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Back pain and Dr almost out of ideas

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Trixiebelle

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Jan 28, 2010
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Dd is almost 12 training l8 and after finishing a good l7 year. 2 years ago was diagnosed with Spondylolysis took 8 weeks off and went on to compete again for 2 more years. About 2 months ago she came to me when she first felt some low back pain, She said it was different but erroring on caution i pulled her from the gym and went to her ortho (ped spine specialist, same one who diagnosed her previously). Pain Is mostly on left side but she can feel radiating down her left leg, however she sometimes feels pain on the right side and right leg too.

Based on a physical exam her believed this was a flare up of the spondy. Prescribed 2 weeks rest, followed by 2 weeks pt. At the end of the 4 weeks, dd was pain free so we sent her to gym to begin light conditioning 1.5 hours. On day 2 of conditioning she had a reoccurence of pain so we pulled her for 2 more weeks.

Now, 9 weeks out she is still in pain. X-ray is clear, MRI is clear and waiting for ct results. Dr is perplexed as he sees nothing (nor does radiologist). He does however trigger the pain on a manual exam of her spine so ordered a CT. If the CT is clear she can resume gymnastics, if the pars shows up, she is looking at having to leave the sport.

i am coming to this community to see if you have any ideas I could bring back to the dr at our next appt. while dd will be crushed if this is the end of gymnastics for her, I won't let her continue if there is significant risk of this progressing. Could this be muscular? Ligaments? SI disorder? Should we see another dr for soft tissue issues?


The silver lining in this is that I her spine looks great and the MRI shows no nerve/disc issues. And to top it off we have spent more family time together than ever.
 

LizzieLac

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May 4, 2010
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What does the pain feel like? Sounds like you are doing all the right things and good news that xrays and MRI are clear. Radiating down the leg sounds like a nerve thing, but I am not a doctor.

Good luck - I hope you get the bottom of it and it is not serious.
 

bogwoppit

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Good luck in getting answers. I have nothing to add. But I do know how hard it is to have to give up a sport you love for back pain, my dd still talks about it.
 

coachp

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This is probably already been asked, but she isn't doing back walkovers is she?
 

wandrewsjr

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^^^I am curious about this, too. Was she doing any bridges, back bends or walkovers on those conditioning days?
 

bogwoppit

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This is probably already been asked, but she isn't doing back walkovers is she?
Oh I do hope not. I banned my dd from BWO's permanently when she first got back pain. She never did one after the age of 11.
 

iwannacoach

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I'm confused..... I thought that spondylolysis was a condition cause by small or micro fractures of structures that support the spine just above the tail bone and (I think) the next vertebrae up, and I'd think that would show up on the original imaging done two years ago, as would any healing since the original diagnosis.

Has the doctor given you ideas of what it could, and couldn't be. It seems nerve and disk damage has been taken off the table, and if the MRI take spondy of the table, you pretty much get down to the point of just muscles. I'd pose the question..... could it be that one side of her lower back is far too strong to work in concert with the other, weaker, side... like maybe her weak side just can't "go there" when her strong side does something that causes a quick extension, or hyper extension experienced in skills like casting, front layout, front handsprings, and all others that use a fast twitch into that reverse hollow position.

So if the doc rules out spondy, but can't rule out the muscle imbalance though I've described, see if he/she can suggest the next person to see. Possibly a physio, a chiropractor, or acupuncturist. I think taking her to an ortho pediatric spine specialist was a good choice, but would a neurologist offer some insight?

Good luck, I hope you guys get this figured out and have her back to full health soon.
 

Trixiebelle

Member
Proud Parent
Jan 28, 2010
104
Thanks all for your input. She has not worked back walkovers in 2 years! Her coach is very good about that. What I think set this off was working fulls on floor, but that is just my unprofessional opinion. As for the original diagnosis- she had the bone scan for that and it "lit up" which I guess is the pseudo medical term for a positive diagnosis.

I frustrated a bit with the Dr. But I think I'm just transferring general frustration to him. What I don't understand is the statement he made that the original fractures never really heal. I need to have that clarified on Weds. As for a neurologist that's a good idea. I will add that to my list of things to discuss.

Thanks again for the help.
 
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dunno

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this condition is commonly referred to as "kissing vertebrae". they kiss because 1 or more of the pars (dog ears) fracture or break off sans "pars syndrome".

either the pain is radiating from the area that is "kissing" or something is taking place near the SI area. and i hope to God that she has not been doing any back walkovers.

my recommendation would be to see a neurologist. maybe an old fashion myelogram could be useful. sometimes they pick stuff up that the other fancy technology can't. Myelography (Myelogram) Video: Diagnostic Procedure
 

dunno

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Thanks all for your input. She has not worked back walkovers in 2 years! Her coach is very good about that. What I think set this off was working fulls on floor, but that is just my unprofessional opinion. As for the original diagnosis- she had the bone scan for that and it "lit up" which I guess is the pseudo medical term for a positive diagnosis.

I frustrated a bit with the Dr. But I think I'm just transferring general frustration to him. What I don't understand is the statement he made that the original fractures never really heal. I need to have that clarified on Weds. As for a neurologist that's a good idea. I will add that to my list of things to discuss.

Thanks again for the help.
YES! sorry i didn't read this 1st, but my post above is still valid. YES, twisting on floor can certainly make a back problem rear its ugly head.

it has to do with torque. even though you can't see it easily. when the feet plant/punch, a load (conservation of energy) will take place in one of the legs/feet. so then, if the body twists right, the load is on the left foot/leg/calve. vice verse for left twist.

as the body leaves the floor, the feet are momentarily "stuck" to the floor. this is how the load and eventual twist take place. so in the example of right twist, the upper body (now visualize the spine) begins twisting to the right. but the load is to the left causing the lower spine to counter twist to the left ever so subtly. so then, you have the lower lumbar turning the opposite direction of the upper spine beginning with the thoracics.

kind of like wringing a towel dry if you can understand that action. just turn the towel vertical and wring it and you can 'see' how the spine functions when you punch/leave the floor for a twist.

now, there are several things that can cause what you are describing. it can be from pars syndrome. it can be from muscle imbalance. but it also can be something more subtle and insidious like 1 leg shorter than the other by just a bit.

so, i recommend my post above. i think first that any structural problems must be ruled out. then, a myelogram could show stenosis or something else that the fancy technology did not pick up. i think a neurologist would be best suited for this work. this is my opinion based on years of experience with athletes and backs and within a reasonable degree of professional certainty. yet, this is NOT medical advice per se. :)
 

Trixiebelle

Member
Proud Parent
Jan 28, 2010
104
*UPDATE*. Dds doctor called today withy he results from her CT scan and she is all clear. No fractures. He has given her the go ahead to resume gymnastics with no restrictions (except she needs to build back up after 8 weeks off!). Dd was beside herself when I picked her up from school today and went to the gym right after school. Thanks for the input and ill keep you posted.
 
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ALgymMom

Member
Nov 2, 2011
159
AL
Dd is almost 12 training l8 and after finishing a good l7 year. 2 years ago was diagnosed with Spondylolysis took 8 weeks off and went on to compete again for 2 more years. About 2 months ago she came to me when she first felt some low back pain, She said it was different but erroring on caution i pulled her from the gym and went to her ortho (ped spine specialist, same one who diagnosed her previously). Pain Is mostly on left side but she can feel radiating down her left leg, however she sometimes feels pain on the right side and right leg too.

Based on a physical exam her believed this was a flare up of the spondy. Prescribed 2 weeks rest, followed by 2 weeks pt. At the end of the 4 weeks, dd was pain free so we sent her to gym to begin light conditioning 1.5 hours. On day 2 of conditioning she had a reoccurence of pain so we pulled her for 2 more weeks.

Now, 9 weeks out she is still in pain. X-ray is clear, MRI is clear and waiting for ct results. Dr is perplexed as he sees nothing (nor does radiologist). He does however trigger the pain on a manual exam of her spine so ordered a CT. If the CT is clear she can resume gymnastics, if the pars shows up, she is looking at having to leave the sport.

i am coming to this community to see if you have any ideas I could bring back to the dr at our next appt. while dd will be crushed if this is the end of gymnastics for her, I won't let her continue if there is significant risk of this progressing. Could this be muscular? Ligaments? SI disorder? Should we see another dr for soft tissue issues?


The silver lining in this is that I her spine looks great and the MRI shows no nerve/disc issues. And to top it off we have spent more family time together than ever.
I can sympathize! My DD deals with back pain & also has clear scans! It's frustrating! The only thing that helps her is daily PT exercises and visits to the Chiro for adjustments. She's tall & skinny, seems like that body type always has back pain.
 
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