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13 year old figure skater with frustrating back pain

Hello, I am so frustrated with the back pain my daughter has been dealing with. Here's a brief history:

Age 10 - small fracture in L5 (left side) treated successfully with p.t. and 2 months limited activity

Age 13 (3 years to the month after her previous injury) - back pain, lower left side presents itself mid to end of January

Visited sports injury doc with experience with figure skaters. Bone scan ordered - normal - no fractures anywhere in her body.
Started PT, did PT for 6 weeks, very limited activity, back was feeling 95% better and then track season started.

First day of training sprints on the track (yes, she has good running shoes) her back flares up again worse than when it started in January.

Another visit to the doc - MRI ordered - came back normal, no disc damage. More PT and very limited activity (this is killing her not being able to be active an she missed the entire track season).

Pain still present end of April ~ CT scan of Lumbar spin - came back normal. Still in PT.

Now she's on a trip, texting me that her back is really, really sore (lots of walking today, but wearing her good running shoes).

She has also visited a chiropractor who is well known for helping figure skaters. She never felt any relief after multiple visits with him.

I am at a total loss as to what to do now. There has to be something that can help my child. In the meantime, her skating season is slipping away and she has now lost 4 months of training time (which can be devastating to a season).

I would think that if she was not training her double jumps 5 days a week (which she has not done in months) that the pain would go away.

Oh, it has been noted by the p.t. and the chiro that her hips are out of alignment and we are working on that as well.

Please help with any advice.
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replied May 13th, 2011
Experienced User
If her hips are out of alighnment, she will need to wear a shoe lift. One of her legs may be shorter than the other. If so, then she may need to gradually go up in size on the shoe lift. You should be able to buy the inserts once they determine how much she is off while getting more adjustments while going up in size. If this is the case, she would need to wear that lift at all times. I have one for every shoe and if she wants to wear sandles, she can take a shoe lift to someone who repairs shoes and have that exact height added to the heal of the shoe. Walking around bare footed for long periods of time will cause her back to hurt. Oh, and if it is a height difference and she gets the lift, I would suggest a regular xray with her wearing that lift to make sure she is using the correct size in the lift. I was given the wrong height once and had to replace it with a bigger one from a different chiropractor. Good luck!
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replied May 13th, 2011
After wearing lifts, did your hips ever get back in alignment? No one has suggested lifts, but everyone is telling us it can be fixed with therapy, exercise, and chiro manipulation.

I'm thinking about getting a second opinion from a spine doctor. I am just so sad about all this. And last night she was texting me that her pain was an 8/10 ~ the highest it's ever been ~ after months of treatment.

I will definitely bring up the lifts to the new doctor though. Thanks!
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replied May 13th, 2011
Experienced User
Yes, my hips are in alignment now and I got alot of relief. I still had some pain due to the fact that I have degenerative disc disease and a ruptured disc and herniated disc. Was suppose to have a fusion but insurance would not cover it so a doctor put me on Neurotin for nerve pain and Soma for the muscle spasams incase i needed it. I started wearing tennis shoes only..Nike "alvrod" and I no longer have pain. The Neurontin (gabapentin) has worked a miracle for me along with wearing comfortable tennis shoes.

You can be out of alignment and not need a shoe lift. A good specialist can touch both her hips and feel a difference in the height so if thats the cause, she should recover with the heel lifts as long as she doesnt have disc issues. Keep me posted...I hope she feels better soon. She may need to take it easy for alittle while.
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replied May 13th, 2011
Ahh, she's been taking it easy for four months...which has been devasting for her. I'm now concerned about depression and have been seeing some signs of that, too. Her and her coaching team had great expectations for her this season and she was recruited for track and field and was so excited to try that.

I just keep telling myself that all things happen for a reason and her body probably needed a break. But her coaches are very knowledgable and I don't notice them pushing any of their athletes excessively.

Thanks for letting me vent. I could go on for paragraphs ~ but I will spare you!
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replied May 13th, 2011
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yea, depression is normally followed by pain. I know all about that. So i assume that they didnt find any arthritis from where she fractured the L/5 at age 10? I wonder if she could be having muscle spasams which could cause pain. Its worth a try on having a massage. Maybe she could lay on a heating pad no longer than 15 minutes and then ice the area for 20 minutes. Has she had any deep tissue massages? Always be sure to seek 2nd and 3rd opinions showing them all the reports/films and research anything you can think of so you can bring it up to the doctor. You can get some books about back pain from your local library. I've learned alot about treatments and other conditions that way.
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replied May 13th, 2011
She gets heat at PT (3 times a week) and we've been icing at home. She gets a massage two times a week from her personal trainer, but I'm not sure if it's deep tissue. I will ask her trainer. And I've been thinking of having her get massage at the chiro office (insurance will cover that).

I just scheduled a second opinion for Tuesday. I hope they can work miracles, because she really wants to do her ice show (and she has a solo). Practices start in 2 weeks for that. *sigh*. It won't be the worst thing in the world if she can't do it ~ obviously her health is way more important. But it will be sad.

Is your back pain all from your uneven hips?
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replied June 23rd, 2011
Update - and need advice as to what's next!

My daughter was just discharged from a PT facility where she has been doing MedX for lumbar back and McKenzie exercises. Her back strength increased 85%, but her pain never improved. When she is active her bothersome pain is always a level 4 out of 10. Also, while she was there she received Neuro-Muscular therapy each week ~ which provided some immediate relief, but nothing long lasting.

The PT that discharged her suggested maybe steriod shots in her back. I've been researching on-line and I guess this would be the same as the epidural shots I've been reading about. I don't really want to subject my 13 year old to this treatment ~ and from what I've read, it's only effective for about half of patients treated. I don't like those odds.

So, what is our next option? The sports med doc gave me a name for an orthopedic surgeon that specialty is the spine. A nurse at work told me maybe she should see a neurologist.

All I know is that I have a 13 year old that wants to compete, is a great athlete, and is watching all her dreams fade away. She has been somewhat active these past four months through pt and very limited activity ~ and still no improvement! Arrrgghhhh!

Bone scan, MRI, and CT scan of L5/lumbar region were all negative. No arthritis was found. What else can I do short of putting her in a full body cast? Sad
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replied December 13th, 2011
Here is my 2 cents....
Contact one of the two:
Dr. Stuart M. McGill is a professor of spine biomechanics at the University of Waterloo
Someone I respect and may give you a different opinion from outside the skating world but still in the sports world.
Either way there is not a quick fix. Don't loose heart.
My rant... I hate the hight of skating heals it does not help lower cross body problems.
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replied July 14th, 2011
Experienced User
Has she had a a scan of her entire spine and not just the Lumbar? How many specialists have you seen. Maybe other opinions could help. Sure, go see the Neuro..It wouldn't hurt. Would not hurt to get blood work either..so I guess RA is out of the question? Is she just wanted to get through the pain to compete or is she wanted to make a career out of skating? Yes, the cortisone will help after the 3rd shot. It will initially make her feel worse for the 1st couple of days and It could take a month before she notices it helping..however, I personnaly would not have it only because of the possible side effects that can come from it from my own experince..Stuff I'm dealing with 3 years after the fact and may never bounce back. Not saying it will effect her but if she does decide to do the shots, please let me know so I can tell what steps she can take to avoid what happens to others. The pain management doctors provide this information..Good luck..
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replied July 16th, 2011
Active User, very eHealthy
Questions I would ask are:
1) Is one hip higher than the other? this is not a bone issue but 98% of the time is purely muscular causing one leg to APPEAR to be shorter. A heel lift does not correct the problem but instead perpetuates it.
2)Are her ilium (left and right hip bones) twisted? The "longer" leg will have that ilium tilted to the front. The "shorter" leg will have the ilium twisted towards the back.
3) Is there movement at L4 / L5 / Sacrum / Coccyx? Should be at ALL levels. Muscles can lock it up so there is no movement from the trauma.
4) Does she have a strained ilio-lumbar ligament where her spine is shifted to one side? Failure of the lumbar spine is usually lateral.

"Her back strength increased 85%, but her pain never improved."
This is saying the problem is not one of weakness. I would say it is a misalignment problem or the bones in her lower back have stopped moving.

Once her back is out of alignment or has stopped moving, "taking it easy" will do nothing to resolve these issues. Chiro is much to violent IMHO. I prefer ostheopath, neurofascial release, and gentle postural e-cises ( I do Egoscue) to move the bones back into place. Once this happens things can start moving again with gentle things like walking.

Please note that pills, injections, and surgery do not fix anything. They just cover up the symptoms. Okay if you're 70+ and on your way out. She's way to young to not be addressing and fixing her problems IMHO.
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replied July 17th, 2011
Experienced User
As far as the "taking it easy" comment I made was because people with back problems do need rest periods especially when we over do things. That doesn't mean lay in the the bed for three days and I'm sure Skate mom knows that these pills, injections and etc.. are not a cure all. Neither is the Heel lift but if the leg is shorter than the other, then wearing the heel lift at all times will help with the pain.
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replied December 13th, 2011
Here is my two cents....
If you can try these routes, maybe either one can put you in contact with someone near you.
Dr. Stuart M. McGill is a professor of spine biomechanics at the University of Waterloo
Sometimes someone outside of the ice world may give you a different perspective.

Also I hate heals on skates, just enhances the lower cross body problems. If you could stand correctly with heals you would land on your nose. I know there are arguments for haveing the heal, but I had to learn when to not trip myself up.
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