Dr. Elspeth "Elly" Hart is the creator of the Gymnastics Medicine program at St. Elizabeth's Medical Center in Boston, Massachusetts. Hart drew on her extensive background as a competitive gymnast and medical professional to build a clinic that addresses the unique needs of gymnasts, their parents, and their coaches. Elly was a Region VI Level 10 Junior Olympic gymnast, and was recruited for Division I gymnastics at James Madison University in Virginia. At James Madison, she graduated with a BS in Athletic Training and Sports Medicine, and then went on to pass her boards as a Certified Athletic Trainer. She worked as an ATC at New England Sports Academy (NESA) and attended Massachusetts College of Pharmacy and Health Science in Boston, where she received her master’s degree in Physician Assistant Studies. Before coming to St. Elizabeth’s, Hart worked at Boston Children’s Hospital as a Physician Assistant in Sports Medicine in the operating room and clinic. There, she started the first ever injured gymnast clinic. After leading the clinic, she gained more insight and knowledge on gymnastics injuries and treatment and caught the eye of USA Gymnastics, who selected her as a volunteer medical staff.

For this month’s FAB Series, GKC staff members had the opportunity to “virtually” sit down with Elly to talk about the most common growth related injuries for young gymnasts.
Listen to the full conversation here:

Most Common Growth Plate Injuries

• Severs(Calcaneal Apophysitis): Inflammation of the growth plate in the heel.

• Osgood-Schlatters(Tibial Tubercle Apophysitis): Inflammation of the growth plate found at the bottom of the patella, or knee cap.

• Sinding-Larsen-Johansson: Inflammation of the growth plate found at the top of the patella, or knee cap.

• “Butt Bone”(Ischial Tuberosity Apophysitis): Where the hamstring connects to your sit bone there is a growth plate that can become inflamed from overuse. If you are not careful, and do not listen to your body, the continual tugging may pull this off. This may require a surgical procedure.

• Spinus Processes: Pain on the center portion of your spine.

• Little League Shoulder(Humerus Apophysitis): Growth plate widening on the shoulder. May be a result of young gymnasts catching big release moves on bars.

• OCD (Osteochondritis Dissecans) of the elbow: from pounding and impacting (especially pounding with a hyperextended arm with a valgus/inward force) on growing bones, the elbow bones (capitellum) starts to break down from a lack of blood flow and nutrients and in severe cases, surgery may be necessary. *It is never normal to not have full range of motion(ie. straightening or bending arm all the way)*. 

• Gymnast’s Wrist: Pain in the wrist when moving or putting pressure on it. Needs to be treated immediately to ensure the growth plate doesn’t close early. If you don’t treat it properly, it may result in a continuation of pain into adulthood

Prevention and Treatment for Growth Plate Injuries

Prevention

• Sleep: 8-10 Hours(Younger gymnasts should aim for 10 hours of sleep each night)

• Nutrition: Calcium, vitamin D, variety of colors on your athlete’s plate, and no food restrictions(your athlete needs those carbohydrates and calories in order to keep up their energy during training sessions)

• Training: Limit numbers in terms of pounding or impacting. As best you can keep your skill counts between 5-10 per skill per event. Try to rotate your impact, meaning try not to do full tumble passes/landing on floor and also in the same day flip your vault and land on a firm/hard surface; mix it up to give your body a rest. Always keep up with your stretching and strength training.

Rest
Stop and let the inflammation in the injured area go down.

Sport Medicine
See a Sports Medicine Provider before starting any treatment plans. NEVER ignore pain and what your body is trying to tell you.