Child Orthopedics

Frequently Asked Questions

My 14-year-old daughter competes in gymnastics on the balance beam. After injuring her ankle, she's gone back to practice. Now it seems like she can't keep her balance and her hip on the same side is starting to bother her. What's the connection?

Keeping balance is a complex task. It relies on a system called the postural control system. This involves the inner ear, the eyes, the muscles, and the brain. If the ankle is injured it can lose its ability to sense the joint's position in space. A delayed response to a shift off-balance can result in a loss of balance.

If the ankle can't adjust to maintain balance then the knee and hip get in the act. Too much shear force through the hip can lead to hip problems. Walking on a balance beam, with only partial support for the foot can also shift forces through the hip.

You may need to contact a physical therapist to help your daughter retune the ankle, the postural control system, and the hip. Often a simple set of exercises (and a little time)is all that's needed.

Nicola W. Mok, MphtyStud, et al. Hip Strategy for Balance Control in Quiet Standing is Reduced in People with Low Back Pain. In Spine. March 15, 2004. Vol. 29. No. 6. Pp. E107-E112.

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