Pain Relievers: How much is too much?

[gymnomore]

Gymnasts suffer many aches and pains, which we all know is part of being a gymnast. My dd practiced 5 days per week, or 20 hours. I was giving my daughter 2 ibuprofen tablets (200 mg) before practice and 2 afterwards to alleviate her pain. These were not due to injuries, just muscle aches, so coaches did not allow her to back off for awhile. Most of it was back pain, especially during backwards tumbling on beam. On days that I forgot to give the pain relievers to her, she was miserable. I think all the aches were due to improper conditioning, as most of the girls on her team also suffered from back pain as well. My question is, does anyone else think that giving an 80 pound child 800 mg of ibuprofen a day is excessive besides me and our pediatrician? I've heard that some gymnasts take up to 8 tablets a day. How much is too much?

[bogwoppit]

I have just pulled my daughter out of gym for three weeks due to chronic pain, ankle and hip. Some of it is due to her body, some of it is due to not enough conditioning and some of it is due to the stress that gym puts on a body. She is undrgoing treatment through a sports therapist, if we cannot cure the pain she won't be returning, though she doesn't know that yet.

A body is for life, any chronic pain needs addressing not medicating. Taking the occaisional Advil won't harm most kids, but to be taking it to enable a child to train without pain cannot be a good thing. Any parent who has a child in that situation should have the child examined by a pediatrician, an orthopedic specialist and/or a sports injury therapist. I would never suggest a chiropractor, as I think that a real doctor can identify what treatment is needed and recommend from there.

It is hard to make her stop, but she will need her hip and knees when she is 40 years old. The benefits of the exercise have to far outweigh the negatives when we are talking about pain and the long term health effects.

Of course this is just my parental/ex coach opinion on the subject, to be taken or left as desired.

[gymnomore]

Thank you for your response. Your post was very enlightening in that you are right, a parent should not give a child medication just to continue training. Hindsight is 20/20, and as I look back, I feel like that is one of those parental decisions I made that was not right. I should have taken her to be examined more to find out why she was having so much pain. But, I think there are many raised eyebrows in the medical community as to what these kids go through in gymnastic training. Labor laws protect 15 year olds from working more then 15 hours a week, yet we think nothing of sending adolescent girls to work out in a gym for 20 plus hours a week. I was afraid the doctors would simply say "Take her out of the gym", and the gym is where she wanted to be. Gymnasts are there because it's fun, even though it's hard work. I think my daughter's pain was probably from the same sources as your daughter's pains. But, my own daughter finally realized that it hurt too much and became the voice of reason. She decided herself to back off. She has been out of the gym now for a couple of months, and is doing well. She is now officially painfree and drugfree, meaning no motrin or advil except for the occasional headache. She would like to return to the gym, but I honestly do not think she will. She is now using her gymnastic skills in other sports that aren't so intense and is happy and feeling healthy. In my original post, I think I answered my own question. If you have to ask how much is too much, then you probably already know. I was curious as to how many other moms may have found themselves in this situation.

[gym law mom]

Great perspective Bogwoppit---hope your oldest is able to recover from her injuries and get back to some gymnastics.

Gymno, this is what a pediatric ortho told our parent's group about pain/medication etc. She treats many of the gymnasts in the area. There are 2 types of pain. The 1st is usually a little of the overuse type or getting back in the gym after being away for say 2-3 weeks. There will be some soreness, but it should resolve with a couple of days of ibuprofen(Advil) and ice. Then there is the lingering pain. Just seems to hang on and may get worse not better. Her advice is do 2 weeks of ibuprofen as recommended on the bottle, ice everyday(not just on practice days) and cut back on the activity that causes the most discomfort. She said this in front of some coaches who moaned a little, but told them many kids improve with this and its certainly better than ending up with a girl out for 2 mos because she was not allowed to rest. She mentioned back pain as a big source of problems with gymnasts due to the hyperflexion(the bridge position) of the low back and especially when they hit growth spurts. Her recommendation is that after 2 weeks of the home therapy, if no or only little improvement, then see a doctor. Many times with some PT, proper stretching and rest, the child will get better.

[Ingymmom]

Bogwoppit, I am sure it was difficult on your dd, but it sounds like you made a good choice - I hope all works out for your dd, both of your girls sound incredibly talented.

Interestingly enough, I was talking to a mom last week in our gym and she said she gave her dd advil everyday before she came into train, she also gave her some kind of sinus medicine daily... one day I guess she came in without it and came up crying she needed to call her mom. Her dad actually came about 15 minutes later w/her sinus meds, and just happened to mention the next day how she came home from practice & just fell asleep for 4 hours - he said she was tired after her 3 hour workout, but wouldnt sinus med make you sleepy as well... it all just sounded a little dangerous to me. My opinion is in agreement with bogwoppit. I feel that if gymnastics becomes painful it can not be any fun, it would be time for us to get out as well. - nic

[Carmansunshine]

Quote:
Originally Posted by bogwoppit I have just pulled my daughter out of gym for three weeks due to chronic pain, ankle and hip. Some of it is due to her body, some of it is due to not enough conditioning and some of it is due to the stress that gym puts on a body. She is undrgoing treatment through a sports therapist, if we cannot cure the pain she won't be returning, though she doesn't know that yet. A body is for life, any chronic pain needs addressing not medicating. Taking the occaisional Advil won't harm most kids, but to be taking it to enable a child to train without pain cannot be a good thing. Any parent who has a child in that situation should have the child examined by a pediatrician, an orthopedic specialist and/or a sports injury therapist. I would never suggest a chiropractor, as I think that a real doctor can identify what treatment is needed and recommend from there. It is hard to make her stop, but she will need her hip and knees when she is 40 years old. The benefits of the exercise have to far outweigh the negatives when we are talking about pain and the long term health effects. Of course this is just my parental/ex coach opinion on the subject, to be taken or left as desired.

Sorry I have to put the whole quote I didn't know how to just put in the part about the chiropractor. Anyway, Why do you say you would never suggest a chiropractor? I'm curious because my dds are both gymnasts and my husband was a football player in highschool and they all use chiropractic as a general rule and go about once every month or so and also when they are hurting in any one area. I have never had to give my dds any advil or medicatin and we never miss gym because of an injury yet ( thank God). Is there something I don't know? We are new to this sport and I wasn't an athlete in school so this is all new to me.

[gymnomore]

I think chiropractors get a bad wrap in general but I'm not sure why. Maybe because they are not considered 'real' doctors?? I've always heard to not go to a chiropractor and not take a child there. I've never asked a doctor so maybe I should become a little more open-minded. I would be open to any discussions on how they can help, especially if it doesn't involve medication. You mentioned that you are new to this sport. It took many years of gymnastics for the back pain to set in, and it happened to be during a growth spurt which someone mentioned. That was a good point.

[bogwoppit]

Chiropractors, in the majority, are not MD's. Therefore they cannot be called real doctors, at all. They have not gone through years of medical training to get to their position as an "expert". My sister in law is a rheumatologist, she has over 10 years of medical training to put her in her area of "expertise". Can you tell the difference now?

The spine is a very delicate area of the body, not just because of the bones, but primarily because it houses the spinal cord. There have been cases of spinal cord injury due to chiropractic "adjustments", this is why most orthopedic sugeons do not recommend a visit to the chiro for back pain.

My daughters condition is scoliosis, it is a congenital birth defect, it is not caused by gymnastics, her body alignment cannot be corrected by cranking it around. She stretches her muscles and ligaments twice daily, this eases the pain and hopefully will enable her to return to training.

In my opinion, and that is all this is remeber folks , chiro's are therapists, not Doctors. GO to the Doctor first, and for a sports injury, go to a doctor who has a solid background in atheletes. This is probably not going to be your family pediatritian. Have your child fully evaluated, then let the expert recommend the course of tratment. Sometimes that will be advil three times a day for weeks on end, or visits to a sports therapist, like my DD does. The chiro is never going to be my first port of call for diagnostic services.

[Carmansunshine]

Just to clarify, I know that chiropractors are not MD's and are not sports only dr's, I do think they are a benifit for my dd and family. They do not take the place of a physical exam by a MD, but I think they do compliment what my dd's ped does for her. I have found that all chiropractors are not created equal, just like all MD's are not equal. There are good and bad in both professions. Chiroprators DO go through schooling to learn there trade. My current chiro went to the University of Penn for chiropractic and also continued his training and updates techniques at local colledges in NJ every year. The classes he has taken include alot of the Anatomy classes and science classes taken by MD's. (I asked alot of questions before I let him touch my kids!)

I just feel like chiropractors and the people who go to them get a bad wrap. And are considered to be sort of nuts. I don't know what to think at this point. It seems to help my family and we haven't had any ill effects from it. Is there anyone who has gone to a Chiropractor and had a bad result personally????

[gym law mom]

Ok, I'm coming at this from a medical and legal background. I handle alot of work comp for a major insurance company and I rarely see chiropractic care that moves the claim along. In a few states injured workers are not allowed to treat with a DC(chiro), most health plans don't pay for their treatment and they are not trained to treat children. Their practice by most states is completely limited to the back----no therapy for knees, ankles etc is permitted, but I see many try and work on those areas anyway.

Carman, I think they get the "bad rap" because most of their practice survives on auto and work comp claims. If your kids are normal healthy children, my question would be why are they seeing a chiro? They don't do preventitive anything. If your 9 yo gets a little sore from gym ask the pediatrician/DC about some exercises she can do at home and the proper way to ice down the back etc. You mentioned your hubby played some football, so he probably has some arthritis in his back. DC won't hurt that and it probably makes him feel better---for awhile. Will he get better and ever be pain free? No. DCs use much of the same equipment as physical therapists--electrical stim, ultrasound, hot packs etc. That is simply pallative therapy--makes you feel better, but I would be very wary of a child having any of that done unless they have a specific injury.