Gymnastics has been Carson Nolan’s top priority since she was in first grade. But knee surgery recently put a halt to her practices and competitions.
“What I love most about the sport is floor exercise,” said 17-year-old Carson. “It gives me the freedom to express myself through unique choreography and dance elements, and the joy of performing my routine is a feeling I’ll never forget.”
The sport, however, does come with aches and pains, as well as the need for injury prevention education. Since Carson was about 8 years old, she's been in the care of David L. Marshall, MD, a Pediatric Sports Medicine Primary Care Physician and Medical Director of the Sports Medicine Program at Children’s Healthcare of Atlanta.
“He knows the sport well and the kids love him,” said Carson’s mom, Betsy Nolan, whose older daughter Berkley was also treated by Dr. Marshall when she was a young gymnast. “With all the dangerous things they are doing in gymnastics, we know he’ll tell them the right thing to do if they were ever injured or thought they were injured.”
“Having mutual trust between the physician, athlete, parents and coach is vital to optimal care of the young athlete.“–David L. Marshall, MD, Pediatric Sports Medicine Primary Care Physician
Dr. Marshall said it’s been a pleasure caring for Carson and Berkley through the years. “Often, growing athletes are unwilling, or even afraid, to tell their coach, parents or physician the whole story about an injury for fear of being held out of their sport or told they can no longer compete. Having mutual trust between the physician, athlete, parents and coach is vital to the optimal care of the young athlete.”
When Carson began complaining about knee discomfort in May 2018, it only made sense to turn to Dr. Marshall and the sports medicine and orthopedics specialists at Children’s. At first, it was believed to only be a kneecap tracking problem, but the discomfort didn’t go away.
An MRI at Children’s in December 2018 confirmed that Carson did have a kneecap tracking problem, but also revealed a meniscus injury, which is one of many injuries commonly associated with gymnastics.
Michael T. Busch, MD, a Sports Medicine Orthopedic Surgeon and Surgical Director for the Sports Medicine Program at Children’s, said he could perform the surgery then, but there was no guarantee Carson would be able to compete in the spring season.
“Carson agreed to complete that season and to have surgery at the end of her season,” said Betsy.
In late May 2019, Carson had an outpatient surgical procedure to repair a tear in her medial meniscus.
“The tear in her meniscus was problematic and painful for her. It was chronic and relatively stable but would move enough to hurt when she was active in gymnastics,” Dr. Busch explained. “The fragment was repairable, so I used an inside-out technique with several sutures to stabilize the tear.”
“My Children’s physical therapist and surgeon were very cautious and conservative to ensure that I was not rushing my recovery time.”–Carson Nolan, Children’s patient
Carson shared that she was nervous going into surgery, but confident she was in good hands. “Walking back into the operating room and seeing that so many doctors were in the room focusing on my surgery made it clear to me that Children’s treats all of their patients very seriously and with great care.”
Two days after surgery, Carson began sports physical therapy at Children’s at Forsyth in Cumming, Ga., going twice a week. Less than two weeks later, she was walking without her crutches, and about a month later she could walk on her own without a restrictive leg brace.
“My physical therapist and surgeon were very cautious and conservative to ensure that I was not rushing my recovery time,” Carson said. “Four months later, I started to slowly work gymnastics practice back into my schedule.”
Carson completed sports physical therapy right before Halloween 2019 and is expected to compete again this year.
“Children’s has the best team of doctors who are understanding of gymnastics and were able to help me map out a plan to work my way back to being 100%,” Carson said. “Their expert advice and physical therapy services have eased my recovery of a hurt hamstring, dislocated kneecap and now a torn meniscus.”
David L. Marshall, a Pediatric Sports Medicine Primary Care Physician, is board-certified in pediatrics and sports medicine. His expertise lies in the diagnosis and management of nonsurgical musculoskeletal injuries in growing athletes. Dr. Marshall is Medical Director of the Sports Medicine Program at Children’s Healthcare of Atlanta and an adjunct clinical professor in the Department of Orthopedics at Emory University. He is on the medical advisory board for the Georgia High School Association and is a founding member of the Pediatric Research in Sports Medicine (PRiSM) organization. Currently, he is focused on performance enhancement through the use of video motion and physical therapy.
Michael T. Busch, MD, a Sports Medicine Orthopedic Surgeon, founded the Sports Medicine Program at Children’s Healthcare of Atlanta. He also provides program leadership as the Surgical Director of Sports Medicine and is the Pediatric Orthopaedic Surgery Fellowship Director at Children's. Dr. Busch is actively involved in orthopedic academics, giving numerous talks at a variety of national and international meetings. He was a founding member of the Pediatric Research in Sports Medicine (PRiSM) organization and serves on its board of directors. Dr. Busch is a consulting associate for the Duke University Department of Orthopaedic Surgery.
