WAG vestibular issues or something else?

[Deleted member 10727]

My just turned 9 year old son with "immature eyes" has what we think are vestibular issues. He could do RO-BHSBHSBT before the season started, and then once comps were coming, suddenly he couldn't do even a BHS anymore. What I think is happening is that he is relaxed enough during non-comp time practices that he can focus on "forcing" his body through it. When comp season came he lost it all 2 years in a row now. BUT, this year he has managed to force the RO-BHS BT into his routine. I know it is forced because of the way he looks doing it, with legs sort of froggied on the BHS, which is not typical of this kid. He is also having trouble doing flyaways off HB, but has no problem doing layouts off the rings. He says he is not really moving outward off the rings, so it's different.

Yesterday we were laying in bed, and he tilted his head back, and he said, "Look mom, there are 2 pillows." There was only one pillow.

 

[gracyomalley]

Picking up my three at practice yesterday and chatting with a parent of a talented upper level kid with "growing pains" over gym (not vestibular), sharing my experience as the parent of a "stuck" kid (DD was in the process of doing her level 7 bar routine from 2 years ago with a new coach - but at least she's doing cast handstands and fly away out of free hips again...baby steps, although as a parent I miss the pirouette, giants and overshoots with spot she was doing in May), and another parent mentioned a neurologic chiropractor who specializes in vestibular rehab. I know that my older son saw a PT for his concussion who had some drills related to vestibular stuff - but that was a post-traumatic situation (which, thankfully, is 90% resolved). I'm not sure if I should take DD in for an assessment or if it would be a big waste - but the individual who mentioned the option did point out that this problem can be difficult in life, not just gymnastics - something I hadn't worried about at this point! I also know I really want to "fix this" for her, so may be tempted to waste money on it, LOL.

I'm thinking if it makes her able to recognize what's a vestibular issue (and therefor which skills to just work around for the mean time) and what might be a training/fear issue that with proper drills she can easily overcome that would be helpful. Her head coach is encouraging her front tumble as much as possible, but that is the physically harder route to take - and she is such a lovely back tumbler - especially on beam. The feeling ok with a spot thing is interesting but makes medical sense due to the added input on position given to the athlete by both seeing the coach and feeling them spot them - and fits DD to a tee.....just having the coach stand near her is helpful - she thought because of a "dependence" upon the coach - but maybe it was a visual cue to position in space all along....because it never needed to be a coach that could catch her - just one she was comfortable with....

Anyway, if anyone has any quack stories about chiropractics in this area let me know - I can talk myself into it being helpful - but I'll only do it if DD says she wants to see if it will help - I'm working hard at only expressing my parental need to make this all better here on CB!

 

[gymdog]

Picking up my three at practice yesterday and chatting with a parent of a talented upper level kid with "growing pains" over gym (not vestibular), sharing my experience as the parent of a "stuck" kid (DD was in the process of doing her level 7 bar routine from 2 years ago with a new coach - but at least she's doing cast handstands and fly away out of free hips again...baby steps, although as a parent I miss the pirouette, giants and overshoots with spot she was doing in May), and another parent mentioned a neurologic chiropractor who specializes in vestibular rehab. I know that my older son saw a PT for his concussion who had some drills related to vestibular stuff - but that was a post-traumatic situation (which, thankfully, is 90% resolved). I'm not sure if I should take DD in for an assessment or if it would be a big waste - but the individual who mentioned the option did point out that this problem can be difficult in life, not just gymnastics - something I hadn't worried about at this point! I also know I really want to "fix this" for her, so may be tempted to waste money on it, LOL.

I'm thinking if it makes her able to recognize what's a vestibular issue (and therefor which skills to just work around for the mean time) and what might be a training/fear issue that with proper drills she can easily overcome that would be helpful. Her head coach is encouraging her front tumble as much as possible, but that is the physically harder route to take - and she is such a lovely back tumbler - especially on beam. The feeling ok with a spot thing is interesting but makes medical sense due to the added input on position given to the athlete by both seeing the coach and feeling them spot them - and fits DD to a tee.....just having the coach stand near her is helpful - she thought because of a "dependence" upon the coach - but maybe it was a visual cue to position in space all along....because it never needed to be a coach that could catch her - just one she was comfortable with....

Anyway, if anyone has any quack stories about chiropractics in this area let me know - I can talk myself into it being helpful - but I'll only do it if DD says she wants to see if it will help - I'm working hard at only expressing my parental need to make this all better here on CB!

Spotting gives them proprioceptive input. It's extremely common for a kid who feels lost in the air to be able to do something when spotted. If the coach standing there makes a difference, I would tend to think that might be fear but it depends on what you mean by standing there, in some situations it might give them additional information or it might give them the idea to "go" even with feeling lost in the air because they feel their coach will catch them.

It's important to note that although the two are often linked, vestibular problems or problems with spatial orientation don't automatically cause blocks or balking. Obviously, most blocks/balking are due to the kid lacking something, and their body telling them that. But a kid can still have vestibular issues and "go for it" or at least attempt to. This where the bad accidents can happen. So it's actually important to identify these issues and then encourage kids NOT to do it when their body tells them no. Although I think no spotting ever is draconian because I spot for proper shapes on basics, this is the basis behind the "no spotting for confidence or learning timing" philosophy that Sands mentioned in his article. It's important for the kids to respect when their body tells them no and NOT initiate a skill that they don't have the awareness to complete.

So, a kid who lacks orientation can still chuck something. The coach standing there might make them go for it, it just might not end well unless that coach is ready to spot and has incredible reflexes. So I don't necessarily recommend this approach.

I have coached a kid who lacks the spatial awareness to "recover" or find their feet but doesn't have the accompanying mental blocks. It's difficult and slow going. I do tend to spot them in case on the high bar or things like that, and they probably won't go much beyond the basics. It's very interesting. On the other hand I have kids who will do the wildest techniques with insane fast twitch muscle, and still land on their feet or recover no matter what, like a cat. The latter is what I tend to select which is why I have more of them. Interestingly, most of them have what seems to be clinical ADHD (a neurologically based disorder), so I wonder sometimes what to make of that. I'm not a neurologist, it's just interesting.

 

[gymdog]

Be VERY, VERY careful with someone claiming to specialize in vestibular rehab. I would expect them to have a doctorate degree which I'm not sure is the case of the chiropractor you mentioned. Some of these things can't necessarily be rehabbed. There is no one size fits all problem with the vestibular system or how it's functioning. And there's potential for more damage to be done. I would tread very carefully.

 

[CanAmGymMum]

Be VERY, VERY careful with someone claiming to specialize in vestibular rehab. I would expect them to have a doctorate degree which I'm not sure is the case of the chiropractor you mentioned. Some of these things can't necessarily be rehabbed. There is no one size fits all problem with the vestibular system or how it's functioning. And there's potential for more damage to be done. I would tread very carefully.

Just as in any profession, there are good chiropractors and bad chiropractors. In order to get into chiropractic college, you must first obtain a 4 year bachelors degree. From there you must complete a 10 semester course (5 years) that includes a 1 year residency. There are several in depth neurology courses required to graduate. Upon graduation, you are a doctor of chiropractic (DC). No one in the United States or in Canada may call themselves a chiropractor without this training. Chiropractors are also required to complete continuing education in order to maintain their license. Many neurology courses are offered as part of this continuing education.

My point is, chiropractors are, in fact, educated and well equipped to deal with problems involving the nervous system. Most vestibular issues seen by chiropractors are due to inner ear deficits resulting in severe vertigo. Vestibular rehab would involve designing an appropriate exercise program to retrain the brain in the way it interprets signals from the vestibular system. I couldn't possibly see the potential for more damage to be done, as stated by gymdog. My only worry would be that, vestibular training for most average patients would be considered complete long before it reaches the level required to help a gymnast. Therefore, it would be treading in new territory for the chiropractor and most likely only effective if he/she is willing to think outside the box and modify the program to suit a gymnast.

I'll get off my soapbox now. It just seems like many are very quick to bash chiropractors on this site.

 

[gymdog]

Just as in any profession, there are good chiropractors and bad chiropractors. In order to get into chiropractic college, you must first obtain a 4 year bachelors degree. From there you must complete a 10 semester course (5 years) that includes a 1 year residency. There are several in depth neurology courses required to graduate. Upon graduation, you are a doctor of chiropractic (DC). No one in the United States or in Canada may call themselves a chiropractor without this training. Chiropractors are also required to complete continuing education in order to maintain their license. Many neurology courses are offered as part of this continuing education.

My point is, chiropractors are, in fact, educated and well equipped to deal with problems involving the nervous system. Most vestibular issues seen by chiropractors are due to inner ear deficits resulting in severe vertigo. Vestibular rehab would involve designing an appropriate exercise program to retrain the brain in the way it interprets signals from the vestibular system. I couldn't possibly see the potential for more damage to be done, as stated by gymdog. My only worry would be that, vestibular training for most average patients would be considered complete long before it reaches the level required to help a gymnast. Therefore, it would be treading in new territory for the chiropractor and most likely only effective if he/she is willing to think outside the box and modify the program to suit a gymnast.

I'll get off my soapbox now. It just seems like many are very quick to bash chiropractors on this site.

Actually I wouldn't bash them, and work closely with some. However, I would be very careful with vestibular therapy for the reason mentioned (gymnastics) because it is not very straightforward. Most of these kids have nothing wrong with them for everyday life (I.e. Not severe vertigo). I think you would definitely need an expert to address these kinds of issues and most likely there actually isn't even one in existence. I know one guy that might fit the bill, but even he would be quick to tell you it would depend. He's also not a chiropractor.

 

[CanAmGymMum]

I think you would definitely need an expert to address these kinds of issues and most likely there actually isn't even one in existence.

This, I agree with. Vestibular issues aren't even widely known about within the gymnastics community. As far as getting it treated by a medical professional, I think the knowledge is there but it would be entering unknown territory. I don't think it would cause any harm but it may not do any good either.

 

[gracyomalley]

Thanks for the input - that was my gut feeling. The PT that worked with DS specializes in Vestibular issues and although he could tease out issues that DS "felt" on testing - which he thought would still effect his gymnastics until his concussion was healed, he also acknowledged that DS tested in the normal range.

When I spoke to him about DD issues he made very astute observations about both how her recurrent ear infections and mastoiditis (we are talking hospital stays, near surgery to clean out bone, etc) through age 8 could have led to ongoing vestibular issues (which, as a ped, I was aware of - her hearing developed oddly too, with an ear dominance that doesn't fit her other dominances - so brain based hearing preference to avoid her right ear - although "technically" it responds to sounds normally - she did some auditory therapy through her music teacher - I think compensated), and more importantly about how those issues would effect higher level gymnastics - esp. beam and back tumbling. Linked the body's response to the vestibular stuff to the development of stress and fears. He felt she'd likely also test "normal", but that there were some exercises to help her "use other input" to get past the vestibular issue....

The only time I've ever noted her to chuck something that led to a potential danger is when she chucked a BHS-BLO step out on high beam....and believe me, as a mom of 3 gymnasts, I've seen a lot of "chucking" over the years from my youngest boy and more often my kids friends! Otherwise honestly when she says she's "chucking things" she's mostly doing things she's very capable of and with coaching permission - it's just chucking to her if she's not sure she can do the skill perfectly! Perhaps I should be worried, but she's 12, very strong and steady with focus, and although I realize she could still get hurt at any point, the hardest skills she is presently working on are yurchenko, overshoot, fulls and BT on beam - all of which she's close to/can do/or was doing this summer. In either of our wildest dreams, she's not even shooting for past a couple years in small region level 10. In fact, she may be doing all those skills and more before she gets the stupid giants on her own again!!

She does say that when she swings on bars she sees stars...but that she's "getting used to it"....is that crazy, or is that the "getting past the vestibular issues with proper time and training...."

I do think that chiropractics has a place - and I can imagine it being helpful if she starts to notice vestibular symptoms in day to day life - I think if we did anything other than "gym therapy" right now I might have her work with the PT....local and less expensive!!!

 

[gymdog]

This, I agree with. Vestibular issues aren't even widely known about within the gymnastics community. As far as getting it treated by a medical professional, I think the knowledge is there but it would be entering unknown territory. I don't think it would cause any harm but it may not do any good either.

I think there is potential to cause problems when you're working with someone who is not knowledgable about high level gymnastics for something relating to gymnastics. The guy I mentioned before is a high level gymnastics coach who was closely supervising the progress of the gymnast he worked with on this. Otherwise, I think it's best for the gymnasts to listen to their bodies if they're within the normal range and then the coaches need to select skills and drills that are appropriate for the athlete. Attempting to change it when we aren't sure about the efficacy or protocol could cause more issues with the gymnastics side of things. Maybe they will progress for awhile but I think they would eventually hit a wall again and it could cause injury. It's hard to know how the body would respond, because there would also be ingrained habits as the result of the former vestibular issues. So I don't know. My gut is so,some would need to be supervising/monitoring the gymnastics side that knows what's going on and I'm just not sure that's possible.

Obviously if a kid is experiencing severe vertigo or something else that impacts everyday life, then they will need treatment. But that would be a reason to be especially cautious in gymnastics for a long period.