WAG Seeking Advice - How to approach fears as the result of injury?

[LizzieLac]

I am looking for some proactive guidance/suggestions/etc., especially from coaches who have had to deal with the following:

DD broke her tibia and fibula towards the end of October in a bad landing of a tsuk vault. It was an incredibly crazy evening, down to paramedics and clearing the gym. I can give more details if necessary...

A week later we opted for surgery - insert rod into tibia, as it was a clean break. Avoiding keeping in full leg cast for 6 weeks and patellar cast for 4. I will again skip the details of the last 8 weeks to get to this question...

DD is doing PT and back at the gym conditioning, etc. Last night she tried straps and did great. Coach has been quite good with her, although I have been critical of his approach to things in the past. He spent some time with her reminding her of the things she already knew and even coerced her into doing a kip (she did not have her grips with her). She didn't do a giant on the straps, but he felt she could, as her taps swings looked great. Next time maybe, but more importantly, her leg felt fine.

On the way home she commented about being scared to try the strap giants. She said she can see how the bad form of several girls could really lead to a bad result. I think she is hyper-aware of the inherent danger of some of these things and now she sees how many things could go wrong. I down-played it, and told her that someone else's bad form does not mean an accident is inevitable and that her good form, conditioning and smarts are what she needs to come back safely. Then we dropped it.

In my head, I am a little worried for sure. What happens when she has to go back to vault and stare down that runway or start going for BHS on beam (wasn't an easy skill to get in the first place) and LO on floor? She is a level 7 gymnast and very observant and understands form corrections, but also a bit of a thinker and very methodical.

How can help her NOW, before she has to even get up on the beam and attempt a skill or is even ready to vault?

 

[B&M's mom]

I'm not sure you can do much. My daughter went through an injury that also resulted in surgery at the end of last season and I had the same worries. Her coaches did a good job of gradually reintroducing her to her skills again. They didn't force her into the skill that resulted in the injury right away. Then one night last month she got into the car and announced that she had done the skill for the first time since February. Since then, it seems like she's on a roll and things are back to where they were.

I stayed out of the process except to provide moral support. I've learned that with this child, not trying to "help" is better than "helping." She's also a thinker/observer.

 

[Deleted member 14190]

IMO,,, It's too early, this is how I explain it to the kids.
The body has a "splinting" mechanism during and after injury. It's a natural reaction, you break your arm and you automatically cradle it in your other hand. You break a rib and you instinctively put your hand on it to keep the ribs from shifting as you breath. You break your leg and you automatically reach down and hold it. Well, along with you physically splinting things your body also has a mental splinting mechanism as a back up. You suffer a concussion and your body shuts down from any aggressive exercise for weeks or months, (depending on the severity). You suffer an injury (broken bone) and your body automatically holds back and often needs a kick in the pants to get you going again, (this is part of the reason for PT). Some people have a natural reaction to return after an injury and well.... some people if left alone will just curl up on the couch and never get better....
At this point since it's only been a few months, I think it totally natural for her to hold back. And as she builds confidence and more importantly her leg heals a little more, she will return. Time is your friend and also your enemy, but at this stage she sounds on track.
PS. I had the exact same break, recovered fully and returned to gymnastics, except I did not opt for a rod.

 

[LizzieLac]

I'm not sure you can do much. My daughter went through an injury that also resulted in surgery at the end of last season and I had the same worries. Her coaches did a good job of gradually reintroducing her to her skills again. They didn't force her into the skill that resulted in the injury right away. Then one night last month she got into the car and announced that she had done the skill for the first time since February. Since then, it seems like she's on a roll and things are back to where they were.

I stayed out of the process except to provide moral support. I've learned that with this child, not trying to "help" is better than "helping." She's also a thinker/observer.

I totally agree with the "not helping" being more help with my kid too! In fact, I realized that it was best to not talk about skills even is she was struggling. Let her vent, sure, but there was nothing more that I could do. In fact, I needed to shorten her venting. It was like out of sight, out of mind was best. The only thing I might continue to do when she was struggling was have her tell me two good things she did in the gym that night - focus on the successes.

This injury has just so much bigger than any struggle of a skill. I was unsure if the same approach made sense. I mean this has affected her whole life - managing school, not seeing friends much because of recovery, lots of time on the couch, and probably even a little loneliness. It certainly does give you perspective!

Thanks for responding!

 

[poodlemomma]

My DD broke her arm early in her gym career. Even though the doctor gave her the okay to go back in the gym early summer, I kept her out until fall. I figured if there was even a twinge of pain in her arm, it would put her back even further. She went back in the fall and no one pushed her for a couple of months. She was put back in rotation with her new team mates (as she was just getting ready to join team when she broke it) and was the only one not pushed until they felt she was ready to be. She broke it learning the ROBHS. That was a huge set back and she went back to being fully spotted when she started that again. Let her take it at her pace and pushing a little here and there by coaches to see what she was ready for let her gain her own confidence back in her time. I think that "splinting" analogy is very good.

 

[LizzieLac]

IMO,,, It's too early, this is how I explain it to the kids.
The body has a "splinting" mechanism during and after injury. It's a natural reaction, you break your arm and you automatically cradle it in your other hand. You break a rib and you instinctively put your hand on it to keep the ribs from shifting as you breath. You break your leg and you automatically reach down and hold it. Well, along with you physically splinting things your body also has a mental splinting mechanism as a back up. You suffer a concussion and your body shuts down from any aggressive exercise for weeks or months, (depending on the severity). You suffer an injury (broken bone) and your body automatically holds back and often needs a kick in the pants to get you going again, (this is part of the reason for PT). Some people have a natural reaction to return after an injury and well.... some people if left alone will just curl up on the couch and never get better....
At this point since it's only been a few months, I think it totally natural for her to hold back. And as she builds confidence and more importantly her leg heals a little more, she will return. Time is your friend and also your enemy, but at this stage she sounds on track.
PS. I had the exact same break, recovered fully and returned to gymnastics, except I did not opt for a rod.

Thanks! This makes a lot of sense. Makes me wonder a couple of things. 1) How much "mental" cradling is the right amount? 2) What do you do for the people who curl up on a couch and stay there?

The other night her coach explained that in many ways, as we get back to training, she will learn the skills from the beginning again. It will go faster because she knows the skills, has experience and knowledge, and the body will "remember" the skill. But this is how we don't overload the system - physical or mental. We simply take our time. Like you said, time is our friend and enemy. She is s freshman level 7, not a ton of time left in the sport, and the end of this season may come without her even getting to compete her new routines once. That just stinks, but it is what it is...

Thanks for responding!

 

[Deleted member 14190]

Too early to tell, but constant pressure will get them off the couch. . Also, in the injury world this ranks pretty high, in other words this was a violent injury involving two major bones. Not just your typical injury.... Worst I ever had, and I have a pretty impressive list!

 

[LizzieLac]

Coachp, for what it is worth, I have had the orthopedic say that this kind of injury is better that joint injuries - ankles, shoulder, and even elbows. His opinion was based on the range of motion and stiffness issues that plague joint injuries. Bones heal and being that is young there will be no long term issues. But I agree with you in terms of it ranking high in "violence" and trauma.

On a positive note, at practice today she did multiple strap giants!!! Her "bar" workout was that and repeat pushaway kips. I am already intensely proud of her!

 

[Deleted member 14190]

Joint injuries are difficult , but the pain index of breaking your shine bone is well.... Just go kick the coffee table as hard as you can, then multiply that by 10 and add a solid 3 weeks onto the pain. Very happy to hear she is moving along. Keep us updated!

 

[profmom]

What's the predicted timing? When will she be back on weight bearing? The one thing that can be said for her injury is that she will be able to do some real stuff on bars before she's ready to tumble (DD broke her humerus just above the elbow a few years ago and basically couldn't do anything for three months). I think it is just such a confidence builder if they can be working on skills, some of them even scary skills, before they are ready to jump back into it full throttle.

I come to your question from two perspectives, one as the mother of a child who had a significant injury from a fall on beam and secondly as someone who did the tibia fracture thing in sports myself as a child. I worried a good deal about my DD as she was approaching her release date and particularly worried that she would have trouble with the full turn on beam after the injury. And she did have some anxieties. But honestly, it was far easier than I ever would have dreamed knowing what a thinker and processor she is. We did everything we could to prepare her emotionally for the comeback, primarily telling her not to expect to go out there and pick up right where she left off, but she really got a charge out of regaining every skill as they came back. It also sounds like your coach has a good plan for moving her back to where she was. Help her to find the small victories. It won't be hard! From what I've seen of broken bones and other injuries, I'd be very surprised if she didn't come back and get right back to where she was before the injury within a month of her full return.

Now as to my experience: my tib fracture was back in my equestrian days. We were practicing for a tandem riding drill, and the mare next to me lashed out at my horse and caught me square in the shin. From the sound, everyone in the arena knew it was broken, so I was fortunate enough to be lifted off my horse and put on the ground, thus avoiding the usually inevitable fib to go with the tib. Back in the dark ages, the protocol was full leg cast for six weeks, then cast up to knee for two more months. I started the summer vacation in a cast and went back to school in a cast. And you know what? I can honestly say that the worst thing about it was being off riding. I do not remember having any real fears, though I did tend to be more cautious in group riding situations. I just wanted very badly to be back out there on the horse, badly enough that I convinced my mother to let me ride once the cast was cut down. I found that the more I could phase back in, the less anxiety and depression I experienced, and once I was OK to do most of what I'd been doing, I felt fine about it even though I was still in a cast. Of course once the cast came off and my leg looked like a twig and I could barely take three steps without piercing pain, I was all bummed out again, but as I recall, that passed relatively quickly as I regained the muscular strength. And even with the complete immobilization and radical atrophy, the muscle came back quickly.

 

[LizzieLac]

The beauty of the rod was that she could be weight bearing immediately. It was like the cast being on the inside. Her recovery has been from the surgical procedure itself and the general trauma of the injury. But she has been walking on her own since before thanksgiving.

She did have a bit of rough go due to an infection. So there was a slight slow down there. But really now she has some residual swelling around her ankle that we're working on through PT and a lazy toe that is coming back.

I would expect that she can start jogging in 1-2 weeks but I am sure she will be hesitant. Last night she BWOs on the floor but at first had to question if that was ok. I sort of chuckled because doc had a long time ago that Walkovers would be safe as there is not much if any impact.

The other benefit of the rod is that she did not have to have her leg completely immobilized. So she avoided muscle atrophy and joint stiffness. Her knee never lost range of motion.

We will just have to see how quickly it all comes back. Coach is putting a program together for her that we will kick off after Christmas. Starting January she rejoins her workout group full time. My fingers are crossed for sure!

 

[profmom]

I'm so glad the protocols for these sorts of things have changed since I broke my leg! That's great that she's going back full time so soon. I hope her experience is like my daughter's -- with each success, she gains confidence and ambition to try the next thing.

 

[teksquad]

I worried a good deal about my DD as she was approaching her release date and particularly worried that she would have trouble with the full turn on beam after the injury. And she did have some anxieties. But honestly, it was far easier than I ever would have dreamed knowing what a thinker and processor she is. We did everything we could to prepare her emotionally for the comeback, primarily telling her not to expect to go out there and pick up right where she left off, but she really got a charge out of regaining every skill as they came back. Help her to find the small victories. It won't be hard!

Profmom- thank you for sharing your perspective and story! We are exactly at this point right now, with my daughter, in her recovery. She is also a thinker and processor (gets it from me) and I have the very same concerns for her. I love how you advise to celebrate the small victories! She is starting to have some, and is elated. (-: I also think it helps her to feel supported and included, when others recognize her little victories, and celebrate with her. I also love reading about how the rest of the recovery process went for your daughter, and yourself during your injury recovery. It is very reassuring, and I would like her to read this.

Lizzielac- I hope your daughter starts to feel relief and ever-increasing confidence as she does the skills she can do now, so that the "scarier" ones that daunt her now, won't be daunting when the time comes to start doing them again. Today, those skills may feel impossible and generate anxiety, because the leg is not ready at this moment. But, when the time comes, she will have had other successes, and more healing under her belt. I bet she won't be feeling the same way, and will be mentally/emotionally ready, when her leg is ready. May you feel better too, as you watch her recovery continue, and as she feels better. (-:

 

[B&M's mom]

My DD was the same when she was finally cleared to resume tumbling. First it was BHS on the tumble track then she could move to the rod floor once there was no pain. I held my breath those first few weeks in July while she took it slowly. So slowly I began to wonder if she ever get back to her full tumbling (she's been training elite so she does some huge passes). Occaisionally I'd check in with her and ask her where she was. She had to be reminded that as long as she wasn't experiencing sharp pain, she was allowed to work the skill. But by November she was back to her full skills. They weren't polished but she was doing them. She's now confident about the upcoming season.

One good thing that I've seen as a result of the injury is that she is a lot more thoughtful about her practice. She now knows that she can't do tons of repetition on the floor or beam. So she's using the tumble track and rod floors more. Plus the routines that she does on the floor/beam, she's more deliberate so she doesn't have to do constant corrections. Reduces some of the pounding on her entire body.

Wish your daughter good luck. She'll get those skills back!

 

[LizzieLac]

Well, we're moving right along. The two weeks of the holidays meant a quiet time in the gym - less scheduled practices and less kids since some were away. For DD it was a good return and yesterday's practice in particular was successful.

Doc and PT have progressed her some more. So although she isn't quite ready to jog, she is able to jump on trampoline and tumble trak and can do plyometrtics. This is a great addition to leg workout - being able to jump up onto stacked mats, but must step off. Next xray is in 1.5 weeks and fingers are crossed that she is able to add some impact like jogging.

Bars are coming along great and although she was scared and hesitant, with the encouragement and assistance of her coach she did cast flayout flyaway into pit. So she gets to check that off the list!!

Hope this week is just as good!!

 

[emma m]

i had a similar problem, but on a much smaller level one day i was practicing the jump to high bar, which is a skill that's second nature to me, and somehow my wrists just didnt shift enough and i fell from the bar. i landed on my neck and ended up with two sprained wrists and an extremely sore neck (no serious injuries thankfully). after that i was obviously terrified to do the skill. i had an hour private just to work on it and no success, just a lot of frustration. eventually my first meet came and i guess i just felt so much pressure that i did the skill. my advice to you would be to break down the skills that she's scared of into manageable pieces and one by one, she will get comfortable with them. eventually, she can start to put the pieces together and try the skill, and hopefully she'll be more confident to do them. good luck!

 

[LizzieLac]

Just thought I would give a quick update on DD and how she's doing at the gym.

It has been 14 weeks since the tibia/fibula break and 13 weeks since the surgery and I have to say I am blown away by DD's progress. She is not yet tumbling on floor or doing vault (no surprise there, right? ).

She is doing BWO and CW on middle beam, and full turns which are so-so given that is the broken leg she is standing on, and poses etc.

Bars - all of it except dismount - hopefully get clearance on that tomorrow when she gets a new xray. But giants on pit bar and straps, kips, clear hips, squat on and can jump to high bar. Looks her cast to HS suffered the most, but she's working on it.

She started the running protocol from the physical therapist and that is going well - even though running has never been her favorite activity!! She's doing BHSs and RO-BHS on tumble trak and even standing back tucks off the end to mats. Today she did the floor conditioning with the rest of the team, which means lots of releve!

PT is lots of jumping and agility as well as strength stuff.

I have no idea if this it typical healing and recovery, but the progress is so cool to see and I am happy for her!

 

[UnoMas]

Glad she is progressing...sounds like she is on her way to a full recovery!

 

[teksquad]

Sounds like great recovery to me! Hope the x-ray gives her full clearance today!