Dr David Marshall talks with Bridget about the symptoms, treatments and prevention of common injuries of young gymnasts.
Read the full transcript »
Bridget Snapp: I am here today at the Gwinnett Gymnastic Center talking with the friend of the show, Dr. David Marshall once again; Director of Sports Medicine over Children's Healthcare of Atlanta. Thanks for being back with us Dr. Marshall. Dr. David Marshall: Thanks for having me. Bridget Snapp: Alright, so when I was a little girl, I always wanted to do gymnastics. My parents had never let me because they said it was too dangerous. Now did they have any sense there, or they are just being mean? Dr. David Marshall: Well it depends how they define dangerous. If you look at catastrophic injuries about -- concussions and broken collarbones and fractured ankles and things like that, not a pretty safe spot. If you defined dangerous or you like that you get on overuse injury then we see quite a few overuse injuries in gymnastics, just because the nature and the hour sometimes these young kids put in to compete. Bridget Snapp: Now what are some of the most common injuries. Dr. David Marshall: Probably, the two most common body parts that I see office are the low back and the wrist. The low back is very common, that's probably the most stressful. That's the one that they can sideline an athlete for 8 to 12 weeks and that's one that the parents and the athletes, and of course the coach is worried about is spine injury. The most common spine injury is something called a spondylitis or a spondylitis and what that means is Spondy means spine; losis means to separate and it's a development of a stretch fracture back in the lower lumbar region. Now if you think of the spine, there is 30 vertebrate, from the base of your skull all the way down to your tail bone and normally it should be -- it should have these nice flowing curves in it. You can just imagine when a gymnast does a lot of arching or a lot of back bending, or tumbling, they arch their back. Now if you look at this column, the shear forces are greatest right across L5, that's the fifth lumbar vertebrae down the lower back where the pant line is. So just overtime, repetitive loading of the spine and extension they can get stress reactions and eventually a stress fracture right through that L5 vertebrae. And that's called a spondylitis. Bridget Snapp: And is that going to set them out for the season, is that --? Dr. David Marshall: It's not necessarily a season ending injury there is a different ways to treat it. Different doctors and different orthopedists have different philosophies in how to treat it. My feeling is we should treat a stress fractures in the spine, just like we treat stress fractures in the shin, stress fractures in the wrist. If there is a disruption in the integrity of a bone, then motion becomes the enemy. So we need to try to stop all motion, so the body is unchallenged and trying to lay down new bone to repair that area. In the wrist and the ankle, it's very easily done with the cast, with the foot in a dancer, easily done with the cast. Well it's tough to put a back in a cast, you can't do it. So we try to limit their activities, we really shut them down for period of 4 to 6 weeks. If we stop that pounding, that twisting, that tumbling then at least the body will have that going for it. We also put them in the lumbar support brace, a corset type, a lumbar girdle type thing, that's going to try to keep their back in that neutral position. Again the goal is trying to prevent motion, front, back, side-to-side and twisting. So if we can take them out of the gym, maybe let them do just some light conditioning and put them into brace 23 hours a day over about 4 to 6 weeks we should have to have ample time to allow that fracture to heal. Bridget Snapp: Of course we don't want these girls having to be in these -- for 23 hours a day. What does it look like on the prevention side, girls and guys for that matter? Dr. David Marshall: Yeah that's right male gymmies can certainly get this as well. For any injury, and overuse injury prevention is the key in order t