned it. It was after the soccer thing that she revealed it has been bugging her for some time and she has been skipping some workouts on occasion.

Right now, she is resting. No soccer at all. No PE at school. No running or sports at recess. At gym, she has been doing conditioning, choreography, and shaping only. No tumbling, nothing that requires running, nothing involving the back, etc.

Didn't want everyone to think that we were sending our poor kid to do full gym practices on an aching back...

I wish I would have known it was really bothering her sooner. It's just hard because she isn't good at communicating and has a tendency to want to push through...

 

[MUTigerMom]

One more thing... we do have an orthopedic doctor that we trust. He specializes in pediatric sports injuries and spinal injuries. He worked with us when she broke her arm 4 years ago and was very good. He is very conservative, but that is what my husband and I want with something this serious. (My daughter probably wants the one that will let her back soonest, but good thing the adults get to pick the doctor.) His PA is the mother of an upper level gymnast. So... they seemed very knowledgeable about the world of gymnastics last time we were there. We will go in Monday and see what he thinks...

 

[Aussie_coach]

Wow, 4 figure costs for an MRI! My advice to get an MRI early on is reflective of the country I live in and if we had to pay costs like that then I wouldn’t be so quick to recommend it, as an early response. For us if you get the correct doctors referral you don’t pay for the MRI.

 

[MILgymFAM]

Wow, 4 figure costs for an MRI! My advice to get an MRI early on is reflective of the country I live in and if we had to pay costs like that then I wouldn’t be so quick to recommend it, as an early response. For us if you get the correct doctors referral you don’t pay for the MRI.

For me, with the proper referral, I wouldn’t pay either. But it seems at times here that doctors are mostly worried about keeping costs down. I have trouble getting doctors to request blood work and xrays at times, let alone anything more costly. Whatever medical we get is cost-free to us, but everything is an uphill battle.

 

[mommyof1]

For me, with the proper referral, I wouldn’t pay either. But it seems at times here that doctors are mostly worried about keeping costs down. I have trouble getting doctors to request blood work and xrays at times, let alone anything more costly. Whatever medical we get is cost-free to us, but everything is an uphill battle.

A lot of it depends on the type of insurance you have and the health care provider you use. If you have private insurance and a physician who's outside of a managed care system, the doctor is often incentivized to overtreat while the insurance company is incentivized to deny treatment. We actually had a doctor try to convince us to put our daughter through surgery for complications from a minor injury that were easily resolved through PT. And I can't even tell you the number of times I've had to make two or even three separate appointments just so the doctor could bill insurance separately for what should logically have been one appointment. It's madness.

 

[Deleted member 14190]

Yes here in the states getting an MRI is a process because the insurance companies want you to at least try to rest and do PT for a few weeks or longer prior to MRI. Unless a blunt trauma incident was the cause. If MRI was free and easy then who cares. $2600 average cost for MRI according to nerd wallet . That may include having it read , maybe not. Pulled back muscles do heal faster with rest and PT. So.... that is the course here

 

[Pineapple_Lump]

Yes here in the states getting an MRI is a process because the insurance companies want you to at least try to rest and do PT for a few weeks or longer prior to MRI. Unless a blunt trauma incident was the cause. If MRI was free and easy then who cares. $2600 average cost for MRI according to nerd wallet . That may include having it read , maybe not. Pulled back muscles do heal faster with rest and PT. So.... that is the course here

I think we had to pay $100 for an MRI here... I felt so ripped off at the time. Paid essentially $30 for specialist consult and X-ray in Japan, then paid another $30 for the paper work to claim it on travel insurance

 

[MUTigerMom]

Update: We went to the doctor today. He ordered an MRI, which we got this afternoon. He suspects a stress fracture but he (and we) are hoping he is wrong!!! He is sending us to PT 2x/week for 6-8 weeks regardless of what the MRI shows. We will know more later this week. I have the CD with her MRI images. I REALLY want to play Dr. and look at them, but will have no idea what I am looking at. Hope to hear something back tomorrow!

 

[Amanda]

Glad they were able to get you in right away! I hope you hear everything is clear soon. I have also been tempted to try and interpret MRI images- my daughter get one every 6 months or so to track a medical condition. But so far I have resisted too!

 

[cp13]

I hope it's not a back fracture and just something muscular. My daughter injured her back last year after a fall on floor and was sent to PT. It was diagnosed as muscle spasms. The nice thing about PT is that they can work with you to ease her back into the sport and they can tell you when to re-introduce conditioning/skills as she recovers. My daughter was in PT 2-3 months but she did get fully back and was able to complete her L5 season, including the back walkover on beam. Although she had to be careful about how many she did per practice.

 

[NutterButter]

@MUTigerMom - keep us posted once you learn the MRI results. When my DD was diagnosed with stress fractures I scoured chalk bucket for any thread about back issues. My two big takeaways after reading personal stories of back injury recovery were 1. take the recovery SLOW and 2. find a PT that has experience treating gymnasts. It seems that the combination of the two yields the best chances of the athlete making a full return to gymnastics. For example, my DD was 'cleared' to return to the gym 4 weeks post diagnosis but the ortho didn't define what cleared means. My DD was in PT for 7 months and during this time she worked on exercises to properly strengthen her core and other areas that will best protect her back, she learned different ways to land on tumbling and dismounts to protect the back and the PT explicitly defined DD's progression back into full training with all skills. Her entire recovery was 10-11 months. Feel free to DM me with questions!

 

[Sk8ermaiden]

Please keep us posted. Of course you hope it isn't fractured but it really did sound like it probably is. If she is diagnosed, there is a spondy group on Facebook too. It is very useful (and also shows the WIDE variety of opinions on treatment.)

One thing I notice again and again is that gymnasts, once cleared, who return to doing gymnastics how they did before seem to have a higher rate of re-occurrence. A combination of PT and training modification is important. The things Nutter Butter said and removing or seriously limiting problem skills. It will be years before my daughter does a front walkover or front handspring again. She has to be mature and aware enough to engage her core every single time.

Just because their back recovers doesn't mean going back to the same things won't yield a repeat of the same results. Kids who are told to "take it easy" or "limit numbers" almost universally don't. There have to be hard limits and an adult invested in making sure they're respected.

 

[Freddy's Fred]

Please keep us posted. Of course you hope it isn't fractured but it really did sound like it probably is. If she is diagnosed, there is a spondy group on Facebook too. It is very useful (and also shows the WIDE variety of opinions on treatment.)

One thing I notice again and again is that gymnasts, once cleared, who return to doing gymnastics how they did before seem to have a higher rate of re-occurrence. A combination of PT and training modification is important. The things Nutter Butter said and removing or seriously limiting problem skills. It will be years before my daughter does a front walkover or front handspring again. She has to be mature and aware enough to engage her core every single time.

Just because their back recovers doesn't mean going back to the same things won't yield a repeat of the same results. Kids who are told to "take it easy" or "limit numbers" almost universally don't. There have to be hard limits and an adult invested in making sure they're respected.

I am always astonished by the numbers of people who don't take injuries seriously. These kids have their whole life ahead of them and so many things and activities to explore. I always tell my kids, you get one concussion. If you get another, we are out. Same with back injuries. You get one.

 

[MUTigerMom]

I got the call at 6:00 p.m. tonight from the orthopedic doctor. It is a confirmed stress fracture in the L4 vertebrae on the right side. Definitely not what we were hoping to hear, but it was kind of what I was expecting after talking to the doctor and reading what everyone had to say here. We start PT tomorrow and it looks like we have a VERY long road ahead of us for recovery. I will probably reach out to a few of you that have personal experience and I think someone mentioned a facebook group. I think she is going to need to hear some success stories and the importance of patience. She has worked so hard and was making some fantastic process. It is so hard to watch her in physical pain and the disappointment of being sidelined from everything.

 

[Sk8ermaiden]

That's what mine had exactly. So sucky. Is it lolsys or thesis? (Has it started to slide or not?)

The group is https://www.facebook.com/groups/2064600470291669/

 

[RTT2]

Sorry to hear it is a stress fracture, but so glad you got the diagnosis now and she can begin healing. Good luck to her on the road ahead!

 

[MUTigerMom]

It hasn't started to slide yet, which sounds like a really good thing. So that's loysis, right?