Parents Feeling helpless with DS

[Trackandgymmum]

I am new here, and wantto ask your experiences and words of wisdom with my 14y/o son... Prepare for a long history, sigh..

For starters, son does not do gym, her younger sister does. But during son's injuries, this forum has given me most help, advice and comfort.

DS always been sporty and active. In early school years did little bit of gym, soccer, swimming, cricket, aussie rules football (weare in Aus). Forthe last 3 years Track and Field, and aussie rules football, have been his sports of choice.

He never had any injuries or pains, but at are 6 I took him to the podiatrist as I noticed knock knees/ pronated feet. Knocked knees are very visible on my husband's mother and sister. Podiatrist at the time gave him custom made orthotics, which we used for about 2 years. They didn't make a visible difference.

In May/June 2018 he first suffered terrible knee pain at the start of the football season, but that passed within a month, and didn't return, and se didn't see anyone. In Oct/Nov 2018, at the start of the track season, he had lower back pain for around 4 weeks. We saw physio, who gavehome excercises, which seemed to help and back pain stopped.

In Feb 2019 towards the end of the track season, aged 13, his left heel started hurting. Diagnosed byphysio as Severs. This was pretty bad for 2 months, but somehow he managed to even compete at nationals in April.

During winter 2019 left heel bothered him here and there at football, but not enough to miss games or training.

In Sep 2019, at the very start of track season, the right heel started hurting. It was so bad until xmas, son didn't do any jumping or sprinting. Instead we started doing more throws and athletics coach got him in second strength session a week, where they were doing more stuff with weights etc.

Just before xmas, we saw a new podiatrist, got custom made orthotics and by new year, things started to feel brighter. During January 2020 summer hols, DS was able to try jumping, hurdling, and sprinting. I vaguely remember he mentioned once or twice hislower back hurting, but wasn't concerned, as we were just wanting to get him out of severs.

Start of Feb 2020, he did a two day state wide comp, during which lower back started hurting and following week, it didn't settle.

10th of Feb 2020 he was diagnosed with L5 stress fracture on his right side. Diagnosed by sports Dr with MRI. At 9 weeks he started physio, which he is still doing 8 months on. At 12 weeks said he could start jogging program, as he had had no pain since the initial diagnoses week. Running seemed to bring him "feel" his back, we reduced jogging once a week 10min only. At 16 weeks had repeat MRI, which showed fracture healed but bone odema still there. He kept feeling the fracture spot, so in JulyI said he won't run until we have completed the month CT scan. Until mid August CT scan, he was doing once a week physio (strength) and once a week clinical pilates, stationary bike at home, and some home excercises. No pain.

Mid August 2020 CT scan showed full healing. We had high hopes and son was prepared to return to training slowly and continue work at physio. 2 months later, he still "feels" hisback every now and then after running, and hasn't been able to progress running.

Then, 6 weeks ago, his right knee started hurting. Its like a vicious cycle, he rests a week, no pain, and then goes running, and within first 5min warm up, the knee pain starts. Pilates physio pointed out that his knee(s) roll in when he runs. This can be seen with a trained eye only, as his running technique is great. I can see it in a slomo video.

Now, I am starting to feel hopeless, as is he. I have made the theory, that he has knock knees (This is quite visible when he stands freely), which caused overpronated feet, which cause pressure on lower back, caused the fracture (?), and now give him knee pain. Where do we go from here? I feel like the worst mother in history, why didn't I get his knees/posture thoroughly fixed when he was younger. He is at the end of his puberty now (age 14y 7m) ,not sure if will grow more in height. We are so tired of trying to wait and I honestly feel no amount of stretching or excercise will fix the cycle, if it's his bonestructure and the knee is sitting on a tilted angle.

I'm not even sure what I am asking, anyexperience, recommendations, advice, whom to see... Thank you so much for reading

 

[Madden3]

Hi, first, I completely relate to the feelings of mom guilt. I have two athlete sons and a long history of injuries between them. But you did not cause any of this to happen to your son. I do suggest, try to turn those feelings of guilt to action. I have found that when there is no clear medical/doctor ordered path, what works best is to follow my instincts.

I do not know what doctors or HC system is like there. My personal experience is that finding a doctor who really listens and considers everything thoughtfully is very hard. The system is set up for them to spend so little time with each patient. But I do think your instinct that there is something systemic going on is worth following up on with someone who will look at the situation wholistically. Even if your son's knocked knees cannot be "fixed" there are probably ways to lesson the ill effects. I am not sure who such a person might be, doctor or someone else. But there is a long history here and a whole person that needs to be considered. Fixing each thing individually has not worked so far, so maybe it is time to look at it as a whole.

I personally have never been to a chiropractor nor has anyone in my family. But I know many rational people who swear by this treatment.
I do have experience with yoga, and I can tell you that when I did yoga frequently with a good teacher I felt the healthiest and strongest of my adult life. (And yes, I know your son is 14 and if he is anything like my 14 year old there is no way he would do yoga. Just throwing it out there.)

But I do think that with young athletes, a lot of these types of injuries are because the coaching and conditioning strategies are very result oriented rather than about building an all-over healthier body. And this is nothing against your son's coaches who may be great. It's just an entirely different mindset in athletics vs. something like yoga.

I have seen myself the cascade effect of injury many times with my kids. Pain or weakness etc. in one place leads to a problem in a completely different place. It may be your son needs a much more prolonged rest from any high impact sports. Has he ever considered anything aside track and field? What about swimming, water polo, climbing?

One last thing. Posture is a something that is going on all the time and sometimes the simplest things help. My friend who is a physical therapist noticed my 17 year old son was hunching. She asked to see his room. Within minutes showed us why he needed to change his school-issued chomebook set up. Investing $10 in a keyboard so he could use some books to raise the chromebook to eye-level has already worked wonders. She also showed him some quick and easy exercises he does every day with a roller.

Also my son has to wear inserts to correct pronation. He also does track. He has a set of inserts for his training shoes and his regular shoes and he has learned to always be wearing one or the other for any prolonged walking (not just around the house.) Some people would need inserts even then.

 

[kendo348]

My suggestion, based on my own experience, would be to look for a DO. A DO can offer chiropractic adjustments but is also trained holistically, and they tend to be inclined to take the time to uncover a systemic issue. If you can find one who works independently from insurance and can afford it, all the better as they will be free to take as much time as needed and treat in whatever way is best.

 

[Trackandgymmum]

Hi, first, I completely relate to the feelings of mom guilt. I have two athlete sons and a long history of injuries between them. But you did not cause any of this to happen to your son. I do suggest, try to turn those feelings of guilt to action. I have found that when there is no clear medical/doctor ordered path, what works best is to follow my instincts.

I do not know what doctors or HC system is like there. My personal experience is that finding a doctor who really listens and considers everything thoughtfully is very hard. The system is set up for them to spend so little time with each patient. But I do think your instinct that there is something systemic going on is worth following up on with someone who will look at the situation wholistically. Even if your son's knocked knees cannot be "fixed" there are probably ways to lesson the ill effects. I am not sure who such a person might be, doctor or someone else. But there is a long history here and a whole person that needs to be considered. Fixing each thing individually has not worked so far, so maybe it is time to look at it as a whole.

I personally have never been to a chiropractor nor has anyone in my family. But I know many rational people who swear by this treatment.
I do have experience with yoga, and I can tell you that when I did yoga frequently with a good teacher I felt the healthiest and strongest of my adult life. (And yes, I know your son is 14 and if he is anything like my 14 year old there is no way he would do yoga. Just throwing it out there.)

But I do think that with young athletes, a lot of these types of injuries are because the coaching and conditioning strategies are very result oriented rather than about building an all-over healthier body. And this is nothing against your son's coaches who may be great. It's just an entirely different mindset in athletics vs. something like yoga.

I have seen myself the cascade effect of injury many times with my kids. Pain or weakness etc. in one place leads to a problem in a completely different place. It may be your son needs a much more prolonged rest from any high impact sports. Has he ever considered anything aside track and field? What about swimming, water polo, climbing?

One last thing. Posture is a something that is going on all the time and sometimes the simplest things help. My friend who is a physical therapist noticed my 17 year old son was hunching. She asked to see his room. Within minutes showed us why he needed to change his school-issued chomebook set up. Investing $10 in a keyboard so he could use some books to raise the chromebook to eye-level has already worked wonders. She also showed him some quick and easy exercises he does every day with a roller.

Also my son has to wear inserts to correct pronation. He also does track. He has a set of inserts for his training shoes and his regular shoes and he has learned to always be wearing one or the other for any prolonged walking (not just around the house.) Some people would need inserts even then.

Thank you so much for taking time to response. Yes I agree that although the Sports Dr we have seen (for the L5 stressie) at the sports medicine clinic has been great, they don't really consider all factors and underlying influences. They seem to assume it's due to overtraining or because of certain sports. It was always a doubt at the back of my mind to think over training caused the fracture, as because of extremely painful severs, DS did minimal training 4 months prior the fracture.

I think chiro suggestion is good. If I'm able to find a good chiro, they can probably see the imbalances in his body and make further suggestions.

I agree with you re yoga and holistic approach to training. Coaches tend to just train a certain still, probably don't realise how important the overall balance is.

I think I am feeling so stressed and worried, as it feels like we are in a waiting game now. There is no plan of action. Lower back is meant to be healed now, but why does he still feels it, when he hasn't even attempted returning to sports. He is also a lot stronger now after 6 months strenghth training with the physio. That's the reason Im almost ready to see an ortho surgeon to hear an opinion from them.

The physio is great though. I messaged her yesterday, and she said she would talk to both the Sports Dr and the pilates physio, and see what they all think of the knock knee situation.

 

[Trackandgymmum]

My suggestion, based on my own experience, would be to look for a DO. A DO can offer chiropractic adjustments but is also trained holistically, and they tend to be inclined to take the time to uncover a systemic issue. If you can find one who works independently from insurance and can afford it, all the better as they will be free to take as much time as needed and treat in whatever way is best.

kendo348, what is a DO? (Sorry the term is not known to me here in Aus)

 

[Trackandgymmum]

kendo348, what is a DO? (Sorry the term is not known to me here in Aus)

kendo348, doyou mean Orthopedic Dr? Would Orthopedic surgeon be the same? At the Sports Medicine clinic, where we have seen a Sports Dr for his back injury for the last 8 months, there are some Orthopedic surgeons, some of them seem to be knee specialist.

 

[Pineapple_Lump]

Sorry to hear of the ongoing problems. I don't have any real advice just wanted to say this caught my interest. I just watched an old webinar lecture from Phil Cossens (GA MAG team physio at the time) about injuries and their likelihood to occur at a certain point after breaks/ reduced training due to injury. He mentioned the need to train consistently to avoid injury (maintain muscle fitness) and consideration for time to build that up when breaks do occur. Very interesting statistical correlation between when the injuries occur after breaks and the types of injuries that do. Perhaps something to also think about.

 

[Trackandgymmum]

Sorry to hear of the ongoing problems. I don't have any real advice just wanted to say this caught my interest. I just watched an old webinar lecture from Phil Cossens (GA MAG team physio at the time) about injuries and their likelihood to occur at a certain point after breaks/ reduced training due to injury. He mentioned the need to train consistently to avoid injury (maintain muscle fitness) and consideration for time to build that up when breaks do occur. Very interesting statistical correlation between when the injuries occur after breaks and the types of injuries that do. Perhaps something to also think about.

Thisis a great point too, thank you. This mayvery well be one of the contributing factors. DS was on very limited training for 3-4 months, then did a big comp, and back pain started. And then again now, trying to get back to running after a very long break... I will try and find that webinar lecture.

 

[Pineapple_Lump]

Thisis a great point too, thank you. This mayvery well be one of the contributing factors. DS was on very limited training for 3-4 months, then did a big comp, and back pain started. And then again now, trying to get back to running after a very long break... I will try and find that webinar lecture.

It's only available to GA technical members, so if you are not a coach/judge then you won't be able to access - I would have included the link if I could

 

[&bs]

kendo348, doyou mean Orthopedic Dr? Would Orthopedic surgeon be the same? At the Sports Medicine clinic, where we have seen a Sports Dr for his back injury for the last 8 months, there are some Orthopedic surgeons, some of them seem to be knee specialist.

I think she might mean an Osteopath, but the difference is in the US they are a trained medical doctor whereas in Australia they are not.

 

[Eleven sol]

So sorry to hear about your son’s injuries.

My daughter went through Severs and back pain. I switched her to low impact activity for several months (swimming). She had to take several long breaks from gymnastics and track, which was frustrating for her but took the inflammation down for a while. And I don’t mean a week, I mean 6-8 weeks. But I see you said he took breaks.

All I know is once the growth stopped, her pain has gone away but that didn’t happen until age 14 for her. It lasted probably two years and many things helped but nothing took it away. A physical therapist was probably our best investment.

I had the overpronation issue and orthotics did work for me. I think it’s the repetitive pounding of high impact sports that can cause stress fractures. Perhaps he needs to find something low impact to balance it out as well as some concentrated rest.

 

[NutterButter]

A few years ago my DD had 3 stress fractures in L3,L4 and L5. She was out of the gym a few months then SLOWLY came back with the help of her PT who managed her progression back into skills. In all, it took about 9 months from when she was first diagnosed to having competition ready skills again. She has always had some degree of pain though and she was constantly managing her pain level with training, taking time off or pulling back when needed to give her body rest. She had MRIs during this time which confirmed that her back was healed. On and off for the next year+ she worked with her PT to address any pain when things flared up again. It wasn't always her back but also her hip flexor, knee and groin. The belief was that all her issues stemmed from her back though.

Just before COVID her pain intensified a bit. Still manageable, but a smidge more than her usual and not in the same location. Around this time there were other new back injuries going on in the gym so I took her back for another MRI. This one showed the beginnings of an injury. Not fractured, but well on it's way. This budding injury was on a the other side. The area of her previous injury still looked good. Thanks to COVID she was out of the gym for over 2 months but she started PT during this time.

Her PT suggested that DD work with a personal trainer over the summer. The goal was to start doing some lifting work and get used to the types of workouts she will have when she went to college in the fall (D3 gymanst). She has been working with the trainer 2x/week since mid-summer. Her back is completely pain-free now. Her trainer and PT worked initially together on a conditioning plan. The trainer noted areas of weakness and pain and wouldn't let my DD progress further until she was pain free. Her trainer has fine-tuned my DDs conditioning and truly fixed most of her problem areas. FWIW - the trainer she is working with has created a niche for himself in working with kids who have some sort of injury. He's expensive and it's 'one more thing' to do on top of being a full-time college student and practice but it's been worth it. Her back is pain free after almost 3 years.

 

[Trackandgymmum]

So sorry to hear about your son’s injuries.

My daughter went through Severs and back pain. I switched her to low impact activity for several months (swimming). She had to take several long breaks from gymnastics and track, which was frustrating for her but took the inflammation down for a while. And I don’t mean a week, I mean 6-8 weeks. But I see you said he took breaks.

All I know is once the growth stopped, her pain has gone away but that didn’t happen until age 14 for her. It lasted probably two years and many things helped but nothing took it away. A physical therapist was probably our best investment.

I had the overpronation issue and orthotics did work for me. I think it’s the repetitive pounding of high impact sports that can cause stress fractures. Perhaps he needs to find something low impact to balance it out as well as some concentrated rest.

Thank you for your response. Severs is thankfully gone now, and I think DS's growth has started to slow down. Growing at such pace, I mean like 15cm in one year, is probably what put him at risk in the first place.

This week we are feeling more positive. A plan has been created bythe 2 PTs, aths coach, Dr and DS to get him towards normal training. PT has said no running for 2 weeks, but given other options.

 

[Trackandgymmum]

A few years ago my DD had 3 stress fractures in L3,L4 and L5. She was out of the gym a few months then SLOWLY came back with the help of her PT who managed her progression back into skills. In all, it took about 9 months from when she was first diagnosed to having competition ready skills again. She has always had some degree of pain though and she was constantly managing her pain level with training, taking time off or pulling back when needed to give her body rest. She had MRIs during this time which confirmed that her back was healed. On and off for the next year+ she worked with her PT to address any pain when things flared up again. It wasn't always her back but also her hip flexor, knee and groin. The belief was that all her issues stemmed from her back though.

Just before COVID her pain intensified a bit. Still manageable, but a smidge more than her usual and not in the same location. Around this time there were other new back injuries going on in the gym so I took her back for another MRI. This one showed the beginnings of an injury. Not fractured, but well on it's way. This budding injury was on a the other side. The area of her previous injury still looked good. Thanks to COVID she was out of the gym for over 2 months but she started PT during this time.

Her PT suggested that DD work with a personal trainer over the summer. The goal was to start doing some lifting work and get used to the types of workouts she will have when she went to college in the fall (D3 gymanst). She has been working with the trainer 2x/week since mid-summer. Her back is completely pain-free now. Her trainer and PT worked initially together on a conditioning plan. The trainer noted areas of weakness and pain and wouldn't let my DD progress further until she was pain free. Her trainer has fine-tuned my DDs conditioning and truly fixed most of her problem areas. FWIW - the trainer she is working with has created a niche for himself in working with kids who have some sort of injury. He's expensive and it's 'one more thing' to do on top of being a full-time college student and practice but it's been worth it. Her back is pain free after almost 3 years.

Thank you NutterButter. That is so good to read, it's so hard to judge with the pain, and last few months DS hasn't really had any pain, mild ache or "feelings" in the back. The PT has really strengtened his glutes, hammies, even lower back muscles. They all pointed out DS had weak core and hammies when he started the PT in April.

 

[Trackandgymmum]

Hi all. Just wanted to update that we saw a chiro yesterday. I felt like he was the first person who fully understood what caused the fracture. He said DS has weak internal oblique, and his thoriadic spine doesn't have good mobility, which puts more stress on his lumbarspine.
Chiro ordered to do skipping, stationary biking and foam rolling, as well as mobility excercises.