Parents Elbow Fracture - What to Expect

[triplethreat+1]

Does your DW watch at gym? I think I would be hesitant if I hadn't previously watched enough to know how closely the gymnasts are monitored, and the coaches style. As others have said, I've seen seen videos of kids in casts or boots doing all manner of things, including at the gym. So some coaches (and kids and parents...) will definitely push the limit.
If it was me, I think I would have my DD on a reduced schedule and have a parent watching. And that's knowing my gym/coaches are generally not the type to push. I know you don't get to go to the gym so I don't know how feasible that would be for you...

 

[rjb123]

My dd broke her radius and ulna a few years ago. She did end up with rod placement, so that might make a difference, but her ortho was fine with her going and doing conditioning. In fact, she had a cast after her rods were placed and he told her she could do "anything that she could do with a cast in place". And she did. My concern in your situation is that he seems to be VERY worried that her bones would move. It sounds like her fracture is quite unstable? DD had a highly unstable fracture and actually was casted only for a week, had no activity other than school and walking and it still moved and needed rods. In the end, the surgery was the BEST for her as it hastened healing, return to full activity (literally MONTHS before she would have ever been able to do so without surgery) and just a return to her "life". I would encourage you to really talk to her doctor in depth about what she is doing in gym, her goals, prognosis, restrictions etc. No one WANTS to choose surgery, but for some kids (mine being one of them) it was the best option for her in the end, and i am grateful she had it done.

 

[profmom]

For both of my gymnasts, doing some kind of conditioning has been necessary to expend energy and keep them sane. The coaches were very good about working with us to enforce strict limits. I think my daughter's record for wall sits is somewhere like 2+ minutes with one leg elevated, and she got up to 3000 crunches last time she was off. A lot depends on the extent to which the coaches are willing to draw and enforce hard lines. When my DD had a healing broken arm, they wouldn't even let her do leaps and jumps with everyone else during warmups lest someone accidentally run into her. She was off in the corner doing hollow rocks or on the exercise bike pedaling to eternity.

 

[LizzieLac]

Here goes...

My DD "lost" about 2 years of training and skill advancement due to breaking her tibia and fibula and all that went with it. It is a long story so PM me if you want to know what the 18 months of her true recovery was like, because there were issues. 6 weeks out of the gym is really nothing in the scheme of things.

That being said, our ortho, who is a great doctor and surgeon and was a D1 lacrosse player who treats all kinds of athletes, didn't really undersdtand the gymnast mindset. There were times he simply could not understand why DD would want to go to the gym, why she wanted to push getting back, etc. There were times, he was incredibly frustrated with us!! He wanted conversations to end, for us to stop asking "can she do this?" type of questions.

But as others have said, a kid in a cast can go into a corner and do hollow rocks or lunges by herself and not be at any greater risk of the bone moving than she would be if she tripped on clothes on the floor of her room. Doctors who don't really know gymnastics don't seem to be able to put it into that context. However, DD's coach was pretty nervous for a while having my DD in the gym. Same reason as your doc - what if Katie is horsing around nearby or your child gets too near someone jumping off a mat. It is reasonable to think that might happen. I have seen lots of disciplined gymnasts act silly and not all that mindful of safety.

So these are the factors that you need to consider when you decide when your DD goes back to the gym to do anything physical, and what exactly should she do that is low risk. It is all about minimizing risk, even when they are fully training and there is not injury.

Your DD will be fine and get through this with no impact to her gymnastics career.

 

[Deleted member 18037]

Folks also need to understand liability

A child who is injured and falls goofing off at home is one thing. From a liability standpoint, doing PE at school or gymnasitics creates a liability risk for the school or business.

 

[profmom]

A good gymnastics program should NOT have kids horsing around in a way that is likely to cause a conditioning athlete to get injured. Lack of attentiveness and horsing around of that nature at my kids' gym is not tolerated. I worry far more about public school gym class.

As for liability, it's not my job as a parent to protect the gym owners from insurance claims. If the coaches and owners believe that an injured athlete can condition safely, that's their call in consultation with their insurance carrier. The real question here is what medical concerns there are and whether any safety precautions can mitigate them. This really all depends upon the specific injury and recovery time frame, and the specific situation at the gym. As outside observers, we can't possibly provide any definitive judgments on either in this case.

 

[LizzieLac]

A good gymnastics program should NOT have kids horsing around in a way that is likely to cause a conditioning athlete to get injured. Lack of attentiveness and horsing around of that nature at my kids' gym is not tolerated. QUOTE]

I never said it is tolerated by anyone's gym or coach, but humans have free will and there are plenty of rec classes and young gymnasts that might take a moment to be silly or jump around while waiting their turn. These things happen unexpectedly and it only takes once to increase the risk for an injured athlete. NY Dad needs to consider that this is possible.

 

[profmom]

It's a matter of relative risk and also a question of what risks are assumed voluntarily and which aren't. My daughter was in a boot a year ago in the fall. She had a lot more trouble with being bounced around and jostled while changing classes at the high school than she did at the gym, but no one would have considered having her home school for that six week period because school is required, not a choice.

As I said, this will vary a lot from gym to gym depending on rules and setup. At my kids' gym, rec kids aren't in the same space much with team kids, and there is a separate room that only team kids use for strength and conditioning. Only NY Dad knows the all-important details like the nature of his child's injury, his child's personality and degree of physical and emotional self control, whether the orthopedist she is seeing has any experience with gymnasts, how coaches handle conditioning for injured athletes, whether younger team members are closely supervised, and whether overall the gym environment is tightly enough controlled that is likely a good deal safer than any other gathering place for youngsters -- like, say, recess. We simply don't know.

One other important note here. Some gyms will give parents a break on tuition if the athlete is out for a longer period (like a couple weeks plus), but they may require a doctor's note for verification. If this is the case, a gym may not be willing to allow an athlete to train against a doctor's advice or may require a parent to sign a special waiver if the athlete is going to train against a doctor's advice.

 

[flipnastic]

So, I'm putting my two cents in as a physical therapist. At this point, if the doctor is extremely concerned about the bones shifting, please listen. Her arm is probably still quite swollen at this time. If she is in a cast, the cast is adjusted to fit her swollen arm. Swelling will go down, and even the smallest change can cause wiggle room in the bones. Now, add movement… Movement that you think your arm has no involvement in it. Someone mentioned hollow rock… Try a hollow rock and feel that The muscles in your arms are contracting as you move back-and-forth… muscle contractions can greatly shift unstable bones into poor alignment. Plus, The affect of gravity is constantly changing the amount of pressure on the bones causing movement in a cast that is slightly to big bc swelling is gradually decreasing. This does not seem huge, but it can cause small movement The affect of gravity is constantly changing the amount of pressure on the bones… This does not seem huge, but it can cause small movements in the bones. You really don't want this to happen! It is much better for a seven-year-old child to allow her bones to heal in proper alignment then to have surgeries to place hardware. If your doctor is this concerned and this adamant about no activity to prevent surgery, it is crucial that you listen and follow these guidelines

 

[LindyHopper]

My two cents: she is YOUNG. She has time. Ultimately 6 weeks is a very small amount of time. And because she is L2, she's not missing as many hours in the gym, and doesn't have to worry about losing a whole lot of skills--especially with the driven little sparkplug you've told is about.

(Short Stack was a 9 year old 3rd grader when she did level 2. Your daughter has time.)

The problem is going to be finding an acceptable outlet for her energy and something for her to focus on. Everything you've told us tells me she is smart and willing to listen to what you say. If you tell her that going to the gym could hurt her arm even worse, and that she would need surgery and be out of the gym even longer than 6 weeks, chances are she would willingly choose no gym.

If the doc sounds really worried, I would get a doctor's note for the gym and keep her home.

 

[Deleted member 18037]

What Lindyhopper said.

To add she is 7 and a level 2. There is not much she will need to get back in 6 weeks.

If she were older and a higher level different thing. For 2 reasons.

First. What they are doing requires more strength and conditioning so they should be doing what they can.

Next. When they are older they have a better grasp on what they should or should not be doing and should (yes, should) be able to say sorry coach, not able/ready to do that. And 7 yr olds tend not to be at that point. Even my almost 11 yr old has a hard time with that. I don't however. I can very easily say no she is not to do that.

JMO, With an injury that new, for all the reasons Carrie994, stated, if it were my kid I would keep her out for now, readdress at 2 or 3 week follow up. Remember it's not all or nothing for 6 weeks, it's a progression.

And given her age I would watch practice (which is something I don't encourage or do under non-injury times) so I could make sure she is not doing what she shouldn't

When my kid was off weight bearing stuff for her wrist last spring I sat through conditioning. She really didn't grasp what she needed to back off on, to her it was just tumbling.

Same with her time in her boot. I watched and so no, you need to adapt x,y and z. She did, and I went back to not watching.

 

[Deleted member 18037]

And this thread brings to mind one of my favorites.

Just because you can do something, doesn't mean you should.

Kids in casts and boots do not mean their injury is the same. Even a "fracture" of a bone can be very different, depending on where on the bone it occurred and how severe. Bone type as well.

Tibia is much more of a concern then fibula. How big a break can make a huge difference. But the boot/cast looks pretty much the same.

 

[profmom]

Not all orthopedists are equally knowledgeable about gym and how gym practices work. A knowledgeable orthopedist can give you better advice than one who imagines a bunch of kids bouncing around and doing cartwheels and forward rolls for a few hours a week when you say "my son/daughter is a gymnast." Carrie994, in my kids' case, your argument would actually militate toward taking my kids out of public school before taking them out of gym. My daughter did get bumped into several times walking in the hallway while her arm was healing and likewise when she was in a boot. If an injury is that severe, perhaps the child's entire lifestyle should be reviewed and major accommodations developed.

With my two (who were at higher levels and doing a lot more hours than OP's daughter when injured), an additional factor that had to be considered was the risk of depression induced by a sudden cessation of a high level of physical activity and an abrupt disconnection from an important social network. They didn't come in and condition primarily because we were all afraid they wouldn't progress or would be left behind. They did so because maintaining some level of physical activity and continuing their social engagements were critical for them emotionally while they were recovering. Of course, the further along/higher a level a gymnast has gotten, the more this piece must be taken into account. Higher level gymnasts also tend in general to be more self disciplined and to respond well to the argument that if they do too much too soon, they may extend their layoff longer. Every physical therapist I've ever encountered has loved having gymnasts as patients because they are so compliant with the exercise regimen.

Once again, we can all speculate all we like about the small handful of tea leaves we have from the OP's report of what his wife told him the orthopedist told her, but injuries are very individualized events that should be addressed by the people closest at hand to the situation: ideally an orthopedist or other specialist who knows something about gymnastics, a concerned parent who is committed to the child's long-term recovery, a coach who is willing to develop a concrete plan for recovery and retraining on an appropriate time frame to prevent reinjury, and an athlete who can trust in the judgment and support of this network.

 

[Deleted member 18037]

In our schools kids in casts, boots, slings, crutches and wheelchairs (I think I got it all) can be release early and or come in early/late so as not to be in halls during the hustle of high traffic times like arrival, dismissal and class changes. Also may have seat changes for that reason.

 

[flipnastic]

Not all orthopedists are equally knowledgeable about gym and how gym practices work. A knowledgeable orthopedist can give you better advice than one who imagines a bunch of kids bouncing around and doing cartwheels and forward rolls for a few hours a week when you say "my son/daughter is a gymnast." Carrie994, in my kids' case, your argument would actually militate toward taking my kids out of public school before taking them out of gym. My daughter did get bumped into several times walking in the hallway while her arm was healing and likewise when she was in a boot. If an injury is that severe, perhaps the child's entire lifestyle should be reviewed and major accommodations developed.

With my two (who were at higher levels and doing a lot more hours than OP's daughter when injured), an additional factor that had to be considered was the risk of depression induced by a sudden cessation of a high level of physical activity and an abrupt disconnection from an important social network. They didn't come in and condition primarily because we were all afraid they wouldn't progress or would be left behind. They did so because maintaining some level of physical activity and continuing their social engagements were critical for them emotionally while they were recovering. Of course, the further along/higher a level a gymnast has gotten, the more this piece must be taken into account. Higher level gymnasts also tend in general to be more self disciplined and to respond well to the argument that if they do too much too soon, they may extend their layoff longer. Every physical therapist I've ever encountered has loved having gymnasts as patients because they are so compliant with the exercise regimen.

Once again, we can all speculate all we like about the small handful of tea leaves we have from the OP's report of what his wife told him the orthopedist told her, but injuries are very individualized events that should be addressed by the people closest at hand to the situation: ideally an orthopedist or other specialist who knows something about gymnastics, a concerned parent who is committed to the child's long-term recovery, a coach who is willing to develop a concrete plan for recovery and retraining on an appropriate time frame to prevent reinjury, and an athlete who can trust in the judgment and support of this network.

You are absolutely correct and that every patient/injury is very different and should recommendation should be given on a case-by-case basis. That is exactly why I wrote what I did… It sounds like the doctor is very adamant about no physical activity due to instability of the bone . Many posters mentioned that it may be OK to do conditioning because it does not use arm, I just wanted to give insight on to why the doctor may be very adamant about no physical activity at this time, as harmless as some activities may seem. Yes, gymnasts are great patients at therapy clinics because of their work ethic, perseverance, dedication, etc. ... But remember that if they are in the clinic, they have been released by the doctor for physical activity. I'm sure op will have a follow-up with the doctor in the next week or two, with more imaging and the doctors recommendation may change at that time depending on how well the bones have healed, but since it is still a very early, I would highly recommend listening to the doctor. He is the one with access to imaging and the expertise to know what ops daughter is ready for.

 

[Deleted member 18037]

I'm sure op will have a follow-up with the doctor in the next week or two, with more imaging and the doctors recommendation may change at that time depending on how well the bones have healed, but since it is still a very early, I would highly recommend listening to the doctor. He is the one with access to imaging and the expertise to know what ops daughter is ready for.

Yes and really the key point that seems to be getting lost is, no activity for now.

It is not all or nothing, not necessarily the whole 6 weeks.

And as with all medical threads the advice should be listen to the doctor. If you are not happy with what the doctor says, get a second or third opinion.

 

[NY Dad]

Thanks for all the replies and well wishes. The quick answer is that she’s not going to gym/no conditioning at home for now. (I've added a few details below )

Yes and really the key point that seems to be getting lost is, no activity for now.
It is not all or nothing, not necessarily the whole 6 weeks.

Not lost at all!

I'm putting my two cents in as a physical therapist. At this point, if the doctor is extremely concerned about the bones shifting, please listen.

I can’t thank you enough for this post. It changed my thinking (and I rewrote the response that I was about to send) based on your comments. My dd’s doctor had given me the impression that it’s okay for her to do anything at home (she can’t fall, non-aggressive) but she can’t do these things at the gym. That’s why I was so confused. You’ve explained it and it makes more sense now. I’m sure he wasn’t thinking that she would be doing v lifts and super girl holds at home (not sure if that’s what it’s really called).

He did specifically state that there’s a risk for slippage for 2 weeks. (He won’t even recast her until next week). So 2 week wait to start conditioning sounds like a great idea. Also, I plan revisit this conversation with him at next week’s appointment. (I’m sure he’ll be thrilled to chat with me in person )

When my kid was off weight bearing stuff for her wrist last spring I sat through conditioning. She really didn't grasp what she needed to back off on, to her it was just tumbling.

Her doctor wasn’t ready to discuss this part with me (too many “what if” scenarios) but broadly speaking he said first 6 weeks no gymnastics another 2 weeks for full mobility and another 4 weeks for a full recovery (I know he was just giving me rough estimates). Also, I was planning to say that my dd is cautious but you gave a great example, she’s not going to be able to decide what she should and shouldn’t do and I was going to put too much faith in her coaches.

A good gymnastics program should NOT have kids horsing around in a way that is likely to cause a conditioning athlete to get injured. Lack of attentiveness and horsing around of that nature at my kids' gym is not tolerated. I worry far more about public school gym class.

(This is for when she does return to the gym so I know what to expect.) This is exactly what I was hoping to hear, but based on the range of answers I’ve read here, not all gyms are like this. I think my dd’s is, but I’ll check in with her coach to confirm. I’ve got a list of specific questions/concerns for him based on what I’ve read here. I’m also going to tell him specifically what her doctor told/tells me.

here on CB (while we have lots of opinions and experience relative to us) are the least of it.

I don’t agree. I’ve made so many informed decisions based on comments/information I’ve received on CB. I didn’t know about the typical environment during a team practice at a gym I assumed it was a relatively control environment. I’ve gotten a great range of answers and I that’s what I was looking for to make a more informed decision. As usual I’ve been given some additional things to think about that hadn’t occurred to me.

but know that she could injure it just as likely in school at recess or playing in the house.

This was my mentality when I posted the question. It’s about relative risk. Her doctor wasn’t distinguishing /gymnastics/dance/any other sports/gym class/recess. He just lumped it all together.

You really aren't in a position to know from an online forum whether other children here have had a worse injury than your DD.

Good point, thanks. (and thanks to the other posters (and PM’s) with specifics.

sometimes it is harder on us as parents I swear....

So true. She doesn't feel nearly as bad for herself as I feel for her.

"This won’t make a difference in the long run (for her career)" (several similar comments)
This response isn’t as applicable after I read Carrie99’s posts but I it got me thinking about why my dd does gymnastics and why it’s so important for me for her to get back to the gym.

I love seeing my dd so focused and working so hard towards achieving her goal to compete in a meet some day. In the process I’ve seen her gain confidence, overcome fears and become very strong and flexible. I also want her to get back to gymnastics b/c she loves it. I think mentally, being in the gym and with her teammates is different than conditioning at home. (Which, based on what the doctor said, she is allowed do now but I'm no going to let her until she sees her doctor again and I get a clarification)

True, 6 weeks isn’t a big deal in the scheme of things but when her doctor told me she can do anything non-aggressive at home but can’t step into her gym I don’t think he’s making an effort to understand where we’re coming from.

(Hopefully I don’t get too much negative feedback for this thought)
In the back of my mind (after her health and her wellbeing) I had been wondering if her gym tends to move girls up after states (in May) and how she would take it if she got held back b/c of the timing of her recovery. Before Carrie994 explained it, the decision about no gym seemed arbitrary. Without understanding why she couldn’t do anything physical outside our home for 6 weeks and then potentially have to spend a few extra unnecessary weeks working on mobility/strength didn't make sense to me and I was trying to understand. Now I feel like I understand why she's not going to the gym for now.

 

[Deleted member 18037]

I had been wondering if her gym tends to move girls up after states (in May) and how she would take it if she got held back b/c of the timing of her recovery.

That would be a thread unto itself. And you can search too.

Short answer. My kid is coming off a month layoff there abouts. Whether she to gets to L7 by next season will (99%) depend on how her summer training goes. It has not one thing to with these last few weeks.

And any move up thus far has always been driven by what happens after the season ends in May to August. Now that we are heading to optionals that might shift a bit as a new skill mid season could potential mean a mid season move up. A flipping vault comes to mind for one.