WAG Coach and doctor different ....long thread

[DND]

I will pre-empt with warning I avoid posting as everything seems to end up being so long. If you make it through this I appreciate any feedback.

DD had been complaining of hip pain a couple of months back while working kips and front walkovers. Her coaches had her back off those to let it rest, but after a few weeks still not better. After another conversation they had apparently it was also hurting on vault, floor and most things so they pulled her to strict upper body and no bars.

I called and made an appointment with the Sports Medicine Clinic and we waited to be seen about two more weeks. The doctor there took Xrays and did some ROM tests and put her on crutches for another week and a half to see if complete rest would help. Back in and no relief so she requested MRI (side note so amazed as she requested it on a Wed. and we were in Mon. 7am...unheard of hear anyways) and was truing to get us in with an Ortho Ped Specialist.

We met the doctor the Friday after the MRI as we had not heard from the specialist yet and she said that good new was not fractures, growth plate issues etc, but they saw "something" they were not expecting and not sure what it is. Another week and in with the specialist and more new xrays and his verdict is the something is a syst, but he is not worried at all about it....just ignore it as it is not where she is complaining of pain.

He feels it is more of a groin issue and to continue with resting and if it gets worse come back they will do an ultra sound and go from there. Of course also the R.I.C.E is advised.

I emailed and let the coaches know and inquired about what size tensor I should send her with as I have no idea.

Now I get to my questions and or issues so to speak....

1. DD made comment that coach asked where the doctor came from the yellow or white pages...ugh! This was not to me but my sister who was concerned and I agree that I get they have a special relationship and there has to be complete trust in his ability to do whats best for her, but it cannot come at the expense of listening to doctors. Not so much in this case, but anything that could come down the road. Her opinion is the doctors don;t know what they (gymnasts) do so they have no idea what is really wrong with them or what is best to do.

I have talked to DD to explain to her the balance and that it is important to listen to doctors first when it comes to injury as they are the trained coach of the body. Should I mention this to the coach as I don't want to be the CGM, but I dont think it is realized how what may have been a joke was taken as "gods" word to a 9yo.

2. When I picked up DD from last practice the tensor is still in the box. When I asked her why she said coach thought it would not help and are staying with course of restricted training, but I did see her in splits and she mentioned getting moved while in splits and how it hurt. She said they think it is more a hip flexor issue???

Can anyone shed light on the difference between hip flexor and groin strains? How long have you seen them take to heal and should I be insisting that the coaches wrap my DD? I know they have seen a lot and maybe they are right, but I don't want to be not doing something that will have DD held back longer than necessary.

She has be doing nothing since September and at this rate she will be missing first competition in late January as the coaches have decided that she wont be ready.

 

[cbone]

I'm sorry to hear all of this. It can't be easy for you to deal with. My best advice is to listen to your doctors' advice and follow it. They are in the business of healing the body. Gymnastics coaches are in the business of coaching gymnastics. Best wishes to you and your family.

 

[GymBeeMom]

This is not as easy to answer as it may seem. Yes listen to the doctor...and your instincts. Our sports/ortho doc is conservative with treatment and WE HAVE SEEN him many times for all her big and little gym booboos. I take her immediately after injuries, listen to what he says and THEN I TALK TO THE COACH. I trust our coaches. They have a ton of experience with gymnasts of all levels and their injuries. I use the information but from both, plus my gut, to come up with a plan. So far this has worked and my dd has healed quickly from all of her injuries while continuing some level of training through the healing process. My 2 cents...

 

[iwannacoach]

I think a visit to a physical therapist would help, as their training and daily practice allows them a reality based insight that niether coach nor doc can easily aquire. They also have a better context of what doctors mean when using words like rest, mild exercise, ROM exercise........

I kinda get that GymBeeMom is acting in the role I would choose the PT for, and doing it pretty well from the looks of things.

 

[Deleted member D3987]

i have pm'ed this mother. everyone here should understand that this is a pre-pubescent child whose anatomy is forming in that area. the hip flexor, inguinal ligament (groin) IT band and pubic and hip bone are all interrelated. this area of the anatomy is not something to dismiss with simplistic anecdotes. her career could depend on it. it is a very complicated region of the body anatomically speaking. this type of injury has curtailed and finished many a career in our sport. the coach is dismissively arrogant as evidenced in what he said, and the Doc is at a disadvantage cause he doesn't know what ALL a gymnast does. he understands clinically, but not from a practical point of view. the coach is the most proximal to figuring out what is continuing this type of injury and he/she has a responsibility to this pre-pubescent child to discuss with the Doc what is best for this child and come up with a comprehensive modality of treatment and modification for practice.

this particular description of this child's region of injury, and nothing comprehensively being done to "fix" the problem is how crap hits the fan and ends badly. that's all.

 

[Amusibus]

try a physical therapist or sports chiropractor. These practitioners are much more well equipped to deal with this than an orthopedic doctor.

 

[Kiwi]

I am a little confused - a specialist sports physician should be a good person to see! My DD saw one who had many years experience, including experience working with gymnasts. A physiotherapist with experience working with gymnasts would also be good, or if you cannot find one, then a physio who works with dancers would be the next best thing. I also recommend St John Neuromuscular Therapy, this has been brilliant for my DD, they work with the whole body and can find postural faults and muscle imbalances that physios and docs may miss. Both physios and NMTs provide exercises to help rehabilitate.

It sounds like you do need to talk to the coach. In the past I have had some issues with coach ignoring the medical advice and it was very upsetting. I really empathise with you, my DD missed her whole competition season this year because of an injury. I hope you can get this sorted out soon and your DD recovers quickly.

 

[Maitland]

Too many coaches (in every sport) make medical decisions based on experience, training, etc. But this varies and is certainly not at the level of a doctor or a PT. And some coaches are very old school and think an athlete should work through pain because competing is everything! In that region of the body, it could be many, many things...some more serious than others. Don't mess around with it, let it get better through rest and PT. Your daughter will need that hip to be healthy her whole life. If she misses a meet or even a season, it is very sad, but sometimes complete rest is the only way to heal a nagging injury. Sometimes modified workouts are not modified enough or in the right way. Good luck to you and your daughter.

 

[Deleted member D3987]

i spoke to a buddy of mine this morning about your child. he (M.D.>DPT>Orthopedics) feels that her labrum might be in trouble. so then, he says to get her to the Doc and get an MRI. i didn't even think of this due to her age. that's all.

 

[DND]

Thanks dunno,

They did an MRI that is how they found syst. Is it something they could have missed or not shown?

Her GP wants to see her on the 14th as she has been copied in on the results and I have been calling sports doc for past two days so hopefully I will hear back today.

That is the problem sometimes with our system too overworked and as she is walking they don't dig and it is tough to get in.

 

[Deleted member D3987]

yes, they could miss it i suppose if a "contrast" view was not taken. bring up the "labrum" and see what they say.

 

[DND]

Will do and again thanks so much!!!

 

[Deleted member D3987]

.......................

 

[littlegirlsdream]

A MRI without contrast can certainly miss a labral tear. I hope you get answers and your DD is feeling better soon.

 

[Granny Smith]

One of my dd's best friends in gym had a hip flexor injury when she was about 12 yrs old and she ended up being out for a whole year. Some injuries take a long time to heal, but in the grand scheme of things a year is an extremely short period of time in her life span and after the year off, she was able to come back and she is now competing L9/10.

One thing I learned through my own dd's journey and experience with injuries in this sport, coaches seem to get normal breaks that take 4-6 weeks to heal, they get sprains and strains, and they basically understand surgeries and recovery times. What they don't tend to get is the freak breaks that take longer than 4-6 weeks, then they start to question your doctor. If things don't heal in the normal time frames that they know, then they are at a loss and start questioning your doctors. Coaches do know a lot and have experienced many injuries, but they still are not doctors and you do need to seek medical help when your child is injured beyond the normal aches and pains.

 

[Twosmiles]

As a psuedo-athlete who has had some hip problems, I wanted to second dunnos comments above. Pain is so difficult to pinpoint in the hip area as it the true source could be from areas completely distant from the point at which pain is being felt. Additionally, if its muscular, it can take a very long time to heal and will likely need a combination of pediatric ortho and physical therapy AND a coach who works well with the information these experts are providing. Due to the muscle involvement in this area, its very easy to re injure yourself if you push too hard during recovery.

If the injury is "old" there are some really neat treatments out there to aid in quicker healing time that do not involve meds. My regular sports doc knew of them so I would imagine the docs you are using do as well. Once they figure out where the source is and use these techniques correctly, its amazing how quickly you can heal (even for an old lady like me!).

 

[DND]

UPDATE:

We saw DD's GP yesterday and she is referring us to another sports ped specialist. I did ask about the labrum and they just said that it was ok...as that is was not mentioned; however I have a copy of the MRI report and nothing muscle or tissue related was mentioned either.

I also have spoke with the Physiotherapist my DD has seen in the past and explained where we are at and what we have been going through. We are seeing her tomorrow and she is going to do her own full assessment and if need be she said she would give me a referral to as it it turns out the same doctor that the GP is suggesting.

We also have an appointment with a Chinese Medicine doctor as someone also suggested acupuncture. Not sure what we will do with that, but I am open to hearing what she has to say. Does anyone have thoughts on acupuncture or things I should ask or watch out for?

Crossing my fingers as having no answers is starting to become quite frustrating!

 

[Canadian_gym_mom]

UPDATE:

We saw DD's GP yesterday and she is referring us to another sports ped specialist. I did ask about the labrum and they just said that it was ok...as that is was not mentioned; however I have a copy of the MRI report and nothing muscle or tissue related was mentioned either.

I also have spoke with the Physiotherapist my DD has seen in the past and explained where we are at and what we have been going through. We are seeing her tomorrow and she is going to do her own full assessment and if need be she said she would give me a referral to as it it turns out the same doctor that the GP is suggesting.

We also have an appointment with a Chinese Medicine doctor as someone also suggested acupuncture. Not sure what we will do with that, but I am open to hearing what she has to say. Does anyone have thoughts on acupuncture or things I should ask or watch out for?

Crossing my fingers as having no answers is starting to become quite frustrating!

Thanks for the update and I will continue to keep your dd in my thoughts. I hope you find some answers soon, that will lead to her healing.

 

[Deleted member D3987]

keep us posted.

 

[BlairBob]

I don't have much to say about all of this, but even simple to moderate strains and sprains can take a long time to completely recover from. You might be able to get back into nearly full action within a month or two, but it can be much longer before everything is alright and anything can set it back off and get tweaked.