WAG elbow dislocation: any experiences, recommendations, advice?

[teksquad]

Hello, Everyone. My daughter dislocated her elbow earlier this week- it was a posterior (to the back side of the elbow) dislocation of both the radius and ulna. (the forearm bones) It was reduced/relocated in the ER a few hours later. Her orthopedic visit is today.

Do any of you have an experience with elbow dislocation with your gymnast, (parent or coach) that you don't mind sharing? I know that every injury is different, but I'd like to hear about how it turned out, any information you found helpful with recovery, and bracing/stability devices you found helpful in recovery and training, rehabilitation techniques that were helpful, etc. I'd love your thoughts and experiences in general.

Thanks so much!

 

[bogwoppit]

No advice, but OUCH. Poor little thing that must have been a horror.

 

[Turk]

GB's Jay Thompson is out with a dislocated elbow at the moment - if you're on Twitter, you could ask him https://twitter.com/thompson_Jay

 

[teksquad]

Thank you, Bog. It was a nightmare of sorts- her having to endure the time before it was reset, from gym to car to ER, etc. Seeing the look of relief on her face when she woke up from the reduction let me breathe again, too.

Thank you Turk- I will ask him! Thank you for the link!

 

[NoDramaMama]

Ouch! Poor thing. I'm glad she's feeling better now.

I don't have experience with gymnastics and elbow dislocation, by my dh broke his elbow 3 months ago serving in tennis. He just used a sling to stabilize it and after 8 weeks of PT he did return to tennis, but had to change the type of racket he uses and make other adjustments.

I hope you find a good PT for your dd and they can work with her so that she can return to gym and continue on. How did she dislocate it?

 

[Tbrov]

Unfortunately, we do have experience with elbow dislocations. How old is your daughter, and was there any bone fractures? Has her elbow growth plate fused yet? It makes a difference to recovery. Some girls at our gym have had quick dislocation recovery (relatively). Just popped it back in and basically had to heal from the bruising. On the other hand, my dd has had a couple of surgeries and quite long rehab. Her growth plate basically was ripped loose and had to be reattached. First she was in a cast, then a brace and months of PT to get range of motion back. When the cast came off, she couldn't straighten or bend her arm. Every day she would stretch it and over time her full range of motion came back. It was slow going. I think it took 4-6 months - I've blocked out the details. She didn't miss any gym time - she did lots of conditioning and aerial work. She now wears a small arm brace at practice and meets.

 

[gymisforeveryone]

My elbow dislocated when I was 13 years old. It happened when I did a BHS and my hands were turned outward. After that I have been super strict about hand placement with my own gymnasts - my heart still stops when I see someone do a BHS with hands in bad position.

My injury was pretty but painful. It didn't take too long to heal and they didn't cast it. I only got an arm sling and was told to use it maybe 2-4 weeks? I don't remember exactly. Then some weeks of physical therapy to get it straight again. Unfortunately I got so scared about the accident I didn't want to go back to the gym in many months and I was actually planning to quit altogether. The injury happened in September and I didn't go back to the gym before Christmas. I know it was my own fault that the arm felt so powerless and at first even handstands were hard and scary and I felt like the arm couldn't support me.

I still feel and hear some cracking when I straighten the arm and I'm scared of anything that goes backwards.

Good luck to your daughter and a hug! I feel her pain! I hope you rehabilitate it well and with patience but don't wait TOO long before going back to the gym. I also recommend you to listen her and help her work through the mental side too - I guess it was scary for her too.

 

[teksquad]

NoDramaMama~ she had just jumped to the high bar, and peeled off. She landed on her back on the mat, but we think her arm hit first. Daughter says she thinks she remembers feeling it before her back hit the ground.

Tbrov~ even though your daughter's recovery is long, it is very hopeful for me to read. (-: Good for her (and you!) in persevering. I might like to message you later about surgeries, braces, she uses, etc. Is that ok? My daughter is 14, she had a small avulsion fracture on the olecrannon tip. I'm hoping her growth plate is close to being fused. I hope we will know more after today's appointment.

Thanks to you both!

 

[Tbrov]

Sure, PM me whenever you want. Wishing you the best news and a speedy recovery.

 

[Deleted member 14190]

Over the years I have seen a few, it's not often that you don't get a break along with the dislocation. Usually at least a chip. Are all the bones completely intact? Did you view the xray to make sure. Reason I ask, is in the past I have had doctors advise not to reattach a bone chip, even a sizable one. Problem with this is sometimes it is the bone where a tendon connects, or a tendon is severed. In other words generally in a dislocation some other damage is done to the bones/tendons during the dislocation. This was a violent dislocation from height plus rotation, your dd peeled off the high bar and both fell and rotated to her back, she put her hand behind her to catch herself probably with a locked elbow... Did you get an MRI? Have you gotten a second opinion? I suggest you do. The prognosis depends the severity of the injury and how long it takes to get range of motion back, each child/injury is different. My last gymnast was told to just cast it and she would be fine, but after getting 4 opinions the 4th doctor said the others were crazy and treating her as if she were not an athlete (more like a 90 year old). She ended up getting ortho surgery to repair the damage and pin a bone chip which had a tendon attached to it. Had she listened to the first 3 doctors the tendon would of never reattached and her range of motion and function would of been limited but not a problem with general life. HOWEVER; she is a gymnast and in order to return to the sport it was advised to return the elbow back to it's original function....
Anyways, not to scare you but GET ANOTHER OPINION from a sports ortho, just to be sure.

 

[Tbrov]

I have to back up what coachp says --dd's first dislocation was treated with cast & sling, not very aggressively. Probably would have been fine for general public. But a year later she tripped on a vault run going into a yurchenko (twisting plus speed) and it dislocated again. It hadn't healed properly from the first injury - the bone had spongy scar tissue, so the tendon pulled the bone right off again. The joint, although healed from outward view, wasn't strong enough to bear the force when she tripped. She should have had surgery to secure the joint from the very beginning.

 

[Deleted member 14190]

Aww. Sorry to hear that. She better now?

 

[Tbrov]

She's fine. But won't do a yurchenko!

 

[teksquad]

You all have been great- thank you for your experiences and straightforward recommendations- it helps so much in making decisions, and for comfort and hope too- that she can return to gymnastics.

Gymisforeveryone- - I greatly appreciate your perspective, especially for the fear issues and mental side of the rehabilitation. I'm glad you feel that getting back into the gym early is important for this. We took her back to the gym the next 2 days for a visit. I think it helped her to see everyone, and have a "normal" experience in the gym right away. The owner/team coach is being really great about keeping her in the fold- making conditioning and training plans that she can do while the elbow heals. My daughter is a coach too- so the owner is arranging other coaches to assist her physically, so she can continue to coach her classes while she can't use her arm. I will listen to her, and address the fear and other issues that come up. Right now, when she is feeling down about the injury, ,she is just deeply sad with this alternate reality, and wondering if the elbow is going to heal well enough to return to gymnastics.

We made an appointment with a sports medicine orthopedic MD in a large orthopedic practice, and went to that appointment yesterday. It turns out that we saw the physician's physician assistant instead- the doctor was out. The visit was more geared to ensuring medical stability rather than sports medicine. They took their own x-rays (the second set) and checked briefly for signs of neurovascular damage. The PA felt there was a small, hairline crack on the ulna, and a bone chip that suggested the pulling away/tearing of the radial collateral ligament. The initial x-ray done in the ER shows a 2.6 cm translation of the bones backward. I can't imagine that there wasn't ligament/tendon/joint capsule damage. When I inquired about doing an MRI to determine the structural damage, the PA gave the standard answer that structures would "tighten up" in 8 weeks, and be fine- that he would order more imaging if he thought there were neurovascular issues. So I appreciate your perspectives and recommendations, coachp and Tbrov, to get that MRI, and get it read specifically for what might need to be repaired for a strong/stable elbow to do gymnastics with. We will be looking for other opinions for a sports medicine perspective now.

Thanks for enduring the ramble. You guys are great, gave me info and encouragement to go on from here!

 

[aksaunders]

My DD is 8 yo and dislocated her elbow earlier this year. She also had a very minor fracture. She was in a soft cast and a sling for a couple weeks each. She did range of motion exercises and other physical therapy at home as prescribed by her doc. One of the exercises was just to hold a can of food at her side to help straighten her arm out. Anyway, about 6-7 weeks after her injury she qualified for National TOPS testing. Kids bounce back very quickly.

 

[Deleted member 14190]

I will add that While all of this is going on It's very important to keep range of motion with her shoulder and wrist, if she keeps her range of motion with her shoulder and her wrist the only thing she'll have to worry about is rehabbing her elbow. Hope that helps.

 

[teksquad]

My DD is 8 yo and dislocated her elbow earlier this year. She also had a very minor fracture. She was in a soft cast and a sling for a couple weeks each. She did range of motion exercises and other physical therapy at home as prescribed by her doc. One of the exercises was just to hold a can of food at her side to help straighten her arm out. Anyway, about 6-7 weeks after her injury she qualified for National TOPS testing. Kids bounce back very quickly.

Now this is one hopeful experience to think about! Thanks for sharing your daughter's story, aksaunders! At what point after her injury did your daughter start loading the joint?

 

[teksquad]

I will add that While all of this is going on It's very important to keep range of motion with her shoulder and wrist, if she keeps her range of motion with her shoulder and her wrist the only thing she'll have to worry about is rehabbing her elbow. Hope that helps.

Thank you, coachhp- that is very helpful. (-: We're on it. Thankfully, she still has great shoulder ROM, and the wrist is coming along nicely. Elbow flexion/extension is going to be tough, but she is gaining some now, per her comfort.

 

[2gymnastand1soccerplayer]

About 5 months ago my youngest dd (7) was jumping to high bar flung off and had a partial dislocation in her shoulder, and broke her ulna and humorous in her elbow. She had surgery to fix and a hard cast for 3 weeks, got another x ray and was told it had to be recasted for another 4 weeks (big bummer since it was over summer break). We were given a 6 to 8 month recovery, currently on our 5, she's back in the gym not full training, but back to full conditioning, before the break she was at a level 4-5 skill level with some optional skills, right now she's back to about level 3 with some 4 skills ( cartwheel on beam, leaps on floor and beam) tumbling is still very limited, but we're taking everyday one step at a time, one peace if advice I can give you is don't try and rush things, it's going to take some time to get back in the groove of thing.

 

[teksquad]

2gymnastsandasoccerplayer~ Best, best heartfelt wishes to your daughter and your family- what a difficult injury and experience this must be. I am inspired by your daughter's courage and determination. We are walking that tightrope of not rushing things, yet doing enough to be sure she regains function and moves forward. It seems apparent that everyone's injuries and experiences are different, and I need to look at my daughter's individual experience as to how we should proceed for her.

Can I ask you, for my own curiosity, how your daughter progressed to bearing weight through her shoulder and arm? You also mentioned that she is doing some tumbling now- on what surfaces did she begin, and how?

Thanks so much for sharing your experience, and the reminder to take this one day at a time!