Women Return to Gym 5 Weeks After Back Injury; No PT?

[NutterButter]

DD was diagnosed with 3 stress fractures 5 weeks ago (L3, 4 & 5 as shown on the MRI). Since then she's been on 'no activity'. I took her back for a recheck and she's been cleared to gradually transition back to the gym. Low impact activities first. No back bends or back tumbling. Very gradual return to high impact. The doctor expects it will take several months to return to full gymnastics. DD has to really pay attention to her body and pain level. The doctor said she will likely experience set backs as she transitions back. DD was not referred for physical therapy. The timeline laid out the the doc is consistent with what I expected however I thought she would have at least another couple weeks of no activity then start PT. It's only been 5 weeks!! Based on what I read here and the experiences of teammates who have faced the same, I was expecting a longer period out of the gym and PT. Any words of wisdom from someone who has BTDT? I might be freaking out just a wee little bit.

 

[txgymfan]

Have you gotten a 2nd opinion? It might be worthwhile, even if it just makes YOU feel better.

 

[bookworm]

My daughter had a pars fracture at T10 and she never did PT either...but she was out of the gym, as in not setting foot in the place and not even conditioning and wearing a hard back brace for 24/7 except to shower, for a full 12 weeks to allow it to heal...and it did. She went out at the very beginning of her 4th level 10 season in the fall and came back in time for Regionals and Nationals, and did well.

Because she gave it the time to heal, she has never (knock on wood) had an issue with her back in all the years (almost 10 now) since it happened. Her sports doc told her that "there are doctors/athletes/coaches/etc who think you can rush a back fracture in under the 3 months it takes to heal the bones but those who do, usually go on to have ongoing back issues". Of the numerous kids in her gym that had stress fractures/reactions of the back , she was the only one who sat out the 12 weeks, and the only one not to have to deal with it again...and she competed all 4 years of high school as a 10 and her 4 years in NCAA...no back issues.

While her coach at the time thought i was a lunatic, It was time well spent letting it heal..

 

[my4buffaloes]

I think I would request PT. Our DR said to stay out 3 weeks with lots of PT. She had the beginning of a stress fracture of the L5. She stayed out completely for 5 weeks (my choice and the timing of Thanksgiving break), then 2 weeks of nothing but PT, conditioning and tramp work to retrain her core to tighten on landings. Then a very gradual return to full gymnastics which took another month.

For the severity of your dd's injuries that doesn't seem like enough time and I think she needs PT to strengthen her core for sure. Good luck!

 

[2G1B]

My DD just had one (L5) and was told NO activity other than PT for 8 weeks, then easing back in to skills. She started PT 2 weeks after her diagnosis, 3 times per week for 4 or 5 weeks and then down to 2 times per week for about a month, then down to once per week. I don't think I'd have been comfortable having her go back sooner and it sounds like what your DD has is WAY worse than what my DD had.

 

[gymmutti]

Often the stress fractures/reactions are due to the kids not utilizing the correct muscles and relying too much on their back. Even with six-packs, a child can have a weak core. If that is the reason for the back issues and you do not do PT and take the time to re-learn how to use certain muscles and re-learn how to do skills correctly - the back issues will return. I would definitely do PT. My daughter had bi-lateral stress reactions and had a doctor who also kept her in the hard brace and out for 12 weeks and then another month of PT before starting any gymnastics (which was ramped up very slowly). She has not had any back issues since.

 

[SurpriseGymMom]

I am absolutely not a doctor and don’t have personal experience other than DDs teammate. I assume there may be many different degrees and kinds of stress fractures..? DDs teammate was in a hard plastic corset brace for several months with very limited activity in the beginning leading up to more as she felt up to it (but still wearing the brace, 24/7 except showers). Ultimately this gymnast ended up leaving the sport before fully recovering, unfortunately.

 

[duyetanh]

Disclaimer, I have no knowledge other than what I have read on here... but that really sounds like a VERY short time, and I would worry so much about a potential reinjury. Any chance at all of pt or a second opinion?

 

[Deleted member 14190]

What did she do ?

 

[IreneKa]

Is she pain free? Did they do follow up MRI or bone scan or something? How did they clear her?

 

[profmom]

Second Irene's question. I'm skeptical and would want a clean MRI at five weeks. And I think PT is a good idea to identify whether she has some uneven muscular development in her back. My daughter learned that one factor in her back pain was that the large muscles were very strong and thus were doing some of the work that should have been done by the small muscles that stabilize the spine. She was assigned some exercises specifically to address this problem.

I think with backs, it's generally better to err on the conservative side with return to gym. And she should never do another back walkover.

 

[Deleted member 18037]

I’m not a doctor nor do I play one on TV.

But I am a parent and as I parent I have a vote too. I partner with her docs.. if I wanted or was concerned with timing and thought it should be longer or PT, doc and I would be chatting. And I’m sure he/she would have no problem extending her time out.

And when a doc is not open to listening, conversation and discussion they don’t stay our docs.

 

[NutterButter]

What did she do ?

This all started later part of December. Due to a mental block with her beam series she found herself exploring new options as it was apparent that the one she had been training all summer was gone. So, pain began when she started training BHS BHS on beam. This was a new skill for her so she wasn't surprised to feel sore. DD said it felt muscular. She saw the gym trainer pretty quickly and got some exercises which didn't help much. Around this time you could feel the knot on her back; massage helped as did a few days rest. The gym schedule between late December and mid-February was weird... several missed training days because of meets (travel and and local), holiday week off and a couple of snow days. She frequently had 4 or even 5 days of no training and when she returned to gym, the back was fine for a day or two. She moved on from BHS BHS but pain still lingered; mostly on jumps and leaps. By late January she was experiencing pain on jumps. Her pain during this entire time was only a 3 and not consistent. Sometimes she felt fine (often on Monday). A couple times it felt a little worse. I do think that she was gradually getting worse and even though she reported the same pain level, I think DD was simply adjusting to new threshold. Late January I made an appointment to get it checked out. She still competed in two more meets but was pretty much doing modified training with fewer reps, less pounding and minimal leaps the last two week prior to diagnosis.

Is she pain free? Did they do follow up MRI or bone scan or something? How did they clear her?

She is pain free though she 'feels a little something' when she leans forward a specific way. Doc said this was normal. No follow up MRI - the doctor said at this point it would still show damage. She said a CT scan could be done but in her opinion it wasn't worth it because it would show healing and that what we really need to go on now is DD's pain. The doc seems to have a conservative approach to radiation. She said she would recommend further imaging if she continues to feel pain. The conversation was really focused on DD paying attention to pain and then pulling back when needed and that this would be a very long comeback.

About a week into 'no activity' DD noted that her back felt different. She believed that the muscle soreness was gone and that all she was feeling was the fracture. She reported that she could 'feel it' if she moved a certain way in a chair or while sitting on the couch. She had never really noticed this before. Apparently this is not uncommon. And even this pain has been gone for 2-3 weeks. She is pain free now.

 

[NutterButter]

Have you gotten a 2nd opinion? It might be worthwhile, even if it just makes YOU feel better.

Yes! I am getting a 2nd opinion next week. I do believe that DD is clinically healed. I believe that she didn't meet whatever criteria the doc has for PT referral. I also believe that additional time out of the gym is a good thing and I also believe that PT, or at the very least a consult, would be beneficial. So, this is my goal for DD and what I'm going to pursue.

DD seems to be a quick healer. She has returned from other broken bones/fractures in the minimal amount of time so I'm not surprised that she might be on the minimal amount of time in healing back fractures too. But as everyone else has said --- this is her BACK! Yeah. I agree. 1000%. A thousand, gazillion %. I do want more information on why this may have happened in the first place and if there's anything that can be done with PT to strengthen her and/or minimize recurrence.

I'm so appreciative of this discussion board. Just think - if I didn't have CB in my life, I likely would have sent my DD back to the gym today. All of your insights and questions are so helpful.

 

[NutterButter]

I’m not a doctor nor do I play one on TV.

But I am a parent and as I parent I have a vote too. I partner with her docs.. if I wanted or was concerned with timing and thought it should be longer or PT, doc and I would be chatting. And I’m sure he/she would have no problem extending her time out.

And when a doc is not open to listening, conversation and discussion they don’t stay our docs.

There's a whole lot of assumptions in this and that saying on ASSumptions is coming to mind right now. Are you implying that I'm not partnering with her doc? That I did not address my concerns and questions with the doc? And then your comment on docs who don't listen are no longer your doc. I gave no indication whatsoever of personal interactions with the doc...what the doc said/did/didn't say/didn't listen. Your advice is often sound and logical but your antagonism is so off putting.

 

[Deleted member 18037]

There's a whole lot of assumptions in this and that saying on ASSumptions is coming to mind right now. Are you implying that I'm not partnering with her doc? That I did not address my concerns and questions with the doc? And then your comment on docs who don't listen are no longer your doc. I gave no indication whatsoever of personal interactions with the doc...what the doc said/did/didn't say/didn't listen. Your advice is often sound and logical but your antagonism is so off putting.

You are taking far too personal what was not meant to be.

If I in anyway felt that my daughter was going back to soon, I would not send her back.

We changed docs last year as a doc wanted my daughter out 6 weeks minimum over an ankle roll. She wasn't out that long for a fracture previously. And he wanted her an over the knee boot. Was not open to any discussion about the matter. I asked questions. He answered none. That was the last time we will ever be in that building. I literally drove my kid to another office from that docs. Love the new guy, includes not only me but my kid in the process. She was back in gym in a week, no hard landings. Full out in 3. And if I thought it was too soon, she would of been out longer.

 

[Deleted member 18037]

You are taking far too personal what was not meant to be.

If I in anyway felt that my daughter was going back to soon, I would not send her back.

We changed docs last year as a doc wanted my daughter out 6 weeks minimum over an ankle roll. She wasn't out that long for a fracture previously. And he wanted her an over the knee boot. Was not open to any discussion about the matter. I asked questions. He answered none. That was the last time we will ever be in that building. I literally drove my kid to another office from that docs. Love the new guy, includes not only me but my kid in the process. She was back in gym in a week, no hard landings. Full out in 3. And if I thought it was too soon, she would of been out longer.

My point was you are the parent, if you want to wait, or take a different direction regarding PT. Do it.

 

[NutterButter]

My point was you are the parent, if you want to wait, or take a different direction regarding PT. Do it.

Then just say this. Your first post insinuates that maybe I did not question it enough with the doc. Or maybe the doctor wasn't listening to me. Your second post provides more insight into your first response with the bad advice you received for the sprained ankle. Now I can better understand your first response questioning the quality of my DDs care. But none of this has anything to do with the specific advice I was in search of for my DD's situation. Your last response is a little more appropriate in that as the parent I gotta do what I think is best for my DD. Couldn't agree more with that sentiment.

When I posted my question yesterday my head was spinning from DD's appointment. The cartoon picture of me would have had a thought bubble that simply said "WTF?" It didn't help that DD was part of the same conversation with the doc and was already thinking about what leo she was going to wear to practice today and all I'm thinking HOLD UP, THIS IS MY DD's BACK! After the appointment I was wondering if I missed asking something which might have changed the doc's mind. And really how to go forward. So I come here to see what others who have been in this situation have to offer. And the responses truly helped crystallize for me what I'm after and just as important how to communicate all this to my DD, her coaches and any future medical/sports caregiver.

 

[NutterButter]

UPDATE! DD is now 7 weeks post-diagnosis. I recently had a consult with a PT. As with the ortho who treated DD, the PT has a lot of experience treating gymnasts. She was so helpful in furthering my understanding of DD's back injury and why she was cleared to return sooner than I expected. I didn't really doubt the doc's assessment as she has treated several girls in DD's gym for all sorts of injuries with a conservative approach to reentry but I was still confused. So, DD will start PT in a couple weeks. I'm not sure when she will return to the gym but my guess is that it will be around the 12 week point. The PT has worked with several girls at DD's gym over the years so she has a pretty good understanding of the dynamics within our gym which will be be beneficial to my DD as she begins the next phase of recovery. I'm not in freak out mode anymore though a crystal ball to know that it will all be OK would be nice.