Teen Gymnast Benefits from Continued Support and Tailored Treatment Plan from Sports Medicine Experts

Claire started practicing gymnastics when she was 5 years old. As her body grew and she reached her preteen years, the cumulative effects of all the bending and twisting were beginning to take their toll. 

“Gymnastics is a chronic injury sport,” her mom, Melissa Foti-Hoff said. “It causes a lot of wear and tear.”

But Claire has maintained her dreams; she’s stuck to her goals. By the time she was 8, Claire was competing and today performs at a high level. Specifically, she competes at level nine out of 10 in Junior Olympic (JO) gymnastics, a program run by USA Gymnastics. Only about 5 percent of gymnasts in the U.S. competitive system reach level nine, which is one level away from the collegiate level.

In the words of Melissa, it also means her daughter is spending 16-20 hours a week “doing a lot of really hard things that are really dangerous.”

Searching for the Best, Finding the Best

Claire’s first gymnastics-related injury—an overuse injury in her back—showed up when she was 12.

Melissa knew her daughter needed to see a sports doctor, so she did what any mother looking for the best treatment for her child would do: She asked around.

“I asked around the gymnastics community and everyone referred me to Dr. Logan, the director of the Division of Sports Medicine at Cincinnati Children’s. They said she’s well known in the broader gymnastics community and has a reputation for helping gymnasts,” Melissa said. “They told me she’d be able to not only treat Claire’s injury, but also treat it within the context of her sport and competition goals.”

A Team Approach to Successful Treatment

With Kelsey Logan, MD, Melissa found exactly what she expected: “Not only a doctor who understands medicine, but a doctor who understands the sport.” She also found a team, with Dr. Logan working extensively on Claire’s treatment plan with Chris Wall, PT, a physical therapist in the Division of Occupational Therapy and Physical Therapy. 

Since Claire’s first injury at age 12, she’s seen them both for several other ailments related to gymnastics, including injuries to her wrist, tailbone and knee. 

“They’ve always been very collaborative and approached Claire’s treatment as a team,” Melissa said. “And they speak directly to her. They understand that this is a very big part of her life and are very sensitive to that. They not only understand that chronic injuries affect gymnasts physically, but mentally, too, because of time lost in the gym, and they help her work through that.”

In October 2022, Claire suffered a second back injury and returned to Cincinnati Children’s.

“[Last fall], she started to notice that her lower back was increasingly achy and tight during practice,” Melissa recalled. “It gradually got worse until she started having shooting pain down her leg. That’s when we contacted Dr. Logan.”

After an X-ray and magnetic resonance imaging (MRI), Dr. Logan diagnosed Claire with bilateral spondylolysis, or stress fractures on both sides of the spine, which is a common injury in gymnastics stemming from repeated backward bending.

“It was during preseason, when Claire was learning new skills and putting together new routines in time for meets, so it was very time-sensitive,” Dr. Logan said. “Fortunately, we have significant experience with that. We have quite a bit of experience working with gymnasts at the high school, college and elite levels. We understand the skills they need and the demands of their sport and sport timing. It allows us to meet their needs in ways that other places can’t. 

“What really helped Claire was the collaboration between Chris and me in terms of what we could push with her gymnastic training and what we could back off on,” Dr. Logan continued. “We were able to help her effectively communicate that to her coaches, which is crucial in the sport of gymnastics." 

Understanding the Young Athlete’s Mindset

At Claire’s first spondylolysis treatment in November, she could only bend forward a little bit, about 38 degrees. So a home exercise program was tailored specifically for her and once-a-week follow-up appointments were scheduled. 

To help heal, Claire took a month off gymnastics and worked on her physical therapy exercises at home. At the end of the month, with her strength improved, she had significantly less pain.

"Chris stays optimistic even when I am feeling frustrated," said Claire. "And he's willing to think of new [treatment] options, like the dry needling, which has helped a lot."  

In addition to PT, dry needling is a technique used for pain and movement issues that involves inserting thin needles into or near trigger points in the muscles. The needles stimulate these areas, causing the muscles to contract, or twitch. This helps relieve pain and improve range of motion. 

“Her mom emailed me the next day to tell me that Claire almost immediately noticed a difference,” Chris Wall said. “She said that Claire told her she felt like a new person. She had a really good foundation of strength and range of motion improvement at that point but still some tightness on both sides of her back. The dry needling really helped her kick into a new gear.”

Claire’s personalized physical therapy continues to focus on her specific injuries and needs. Through her treatment, she’s also learned how doing physical therapy will help her improve her injury and her abilities as a gymnast overall.

“Because we’re treating predominantly kids ages 10 to 18, we’re seeing a very active population,” Chris Wall said of the program. “We understand these kids’ thought processes and personalities and know how to communicate with them and help them. That goes a long way toward maximizing outcomes for our patients. It’s something that sets us apart.” 

A Focus on the Whole Picture, the Whole Patient

Claire returned to competition in February, but still sees Dr. Logan and Chris Wall for follow-up appointments.

Lately, their conversations have drifted away from the topic of gymnastics and toward another one of Claire’s passions: baking. The high school junior has dreams of one day opening her own bakery, and she enrolled this year in a culinary arts program at a trade and vocational school.

“Dr. Logan and Chris are so good at connecting with her and treating her as an individual, not just her condition,” Melissa said. “It’s really important to have a team that not only understands the physiology of the injury but also the injury in the context of the sport and in the context of a kid’s dreams and goals—a team that can look at the whole picture.”

(Published March 2023)