When to see a provider, when to get imaging, and best ways to stretch

Hey guys! Today I want to cover three big things that will help you make the best decisions for the well-being of your gymnast.

Summary:
When to see a physician, PT, or chiropractor
Imaging
Stretching

When should I see a physician, PT, or chiropractor?
When your athlete is dealing with aches and pains, it is often unclear when to go see a physician in contrast to when to see a PT or chiropractor. Physicians are for traumatic instances when your gymnast had a big fall or there is noticeable swelling, maybe even bone sticking out. On the other hand, for aches, pains, and strains, it is appropriate to see your PT or chiropractor. Most, if not all, of the U.S. has direct access to a local physical therapist, so this should not be a problem. Also, in terms of time, it is most beneficial to see a physician or physical therapist within fourteen days of the injury.

When your athlete is always having aches and pains, it is often hard to screen out injuries. In this instance, the best way to test whether or not they need to see someone is if there is a noticeable loss of motion. If they are having pain on only one specific skill every time, this is most likely from nerves or stress and would be more of an issue of sports psychology rather than a physical injury.

How do I know if I need to get imaging done on an injury?
Now onto imaging. Imaging consists of scans such as X-rays, MRIs, and CT scans. These are generally overused and not always necessary to diagnose an injury. The two most common forms of imaging are X-rays and MRIs. X-rays show bones, so problems such as fractures, breaks, and bone spurs. MRIs show everything else like muscles, ligaments, tendons, and joints. So, how do you know when imaging is necessary? Well, X-rays are usually effective after trauma. For example, if your gymnast undergoes a weird landing, not just something that’s been hurting over time. These are also for sudden worsening symptoms, such as if there is sharp referred pain that happens very rapidly. Lastly, if your athlete is not improving from seeing a PT or chiropractor, after 4-6 visits of ineffective treatment, they will probably refer you to get some imaging done in order to see what’s really going on.

What is the best way to increase my flexibility and prevent injuries?
Stretching seems like a simple topic, but really, there are many types of stretches. The two main types are static and dynamic. Static is when you hold in place for usually about 1-2 minutes and stretch. Dynamic is when you move in and out of a stretch. A common misconception is that this requires bouncing. Dynamic stretching does not require bouncing, and should not include this. It is simply moving through a stretch.

If I described my ideal practice, it would probably look different than what most coaches are doing. At the beginning, the most common stretch that you see is static stretching; however, this can actually decrease power. So, at the beginning of practice dynamic stretching is the best way to warm gymnasts up and get them loose.

A little experiment that you can do at your gym to see how static stretching can limit power is:
Have your gymnast sit in a pike against a wall, holding a medicine ball to their chest.
Have them lean forward and throw the medicine ball as far as they can, marking where the ball ends up.
Have them hold a tricep stretch behind the head for 30-60 seconds on each side (static stretch).
Redo the first two steps. Chances are that the gymnast is unable to throw the ball as far, since the static stretch decreased their power.

This is why static stretching should not be included in an opening warm up. At the end of practice, I would do flexibility training. If you haven’t noticed, it is very hard to gain flexibility by static stretching, and increasing force in a static hold will not work as well as other methods. This is where eccentric stretching comes in. This means lengthening the muscle slowly (often adding weight) and then contracting back. Eccentric stretching is something that I often use for hamstrings and calves as well as wrists. These are just some of the places that gymnasts get tight when they grow. Another way of stretching is on-off stretching. Without bouncing, this is where you will add pressure, then release, add pressure, then release. One will be able to push farther and farther as they get more comfortable with the motion and increase flexibility. This will start to really remodel the tissue if done frequently. The goal of on-off stretching is to do the exercise about 3-5 times a day for 10-15 reps.

I hope these tips help you to avoid and manage injuries. If you have any questions, feel free to reach out and email me at [email protected] and I will get back to you as soon as possible. Make sure to stay tuned for our next post!