Men Shoulder bone bruise long recovery time... help!

[Madden3]

At my younger son's first, in house, practice meet in late Dec, he had a crazy fall on floor where he found himself coming straight down onto his head when he straightened out of a back tuck very prematurely on his last pass. We figured out much later that he put out his arms to break the fall, and landed full weight on his straightened left arm. The theory is that this caused his arm bone to jam into his shoulder socket causing a bone bruise in the shoulder (please do not ask me the name of the actual bone.) We did not figure all this out until he had an MRI 3 or 4 weeks after the meet and found out that his "sore shoulder" was a real injury - and then we went back and looked at the video of his fall in slow motion and doctor confirmed that was the likely injury point. It was not at all clear at first as he only started mentioning shoulder pain about a week after the meet, and when he fell we were worried about his head and neck.

Anyway, after MRI and evaluation, pediatric orthopedist prescribed total rest from gymnastics or anything that would put strain or pressure on the shoulders for at least 6 weeks and then slowly going back to gym when pain is gone, plus physical therapy (weekly appointments + 2X a day home exercises.) He has been doing that for a little over 2 months now and still has pain. I finally looked this injury (bone bruise) up online and am seeing that the recovery time can be 6 months or more?!!!

We are seeing ortho again in a week or so, so I am not looking for medical advice but rather ideas to discuss with doctor.

I would love to see my son get back into the gym at least somewhat, he is missing gym big time. But what can he do there with a hurt shoulder? With older son the worst injury so far involved his knees, so once that was past the acute stage he could go to the gym and work many events while still resting and protecting his knees. Would such a thing even be possible with a shoulder injury for a male gymnast? He is a Level 7, or would have been if he had not missed this whole season. My best guess is he will do JD next season.

Any thoughts? Thanks!

 

[Jard.the.gymnast]

At my younger son's first, in house, practice meet in late Dec, he had a crazy fall on floor where he found himself coming straight down onto his head when he straightened out of a back tuck very prematurely on his last pass. We figured out much later that he put out his arms to break the fall, and landed full weight on his straightened left arm. The theory is that this caused his arm bone to jam into his shoulder socket causing a bone bruise in the shoulder (please do not ask me the name of the actual bone.) We did not figure all this out until he had an MRI 3 or 4 weeks after the meet and found out that his "sore shoulder" was a real injury - and then we went back and looked at the video of his fall in slow motion and doctor confirmed that was the likely injury point. It was not at all clear at first as he only started mentioning shoulder pain about a week after the meet, and when he fell we were worried about his head and neck.

Anyway, after MRI and evaluation, pediatric orthopedist prescribed total rest from gymnastics or anything that would put strain or pressure on the shoulders for at least 6 weeks and then slowly going back to gym when pain is gone, plus physical therapy (weekly appointments + 2X a day home exercises.) He has been doing that for a little over 2 months now and still has pain. I finally looked this injury (bone bruise) up online and am seeing that the recovery time can be 6 months or more?!!!

We are seeing ortho again in a week or so, so I am not looking for medical advice but rather ideas to discuss with doctor.

I would love to see my son get back into the gym at least somewhat, he is missing gym big time. But what can he do there with a hurt shoulder? With older son the worst injury so far involved his knees, so once that was past the acute stage he could go to the gym and work many events while still resting and protecting his knees. Would such a thing even be possible with a shoulder injury for a male gymnast? He is a Level 7, or would have been if he had not missed this whole season. My best guess is he will do JD next season.

Any thoughts? Thanks!

I have this same injury in my knee. Also 6 weeks rest (on crutches), then weekly Pt and 2 times a day exercises. I think it has been 6 months now, and the pain is still on and off.

After the 6 weeks of rest, I started to go to gym again. Just sit ups (as I couldn't straighten my leg without it hurting) and my Pt exercises. It helped me feel connected to the team.

Could he do his Pt in the gym?

Edit: I also found out heat helps with all the pain, especially the soreness in my upper legs after 6 weeks of non weightbaring. But also the actual pain in my knee

 

[skschlag]

When D tore his rotator cuff, he did go to gym every practice. HE did stretching, therapy, cardio, and a little tramp (not allowed to set). It kept his spirits up. He would do his therapy exercises 2-3 times while there, depending on what he had done at home, and had very specific things he was allowed to do from his PT> Would that be an option?

 

[kecks]

i would also ask for clearance to go back daily and do anything that does not hurt: core work can be done without involving the shoulder, as can a lot of cardio stuff, speed work (even if he is not allowed to swing his arms while jumping or running he still can do some jumps or sprints without arms, even a good opportunity to work on running technique), strength work for the legs (f.e. leg press at a gym), shapes... and maybe the risk coming with some tramp time would be acceptable, too?

 

[John]

I was going to suggest asking about a Labral tear.

 

[Mom2twingymnasts]

He should work on endurance! As their routines get more difficult and packed with skills, they need endurance.
Also, it would be good to work on flexibility and conditioning that doesn't involve shoulders.

My daughter had back to back shoulder injuries that kept her out for about a year. It is tough to deal with when you can't do much. Hopefully his coaches find a way to keep him motivated.

 

[Madden3]

Thanks for the replies, these are good ideas! A few questions:

and a little tramp (not allowed to set).

What does 'not allowed to set' mean? What is 'set?'

cardio stuff,

He has been running/jogging almost every day, but never for as long as he should be imo. I have long been concerned that gym practice has not been a place the kids get nearly enough aerobic exercise. Is cardio something different? Do you have suggestions on what, at the gym, he could do for this? Even just leaving the shoulder issue aside, aside from running around the gym floor what would someone do for this? Sorry I am sure I sound clueless.

He should work on endurance!

similar to above q- Is endurance the same as cardio/aerobics? What type of exercises specifically?

I think the biggest issue will be helping him to feel comfortable working independently on things no one else is doing especially if they cannot be done quietly in some corner. He has a shyness that can be pronounced when he is doing anything separately from the group so I feel less confident sending him to the gym to do self-directed work than I did with his brother. I imagine it will be important to work with the coaches on coming up with some kind of personalized checklist so he feels more coach-directed as opposed to self directed (or of all horrors, mom-directed.) ? What do you guys think?

Thanks so much, this is all very helpful.

 

[Madden3]

I was going to suggest asking about a Labral tear.

I think this is what they originally thought was wrong ? In any case, after the MRI our pediatrician prepared us for possible need for surgery- but after exam and seeing my son's range of motion, the ortho said that he thought that concern was an "over read" of the MRI and gave the bone bruise diagnosis instead. This was quite a relief- but I will be asking him again about the diagnosis.

 

[skschlag]

"Setting" is when they reach up over their heads before doing a tumbling skill.

 

[profmom]

First and foremost, wow, I am so sorry. This is quite a frustrating injury, both because of the length of time off and the restrictions on activity! (If a guy is gonna be off for months, better he should break something lower down so he can at least still swing.)

I wouldn't overdo aerobics. He needs some endurance, but not the kind of endurance that a track and field athlete needs. To the extent he can do them without engaging the shoulder, he should lean more toward doing a lot of plyometric work to strengthen and activate his fast twitch responses. Any time he puts into building quad and glute strength will more than pay off in preventing back injuries down the road. And let me tell you from watching mine struggle in optionals, there never ever is enough core strength.

Hopefully this resolves soon so he can have a fun summer moving forward on new things.

 

[Madden3]

Thank you for your words of support!

Hopefully this resolves soon so he can have a fun summer moving forward on new things.

Yes, also I am not sure what I am going to do if he cannot be in the gym every day all summer working off his *energy.* Run mad, most likely.

Off to google plyometric...

 

[txgymfan]

Set up a meeting with the coach to make a plan what he can do in and out of the gym.

 

[rosiekat]

With a bone bruise, I thought further activity was OK. It might hurt, but wasn't damaging in and of itself. Obviously, you have to be careful not to compensate for the pain and cause other strains or injuries. I guess one question I'd want to ask is if they are certain it's a bone bruise, and if so, is working out with it actually harmful? I can say that bone bruises do take a long time - I had one on my thumb from doing something stupid and it probably was truly 6 months before it was pain free. However, I only had it splinted for a few days, until the swelling went down, and I wasn't restricted from anything. Regardless, I hope he's feeling much better really soon!

 

[Jard.the.gymnast]

is working out with it actually harmful?

Yes, at least according to all my doctors and pt's. I could push myself until I felt pain. Whenever there was pain, I had to immediately stop. But that might also have been because my acl and mcl couldn't provide stability anymore, so the muscles around the knee had to compensate.

 

[Madden3]

With a bone bruise, I thought further activity was OK. It might hurt, but wasn't damaging in and of itself. Obviously, you have to be careful not to compensate for the pain and cause other strains or injuries. I guess one question I'd want to ask is if they are certain it's a bone bruise, and if so, is working out with it actually harmful? I can say that bone bruises do take a long time - I had one on my thumb from doing something stupid and it probably was truly 6 months before it was pain free. However, I only had it splinted for a few days, until the swelling went down, and I wasn't restricted from anything. Regardless, I hope he's feeling much better really soon!

It is super frustrating, but from what I am reading bone bruise is more serious than it sounds and the doctor was not overreacting on how much to avoid gymnastics. This article explained things in a way I could understand. https://www.tsaog.com/connect-learn...arvin-brown-on-why-bone-bruise-is-a-misnomer/

What is upsetting for me is that we kept sending him to gym for weeks because we never connected his complaints of a sore shoulder to his wipe out on floor. I am sure that made this even worse. He only complained after gym, (it would start to hurt so much at practice he would have to stop whatever they were doing and do something else and that frustrated him) so I had no idea until we saw the doctor that he has pain even with every day movement. Finally his coach suggested we take him to the doctor, who ordered an MRI and I was never so shocked in my life when it turned out he was seriously hurt.

It took us over a month from initial injury to finally see an orthopedist - and he ordered NO pressure or pulling on the shoulder- at all. He said 6 weeks no gym (from the time he saw my son, which was about 5 weeks after the injury) and then he could start going back to gym slowly...if the pain was gone. But the pain is most certainly not gone even though it has now been much longer- over 3.5 months since initial injury, and 2.5 months out of the gym.

Anyway he is finally getting in to see the orthopedist again next week, (getting this next appointment was almost impossible for some reason) so hopefully after that we will know more about how to proceed.

One bright spot? He gets to opt out of the stupid physical fitness test they do here for certain grades. That put a smile on his face.

 

[Jard.the.gymnast]

It is super frustrating, but from what I am reading bone bruise is more serious than it sounds and the doctor was not overreacting on how much to avoid gymnastics. This article explained things in a way I could understand. https://www.tsaog.com/connect-learn...arvin-brown-on-why-bone-bruise-is-a-misnomer/

What is upsetting for me is that we kept sending him to gym for weeks because we never connected his complaints of a sore shoulder to his wipe out on floor. I am sure that made this even worse. He only complained after gym, (it would start to hurt so much at practice he would have to stop whatever they were doing and do something else and that frustrated him) so I had no idea until we saw the doctor that he has pain even with every day movement. Finally his coach suggested we take him to the doctor, who ordered an MRI and I was never so shocked in my life when it turned out he was seriously hurt.

It took us over a month from initial injury to finally see an orthopedist - and he ordered NO pressure or pulling on the shoulder- at all. He said 6 weeks no gym (from the time he saw my son, which was about 5 weeks after the injury) and then he could start going back to gym slowly...if the pain was gone. But the pain is most certainly not gone even though it has now been much longer- over 3.5 months since initial injury, and 2.5 months out of the gym.

Anyway he is finally getting in to see the orthopedist again next week, (getting this next appointment was almost impossible for some reason) so hopefully after that we will know more about how to proceed.

One bright spot? He gets to opt out of the stupid physical fitness test they do here for certain grades. That put a smile on his face.

Is he doing Pt? Chances are he pulled some muscles and ligaments. This can cause pain as well, and instability of the joint

 

[Madden3]

Yes, he is doing PT. He has weekly appointments and 2X daily exercises at home. He is good about doing that. Also he has been doing some core work, jogging, and stretching his lower body.

 

[Madden3]

Update: Saw ortho again (actually a different one but that was just because our original one got so busy the day of my son's appt.) So his associate examined ds and said needs to stay off shoulder but can be at gym as long as he is careful to avoid shoulder work for now.
So he is back at practice 6 hours a week (3 days/2 hours a day) doing stretching, conditioning and trampoline. I thought he would be bored but it has been a week now and he is always excited to go. Shoulder still hurts but apparently these things can just take forever to heal.

 

[skschlag]

Not sure where it hurts, but does raising it above his head hurt? When D had his shoulder injury, he was not allowed to "set" at all for tumbling. He had to do everything with his arm down lol.

 

[Madden3]

Yes it hurts to raise it above head and also out to the side.