Parents Back problems and PT

[IreneKa]

Hi!
As some of you know, my DD has been struggling with the back problems since last year. She was diagnosed with spondylolysis (stress fracture) last June, was in a hard back brace for 12 weeks, fully recovered, but 6 months later started having back pain again. MRI showed stress reaction in the exactly same spot as last year. The fact that it keeps coming back at the same spot tells me that something is wrong, and it's not just overuse.

She did PT last summer, but they were mostly focusing on developing muscles in her back, and didn't sound like they knew a lot about gymnastics. So, this time I decided to look for someone with gymnastics background. We saw a PT this week, she did gymnastics as a child, and then competed in college (not D1 or something, but still). She certainly knows gymnastics, and what skills are causing back problem, she was asking if DD was doing a lot of BWOs, FWOs, BHSs, etc., what skills she does on bars, and so on. But at the end of the appointment when I asked her if she can tell why the injury keeps coming back, she said no, she didn't see anything obviously wrong with DD. That was a bit discouraging, since I'm really looking not to just get her better, but to make sure this doesn't happen again.

Someone here on CB pointed me to this website: http://www.hybridperspective.com
I think it's been mentioned here before, but I didn't pay attention. This time I looked closely and I found this great article: http://www.hybridperspective.com/20...ossible-injury-prevention-for-the-lower-back/
This article points to the most common reasons for the back injuries - hips flexibility and shoulder flexibility, and after looking at the picture in the article, I think DD is definitely lacking the hips flexibility, or maybe even both. And the sports doctor did mention something about her hips being tight.

So, here is my dilemma. Would I be totally out of line to print out this article and bring it to our next PT appointment? Or should we just look for a different PT? I mean, we liked her overall, she was nice, the office is nice, the location is convenient, etc.. And there is no guarantee that the next doctor we go to will know more. And we can't keep on going from doctor to doctor until we find the right one, I don't think the insurance will cover that. So, if the article will give her some ideas of what to do to help DD, that would be great. But at the same time I don't want to sound like I'm telling her how to do her job. Any thoughts?

 

[bogwoppit]

Bring the article, bring anything. My dd with the freaky flex lower back had very tight shoulders and hips. Basically that broke her back. Honestly she never should have been bridging or doing BWO. Should have been spotted in preteam.

AT 18 she still deals with back pain daily.

 

[Iwannabemargo]

I would print it and say, "hey, I found this article and wondered if this may be contributing to DD's problems, can you give me your wise and professional opinion please ?"

 

[ZJsMom]

I think it would be fine to bring the article to the PT's attention and ask her what she thinks.

My dd had a lot of low back pain when she was in gymnastics. We went to a chiropractor who specializes in sports medicine and he helped her a lot.

It probably would make sense to talk with her coaches as well, if they'd be receptive. I'm not a medical expert, but looking at my dd and the other girls who ended up with stress fractures or chronic low back pain, the common thing I noticed is the tendency for them to do BHSs with a shoulder angle and compensating over arching of the back.

 

[Quadqueen]

I PM'd you, IreneKa.

 

[IreneKa]

Thank you all! I'm glad I don't sound too crazy thinking about bringing the article to the PT.
Yes, I've been thinking about bringing this to her coaches' attention to, once she is back at the gym. But I also think it will sound better if I say "this is what her PT doctor suggested", instead of "this is what I found on the Internet".

 

[SurpriseGymMom]

Definitely bring it up with her coaches (but yes to being cautious about saying you learned it on the internet, lol...better say something like "the PT did some further research and...). As a coach, i do want to know if one of my athletes has limitations that I should be aware of so I can tailor exercises to them better and protect them. They probably have noticed already if she's tight in some areas...

 

[SurpriseGymMom]

Oh, and I don't think I'd be in too much of a hurry to switch PT. Finding one that has gymnastics background isn't always easy and I think I would broach the subject with her similarly to with the coach... "Hey, I was researching this to try to understand it better and came across this.... What do you think, could it have anything to do with things or does this not apply at all to Little Suzie?"

 

[SignHere]

My DD is having back pain. No spondylitis on bone scan, so the sports dr has prescribed PT. I am thinking about bringing the article as well. So far, I've told the coaches I don't want her doing BWO until further notice. Fortunately, she can train BHS BHS for beam , but still.... I'm worried I'm looking like a CGM!

 

[IreneKa]

My DD is having back pain. No spondylitis on bone scan, so the sports dr has prescribed PT. I am thinking about bringing the article as well. So far, I've told the coaches I don't want her doing BWO until further notice. Fortunately, she can train BHS BHS for beam , but still.... I'm worried I'm looking like a CGM!

She shouldn't be doing any back skills, BHS including, if she is having pain. Did you see the PT yet? What did they say?

 

[gracyomalley]

Bring the article - as a pediatrician I never mind new information - although I sometimes need time to figure out if its legit!

DD coaches recognized quickly that her tight hip flexors were a contributing factor to her back pain and it does get better when she really works her flexibility (she's got tight shoulders too). A parent may not notice as the kids can still do all their splits, leaps, etc...

DD also went straight to BHS series on beam - then back to BWO without pain later when she got all vestibular!

 

[thefellowsmom]

DD dealt with some back issues for a bit. She is very flexible in her shoulders but her hips were very tight. When we went to PT they tried stretching her hip flexors and they would loosen up the tiniest bit with lots of stretching daily but then tighten right back up. Turns out that wasn't the root of the problem. The muscles weren't tight so much as restricted.

Finally saw someone who really knew what they were doing and did a lot of research to help her specifically and she is doing great. Two things were found that no one had even mentioned before. This may or may not apply to anyone but maybe mentioning them here will help someone in the future.

1. Check internal and external rotation of the hip joint. Her coaches had been complaining about her turnout since she was little and she continually worked on it with little progress being made. Turns out her hips were all blocked up and she had almost no movement in her hips in that direction. This guy did one manual treatment and cleared the blockage and she has been making great progress on both hip flexor flexibility and turn out ever since. Leaps and jumps finally full split. She literally was incapable of lifting her back leg in that way, her body would not do it. Now she is finally able to do it and building the surrounding strength and flexibility she needs to support her back and reach full range of motion.

2. Make sure her glutes are firing properly. The new practitioner we are seeing thinks this was at the root of the back problems and no doctor or PT we had seen previously (gymnastics specialists included) had even mentioned or thought to check this. Her glutes were firing last, not first. So when laying on her stomach she would lift her leg up and it would fire hamstring, back, glute. Should go glute, hamstring, back. This way the back is doing the least amount of the work when pulling over walkovers and such. In our case her back was doing most of the work, hence the back pain. He has been able to activate them properly and then help her form the neuromuscular connections to fix this going forward. She is slowly learning to do this properly for herself.

This is also a key player in explosiveness. It wasn't that she didnt have it because now it is here in spades, she just couldn't physically access it. Vault and tumbling have exploded since getting this working properly.

She is also continuously working on core stabilization exercises. These are key and he emphasizes that since she is prone to back issues she will need to be diligent about them forever. We have done many iterations and circuits and combinations of exercises. One set that she is really liking right now that we throw in to mix up her PT is this circuit from Mary Lee Tracy. Super cool and super hard.



So, I can not emphasize enough finding someone who really wants to learn. Our person didn't know gymnastics but was an elite level athlete and found her situation fascinating and spent a lot of time researching and figuring out what her specific needs were and how to go about fixing it. He is one of her biggest fans now and really helps to push her mentally as well. When she gets lazy about her exercises he reminds her of her goals and what it will take to get there, because he knows himself. I feel very blessed to have found him.

Good luck to everyone with these nagging back issues. They are a real stinker.

 

[IreneKa]

Wow, thank you, @thefellowsmom! This is very informative!

 

[sce]

Bring the article, bring anything. My dd with the freaky flex lower back had very tight shoulders and hips. Basically that broke her back. Honestly she never should have been bridging or doing BWO. Should have been spotted in preteam.

AT 18 she still deals with back pain daily.

I agree, any good professional is always open to learning more. I had been wondering about her bridges, and if she was arching int eh proper part of her back. I did not know what things could cause a gymnast to not be able to arch properly though, that article was very interesting in explaining the possible issues.

 

[gopuckgo]

Definitely bring the article. But my guess is that during the evaluation this was assessed. Sometimes what looks "normal" to a typical person is very "abnormal" as a gymnast (ie meaning her flexibility could have clinically presented within normal limits, however, as a gymnast you need more than normal flexibility to perform specific things). Research Myofascial Release and pm me if you need more detailed information and specifics as to why this is most likely impaired. Good luck!

 

[Firefly]

Sending you a PM also!

 

[LizzieLac]

Bring the article, switch PT, ask a million questions. Who cares if they think you are CGM or what? Your DDs health and well-being is more important and you would be surprised how many "professionals" out there aren't that good at what they do, or in the least they aren't sports certified or don't understand gymnastics.

After DD broke her tibia and fibula and had surgery, she started PT. They were fine for the first few appointments when they were just trying to get her to walk without crutches, but it was clear to me they knew NOTHING about treating athletes, and certainly had no experience with gymnasts.

So, I called a PT I had experience with but she was now working too far away for us to go there for treatment. But I trusted her explicitly, she was sports certified, and was an ex-gymnast and college cheerleader. Talk about the perfect fit for DD! I paid her to treat DD privately, but to afford it, we saw her less frequently than if she was seeing PT in an office or facility. She would come to the house and also met us at the gym. The key was she KNEW what DD needed as a gymnast and was able to give her so much information and exercises to do on her own that she didn't to be treated 2x/week like the other place encouraged.

Long story short, DDs comeback was nothing short of miraculous IMO. Yes, my DD worked hard, but our PT was key to the process.

Good luck, I hope your DD has a full recovery and no more pain!

 

[IreneKa]

Thanks everyone! We had our second appt yesterday. I didn't show her the article, somehow didn't feel right, but I talked to her about it. I told her that I've been researching the back problems in gymnastics, and it seems like hips and shoulders flexibility is the most common issue. She said that yes, she did notice her hips being a little stiff, but didn't want to push her too hard on the first day. But when they started the exercises, I saw that she did pay much more attention to DD's hips than last time. Her right hip seems okay, but the left one is tight. Which explains why her stress reaction is only on the left side. So, they did a lot of stretching, and she gave some good stretching exercises to do at home. So, we'll stick with this PT for now and see how it goes.

I would like to thank everyone who took their time to share the stories and offer suggestions both here and through PM. I really appreciate it. I've got some great ideas of what to try in addition to PT. Thank you all so much! This place is amazing! Those who get offended and leave after one unpleasant comment don't know what they are missing!

 

[MAcastsalot]

Glad it went well! I hope that this solves the problem for your DD.

 

[GYM0M]

Just a thought: any good ballet classes in your area? Ballet is always good for flexibility, esp in the hips. I wish DD could go back to dance just for ballet, but we can fit it into our schedule & privates get expensive after a while........