Gymnastics injuries

NewsBot · Feb 22, 2014

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Wheel-gymnastic-related injuries and overuse syndromes of amateurs and professionals.
Kauther MD, Rummel S, Hussmann B, Lendemans S, Wedemeyer C, Jaeger M.
Knee Surg Sports Traumatol Arthrosc. 2014 Feb 21.

PURPOSE:
Wheel gymnastics is a gymnastic discipline with a history of nearly 100 years. So far, there have been no epidemiological studies on injuries in wheel gymnastics.
METHODS:
The retrospective study of wheel gymnasts surveyed 151 "professionals" competing in the first national league and 352 "amateurs" by questionnaire.
RESULTS:
4,898 injuries and 714 overuse syndromes were found in 988,718.9 h of training, leading to a time loss of 16,302 days. An incidence of 9.44 injuries per 1,000 h was found in wheel gymnastics. "Professionals" had a highly significant lower incidence than "amateurs" (5.23 vs. 11.24 injuries per 1,000 h; p < 0.001). The most common injuries in wheel gymnastics were found at the head (28.1 %), spine (13.75 %), ankle/foot (11.88 %), hip/thigh (11.87 %) and knee (11.61 %). 4,502 (91.9 %) injuries were classified as minor. 221 (4.5 %) injuries caused a time loss of between 1 week and 1 month. 175 (3.6 %) major injuries caused a time loss of longer than 1 month. 1.68 overuse syndromes per 1,000 h were described.
CONCLUSION:
Wheel gymnastics has a high incidence but low severity of injuries compared with other gymnastic sports. Physicians should be aware of the common dangers and overuse syndromes in this highly acrobatic gymnastic discipline
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Admin2 · Feb 22, 2014

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NewsBot · Feb 27, 2015

Evaluation of Men’s and Women’s Gymnastics Injuries
A 10-Year Observational Study
Robert W. Westermann, MD, Molly Giblin, ATC, LAT, MS, Ashley Vaske, LAT, ATC, Kylie Grosso, ATC, LAT, MS and Brian R. Wolf, MD, MS
Sports Health: A Multidisciplinary Approach March/April 2015 vol. 7 no. 2 161-165

Background: Injuries are common in collegiate gymnasts. Most descriptive studies of injury patterns in collegiate gymnasts are limited in duration or are only inclusive of women.
Hypothesis: Injury patterns in men and women differ significantly; women sustain a higher rate of injuries than men.
Study Design: Descriptive epidemiology study.
Level of Evidence: Level 4.
Methods: Musculoskeletal and head injuries reported in the Sports Injury Monitoring System at a single National Collegiate Athletic Association institution for Division 1 men’s and women’s gymnastics teams between 2001 and 2011 were identified. The variables assessed included sex, injured body part, year of eligibility, injury severity, surgical procedures, missed time, and team activity at the onset of injury.
Results: From 2001 to 2011, 64 male gymnasts sustained 240 injuries, while 55 female gymnasts sustained 201 injuries. The injury incidence was 8.78 per 1000 athlete-exposures for men and 9.37 per 1000 athlete-exposures for women. Female gymnasts more commonly suffered major injuries compared with men, and more commonly underwent surgery after injury (24.4% of female injuries required surgery vs 9.2% in males). The anatomic region most often injured in men was the hand and wrist (24%). The anatomic region most often injured in women was the foot and ankle (39%). Overall, injury rates were highest in freshman-eligible athletes.
Conclusion: Injury rates, overall, were similar in men and women gymnasts. Female gymnasts more commonly underwent surgical procedures after injury. Injury rates were higher in freshman-eligible athletes and decreased with increasing year of experience.
Clinical Relevance: Specific attention should be given to gymnasts transitioning into collegiate-level gymnastics; injury prevention strategies should focus on the ankle and foot, as well as the elbow, wrist, and hand.
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NewsBot · Jul 22, 2015

Epidemiology of National Collegiate Athletic Association Women's Gymnastics Injuries, 2009-2010 Through 2013-2014.
Kerr ZY, Hayden R, Barr M, Klossner DA, Dompier TP
J Athl Train. 2015 Jul 21.

CONTEXT:
Recent injury surveillance data for collegiate-level women's gymnastics are limited. In addition, researchers have not captured non-time-loss injuries (ie, injuries resulting in restriction of participation <1 day).
OBJECTIVE:
To describe the epidemiology of National Collegiate Athletic Association (NCAA) women's gymnastics injuries during the 2009-2010 through 2013-2014 academic years.
DESIGN:
Descriptive epidemiology study.
SETTING:
Aggregate injury and exposure data collected from 11 women's gymnastics programs providing 28 seasons of data.
PATIENTS OR OTHER PARTICIPANTS:
Collegiate student-athletes participating in women's gymnastics during the 2009-2010 through 2013-2014 academic years.
INTERVENTION(S):
Women's gymnastics data from the NCAA Injury Surveillance Program (ISP) during the 2009-2010 through 2013-2014 academic years were analyzed.
MAIN OUTCOME MEASURE(S):
Injury rates; injury rate ratios; injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs).
RESULTS:
The ISP captured 418 women's gymnastics injuries, a rate of 9.22/1000 athlete-exposures (AEs; 95% CI = 8.33, 10.10). The competition injury rate (14.49/1000 AEs) was 1.67 times the practice injury rate (8.69/1000 AEs; 95% CI = 1.27, 2.19). When considering time-loss injuries only, the injury rate during this study period (3.62/1000 AEs) was lower than rates reported in earlier NCAA ISP surveillance data. Commonly injured body sites were the ankle (17.9%, n = 75), lower leg/Achilles tendon (13.6%, n = 57), trunk (13.4%, n = 56), and foot (12.4%, n = 52). Common diagnoses were ligament sprain (20.3%, n = 85) and muscle/tendon strain (18.7%, n = 78). Overall, 12.4% (n = 52) of injuries resulted in time loss of more than 3 weeks. Of the 291 injuries reported while a student-athlete used an apparatus (69.6%), most occurred during the floor exercise (41.9%, n = 122) and on the uneven bars (28.2%, n = 82).
CONCLUSIONS:
We observed a lower time-loss injury rate for women's gymnastics than shown in earlier NCAA ISP surveillance data. Safety initiatives in women's gymnastics, such as "sting mats," padded equipment, and a redesigned vault table, may have contributed to minimizing the frequency and severity of injury.
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NewsBot · May 21, 2016

Injuries prevalence in elite male artistic gymnasts
Rev. bras. educ. f?s. esporte vol.30 no.1 S?o Paulo Jan./Mar. 2016

The purpose of this study was to investigate the injuries prevalence in men elite artistic gymnasts. Twenty Brazilian senior gymnasts, aged 23.1 ? 6.5 years, 13.9 ? 5.0 years of practice and 36.5 ? 4.7 hours per week training, participated in this study. The athletes answered a morbidity questionnaire, formulated according to studies from the literature, for information on the injuries? characteristics and circumstances. Information about the injury circumstances (gymnastic apparatus, overload training and physical exercises), the anatomic site injured, the affect biological tissue and the return to training after injury treatment were evaluated. Data were analyzed by descriptive statistics, absolute and relative frequencies. The training overload, and floor, pommel horse and vault were the events that presented higher injuries frequency. In relation to anatomic site, ankle, hands/fingers and shoulder were the most cited regions. The ligament, bone and articular capsule were the most affected biological tissues. In relation to gymnasts? return to their sports activities, 56% of them reported a better condition at return, 33% reported to have returned at the same fitness level and 10% indicated that they were in a worse condition when they returned to the sports activities. The men?s artistic gymnastics injuries are related to the mechanical demands of this sport. The analysis of risk factors helps in understanding the injuries mechanisms in gymnastics, and provides relevant information that can assist in effective prevention strategies.
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NewsBot · Oct 14, 2017

Gymnastics injury incidence during the 2008, 2012 and 2016 Olympic Games: analysis of prospectively collected surveillance data from 963 registered gymnasts during Olympic Games
Edouard P, Steffen K, Junge A, et al
Br J Sports Med Published Online First: 14 October 2017. doi: 10.1136/bjsports-2017-097972

Objective To determine the incidence and characteristics of injuries in female and male gymnastics disciplines (artistic, rhythmic and trampoline) during three Olympic Games with a view to ultimately improving injury prevention.

Methods The National Olympic Committee’s head physicians and the medical teams of the Local Organising Committee of the Olympic Games reported daily the occurrence (or non-occurrence) of newly sustained injuries in artistic, rhythmic and trampoline gymnastics on a standardised report form during the 2008, 2012 and 2016 Summer Olympic Games.

Results During the three Olympic Games, 81 injuries were reported in a total of 963 registered gymnasts, corresponding to an incidence of 84 injuries (95% CI 67 to 102) per 1000 registered gymnasts, with no difference in injury incidence between female and male gymnasts. Thirty-eight per cent of injuries led to time-loss from sport. The most frequent injury location and injury type were the ankle (22%) and sprain (35%), respectively. The most common diagnosis was ankle sprain (14% of all injuries and 23% of time-loss injuries). The injury incidence was highest in female (107±35) and male artistic gymnastics (83±32), followed by female rhythmic gymnastics (73±30), and lower in male (63±69) and female (43±43) trampoline gymnastics.

Conclusions Research should focus on preventing injuries in artistic gymnastics and of the condition of ankle sprain. Injury surveillance studies should be continued during major championships and throughout the entire competitive season as the Olympic Games provides only a snapshot (although an important one).
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NewsBot · Jul 24, 2018

ANALYSIS OF LONGITUDINAL PLANTAR ARCH IN
FEMALE ARTISTIC GYMNASTS
Miriam Kalichová, Petr Hedbávný, Petr Dolana
Faculty of Sport Studies, Masaryk University, Brno, Czech Rep.
Science of Gymnastics Journal

The aim of the study was to use plantographic measurements to analyse the condition of
longitudinal plantar arch in a group of female artistic gymnasts and to find out to which
characteristics of gymnasts they are related. The study group included 52 artistic gymnasts at a
high performance level. Using static measurement on an Emed platform plantographs were
acquired which were then evaluated by the Chippaux-Šmiřák method, the results were then scaled
according to Klementa norms. In 89 measured feet out of 104 a high longitudinal foot arch was
detected. Out of these 5 were slightly high, 14 were medium high and 70 were very high. The
remaining 15 gymnasts had a normal longitudinal foot arch. By calculating the Pearson
correlation coefficient we found out that with the duration of gymnastic practice the height of foot
arch decreases (r = 0.47), these changes might also be affected by increasing BMI (r = -0.51)
during growing up. Regarding the condition of preferred and non-preferred foot, no statistically
significant difference was found out (p = 0.44). Based on the results we recommend compensatory
exercises aiming to plantar flexors stretching to be included in artistic gymnasts’ preparation.
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NewsBot · Jul 19, 2019

Musculoskeletal injuries among elite artistic and rhythmic Greek gymnasts: A ten-year study of 156 elite athletes.
Paxinos O, Mitrogiannis L, Papavasiliou A, Manolarakis E, Siempenou A, Alexelis V, Karavasili A.
Acta Orthop Belg. 2019 Jun;85(2):145-149.

Data on elite gymnast injuries outside North America is sparse. We report the injuries recorded over a period of 10 years in 156 Greek elite male and female gymnasts. A total of 2390 injuries were reported for a rate of 1,5 new injuries per year per athlete. Most commonly affected areas were the hip (18.5%), the ankle (16.5%), the lumbar spine (16%) and the foot (16%). The most frequent diagnosis was tendinitis (32%), followed by low back pain (20%), and sprains (12%). Fifteen athletes (9%) sustained serious injuries that required surgery. Rhythmic gymnasts had significantly more overuse type injuries compared to artistic gymnasts (p = 0.049). Gymnastics is a sport with a high incidence of musculoskeletal pathology that needs proper documentation in order to establish preventive measures.
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NewsBot · Sep 26, 2020

ASSOCIATION FOOT MORPHOLOGY AND PERFORMANCE IN RHYTHMIC GYMNASTICS
Sierra-Palmeiro, E et al
Source

The objectives of the study were to determine the influence of foot morphology on performance in Rhythmic Gymnastics and to analyze the influence of years of practice. The sample consisted of 48 gymnasts who had practiced federated gymnastics and competed during the last year. The results indicate that the gymnasts have predominantly a neutral foot and with a normal footprint, presenting enough asymmetry between feet, not significant, which may be a consequence of asymmetric work and should be corrected in training. Only the range of amplitude of the talocrural joint seems to be a characteristic of foot morphology that affects technical performance and seems more an innate characteristic. The practice of rhythmic gymnastics might not be as decisive a factor as could be supposed in the morphological modifications of the footprint.
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NewsBot · Jul 5, 2021

The influence of growth and training loads on injury risk in competitive trampoline gymnasts
Tejal Sarika Patel et al
Journal of Sports Sciences: 03 Jul 2021

There is currently limited research exploring the relationship between growth, training load and injury in gymnasts. Twenty-one national level, trampoline gymnasts recorded training load and injury for 8-weeks. Percentage of predicted adult height (%PAH) was calculated using the Khamis–Roche method and used to define growth spurt status. Training load was calculated using the session rate of perceived exertion and analysed as differential loads and as a 7-day exponentially weighted moving average (EWMA7day). There was a significant non-linear association between %PAH and the probability of injury when adjusting for either training load metric (differential load, P = 0.015; EWMA7day; P = 0.008), with the highest injury risk estimated at ~90% PAH (circa growth spurt). The probability of injury significantly increased with increases in EWMA7day training load (RR: 1.88 95% CI: 1.21– 2.91, P = 0.005) but not with differential load. No significant interaction between %PAH, training load and the probability of injury were observed. Data suggest that competitive trampoline gymnasts are at an increased risk of injury during the adolescent growth spurt or with higher weekly training loads. Coaches should be educated and encouraged to identify periods of rapid growth and monitor training load, to reduce the risk of injury.
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NewsBot · Jul 19, 2021

TIME LOSS INJURIES AMONG FORMER COLLEGIATE GYMNASTS: THE INFLUENCE OF FEMALE ATHLETE TRIAD SYMPTOMS
Caroline Fryar, MD, David R Howell, ATC, PhD, Corrine N. Seehusen, BA, ...
Orthopaedic Journal of Sports Medicine July 14, 2021

Background:
Female college gymnasts have one of the highest injury rates in the NCAA and are at risk for female athlete triad syndrome. While female athlete triad syndrome leads to bone stress injuries, little research has been done on specific injury location and type.

Purpose:
Our objective was to compare injuries sustained during gymnastics between former collegiate gymnasts who did and did not report experiencing symptoms of Female Athlete Triad Syndrome during college, including disordered eating (DE) or menstrual irregularity (MI).

Methods:
465 former collegiate gymnasts completed an online survey distributed via social media. Participants were grouped based on mensural irregularity and whether they had a history of DE/ED of not. We compared injury outcomes (time-loss injuries and injuries resulting in surgery) and injury locations between groups using Chi-square analyses.

Results:
A significantly greater proportion of those who reported MI during college reported a time-loss wrist/hand and injury during gymnastics compared to eumenorrheic gymnasts (Table 1).

A significantly greater proportion of those who reported MI during college sustained an injury that required surgery relative to those who reported regular periods during college (52% vs 65%, p=0.009). Specifically, they reported a greater proportion of hip/pelvis (2% vs. 7%, p=0.02) and leg/ankle/foot surgeries (23% vs. 33%, p=0.009).

A significantly greater proportion of the group who reported DE during college reported a time-loss gymnastics injury during college that did not require surgery or retirement, relative to those who did not report DE (78% vs 66%, p= 0.005) (Table 2). Specifically, they reported a greater proportion of spine (25% vs. 14%, p=0.002), hip/pelvis (8% vs. 2%, p=0.001), and leg/ankle/foot injuries (53% vs. 41%, p=0.01).

There was a significantly greater proportion of gymnasts who reported DE during college who sustained a hip/pelvis (7% vs. 3%, p=0.04) and leg/ankle/foot injury (34% vs. 23%, p=0.02) requiring surgery compared to those who did not report DE during college.

onclusion:
College gymnasts who experienced triad symptoms were more likely to experience a time-loss injury, or have an injury requiring surgery. Clinicians and providers should be aware of the association between injuries and DE and MI in gymnasts. Early intervention for athletes with triad symptoms should be undertaken to decrease the risk of musculoskeletal injury.
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NewsBot · Feb 27, 2023

Injury Pathology in Young Gymnasts: A Retrospective Analysis
Emma Williams et al
Children (Basel). 2023 Feb 4;10(2):303

Gymnastics has a history of high injury incidence rates. However, little is known about the injury pathology in young gymnasts. The purpose of this study was to fill gaps in the literature by providing insight into the injury pathology in gymnasts aged 6 to 17 years. This study was retrospective in design, where injury data were collected using a Qualtrics questionnaire and distributed via social media. The findings revealed that the most common injury site was the lower limb (60.5%), in particular, the ankle/foot (49%) and knee (27%). Overuse injuries and sprains were most prevalent among the lower limb (25% and 18.4%, respectively), and gymnasts seemed to have a tendency to train through injury with modifications to training. In conclusion, lower limb joint sprain and overuse injuries accounted for the majority of injuries in youth gymnasts. These injuries were more frequently reported in girls in the years associated with peak height velocity and beyond.
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NewsBot · Mar 6, 2023

Characterization of Achilles Tendon Ruptures in Collegiate Women's Gymnastics
Jacqueline K. Kobayashi, MD, Evangeline F. Kobayashi, MD, Kelly M. Tomasevich, MD, Katherine L. Lorens, MS, ATC-L, and Stephen K. Aoki, MD
March 01, 2023

Collegiate female gymnasts are at high risk of Achilles tendon injuries. Achilles tendon ruptures can negatively impact an athlete's ability to return to competitive sport. Understanding the natural history of Achilles tendon tears in collegiate female gymnasts is important in the development of preventive treatment. To expand our knowledge of the natural history of Achilles tendon ruptures among collegiate female gymnasts, a REDCap retrospective survey was emailed to athletic trainers on all 80 National Collegiate Athletic Association (NCAA) women's gymnastics teams. The survey gathered information regarding number of Achilles tendon injuries, pain prior to injuries, events and skills on which injuries occurred, and functional outcome after injuries among athletes competing in the 2013 to 2018 NCAA seasons. Forty-two of 80 (52.5%) programs responded to the survey. Seventy-one Achilles tendon ruptures were reported between 2013 and 2018. Among these, 46% had antecedent pain. Gymnasts sustained 95% of Achilles tendon ruptures while performing on floor exercise, with 98% of ruptures occurring during the take-off portion of a tumbling skill. Of the 61% of gymnasts who were able to return to competition, 59% were able to achieve the same level of function after injury. Achilles tendon ruptures in collegiate female gymnasts primarily occur during the take-off motion while tumbling on the floor exercise. Future studies should evaluate degenerative Achilles tendon changes in collegiate female gymnasts. A collaborative effort among gymnasts, coaches, judges, and medical experts is required to identify at-risk athletes and develop and implement injury prevention programs
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NewsBot · Apr 30, 2023

Link Between the Female Athlete Triad and Gymnastics-Related Injury in Retired Collegiate Gymnasts
Fryar, Caroline et al
Clinical Journal of Sport Medicine ():10.1097/JSM.0000000000001148, April 25, 2023. | DOI: 10.1097/JSM.0000000000001148

Objectives:
To compare gymnastics-related injuries between former collegiate gymnasts who did and did not report components of the female athlete triad (Triad) during college, including disordered eating or menstrual irregularity. We hypothesized that athletes reporting these 2 triad symptoms would have higher rates of time loss injury and injuries requiring surgery.

Design:
Retrospective case–control.

Setting:
Online survey.

Patients:
Four hundred seventy former collegiate gymnasts.

Interventions:
Athletes completed online survey distributed through social media.

Main Outcome Measures:
Participants were grouped based on self-reported menstrual irregularity and disordered eating during college. We compared time loss injuries, injuries resulting in surgery, and injury locations between the groups using χ2 analyses.

Results:
Seventy percent (n = 328) of participants in this study reported a time loss college injury without surgery, and 42% (n = 199) reported an injury during college that required surgical treatment. A significantly greater proportion of gymnasts with only disordered eating reported a time loss gymnastics injury (without surgery) compared with those who reported only menstrual irregularity during college (79% vs 64%; P =0 .03). A significantly greater proportion of the disordered eating–only group reported a spine injury compared with the menstrual irregularity–only group (P = 0.007) and the group who reported neither menstrual irregularity nor disordered eating (P = 0.006).

Conclusions:
College gymnasts who experienced disordered eating were more likely to experience a nonsurgical time loss injury while in college, as well as spine injury compared with those with menstrual irregularity. Sports medicine providers should be aware of the association between injuries and individual components of Triad in gymnasts beyond bone stress injuries.
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NewsBot · Aug 7, 2023

A Research and Clinical Framework for Understanding Achilles Injury in Female Collegiate Gymnasts
Fryar, Caroline MD; Tilley, Dave DPT; Casey, Ellen MD; Vincent, Heather PhD, FACSM
Current Sports Medicine Reports 22(7):p 260-267, July 2023. | DOI: 10.1249/JSR.0000000000001082

Gymnastics is a popular sport with a high injury rate, particularly at the collegiate level. Achilles tendon rupture is a catastrophic injury with career-changing impact. Over the last decade, there has been a growing incidence of Achilles tendon ruptures, especially in female gymnasts. Currently, neither the effects of contributing risk factors on Achilles tendon rupture nor the research frameworks to guide future intervention strategies have been well described. This article reviews the functional anatomy and mechanical properties of the Achilles tendon, provides precollegiate and collegiate intrinsic and extrinsic risk factors for Achilles tendon rupture, and proposes a research framework to address this injury from a systemic perspective. Potential clinical interventions to mitigate Achilles tendon injury are proposed based on currently available peer-reviewed evidence.
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NewsBot · Oct 12, 2023

Asymptomatic Sonographic Abnormalities of the Hindfoot Region in Division I Collegiate Gymnasts
Ryan C. Kruse MD, Lauren Rudolph MD, Matthew Negaard MD
05 October 2023

Introduction
The hindfoot region is commonly injured in gymnasts, and musculoskeletal ultrasound can be used to identify structural abnormalities in this region. While prior studies have shown that sonographic abnormalities may not correlate with symptomatic pathology, the presence of asymptomatic sonographic abnormalities of the hindfoot in Division I collegiate gymnasts has not been evaluated.

Objective
To identify and describe commonly seen asymptomatic sonographic abnormalities of the hindfoot region in Division I collegiate gymnasts.

Design
Cross-sectional study

Setting
Tertiary care academic medical center.

Participants
39 Division I NCAA men's and women's collegiate gymnasts without current hindfoot pain or history of hindfoot injury.

Interventions
Diagnostic musculoskeletal ultrasound of the hindfoot region.

Main Outcome Measures
Sonographic appearance of the hindfoot region, specifically the plantar fascia, plantar fad pad, and Achilles tendon.

Results
37/39 gymnasts included in the study were found to have at least one asymptomatic sonographic abnormality of the hindfoot region. 28.2% of athletes were found to have sonographic abnormalities within the Achilles tendon, with Doppler flow being the most common finding. 35.8% of athletes were found to have a Haglund's deformity, however only 7% of athletes with a Haglund's demonstrated abnormal sonographic findings within the tendon. Sonographic abnormalities of the plantar fascia and plantar fat pad were seen in 30.7% and 69.2% of athletes, respectively.

Conclusions
Asymptomatic sonographic abnormalities of the hindfoot region are common in collegiate gymnasts. Clinicians should use clinical judgement when interpreting these findings as they may not represent symptomatic pathology
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