UR Medicine is a proud participant in the Stop Sports Injury Campaign. To help keep kids in the game for life, STOP (Sports Trauma and Overuse Prevention) targets the sports that have the highest rates of overuse and trauma injuries. The development of STOP (Sports Trauma and Overuse Prevention) Sports Injuries was initiated by the American Orthopaedic Society for Sports Medicine (AOSSM).
Because the upper body is used as a weight-bearing joint in gymnastics, injuries to the shoulder, elbow, and wrist are common and may include:
Labral tears (sometimes called SLAP tears) may occur during any gymnastic exercise, but ring and bar specialists seem particularly vulnerable. It is characterized by pain that initially resolves but tends to recur with return to sport. An MRI can be helpful in establishing a definitive diagnosis.
In gymnastics, the wrist is subjected to forces that can exceed twice the body weight. The first step in treating wrist pain is to reduce the training volume of the athlete, relieve symptoms, and to participate in only pain-free activities. After an injury, gymnasts should avoid extensive pressure on the wrist joint for six weeks. If the gymnast is experiencing pain with non-gymnastic activities of daily living, using a brace or cast to immobilize the wrist temporarily may be helpful.
Anterior Cruciate Ligament (ACL) Injury
ACL injuries can result when a gymnast lands “short” or is over-rotated while tumbling, dismounting, or vaulting.
A "pop"may be heard or felt followed by knee swelling with hours. MRI is often used to confirm ACL injury. As with other sports, ACL reconstruction is recommended for gymnasts who wish to return to full sports participation.
Achilles Tendon Injury
Gymnasts can suffer from a variety of injuries to the Achilles tendon located just above the back of the heel, as a result of the repetitive stress of jumping and landing.
Achilles tendinitis results in calf soreness that is aggravated with jumping and landing. Treatment should initially consist of ultrasound, stretching, activity modification, and calf exercises. Foot immobilization for seven to ten days may be beneficial for severe symptoms.
Foot and Ankle Injuries
Injuries to the foot and ankle are common in gymnastics. Acute injuries are usually sprains which can be minor or more serious. Swelling, bruising and tenderness directly over the bones are signs of a more serious injury. Minor injuries typically have tenderness limited to one side of the joint without significant swelling. Serious injuries require evaluation by a qualified professional while return to participation after a minor injury is often possible within a week if there is no pain (or limping) with weight bearing activity. Protection with taping or a brace can aid recovery and reduce the risk for reinjury. Chronic ankle pain or repeated injuries are worrisome and require evaluation before continuing with participation.
Lower Back Injuries
The cause of low-back pain can include muscle strain, ligament sprain, fracture, and/or disc disorders. Frequently, low-back pain will worsen with activity, especially with extension movements, such as arching the shoulders backwards.
Low-back pain in gymnasts related to muscular strain or ligament sprain usually responds to rest and physical therapy exercises. Persistent back pain is uncommon and should not be ignored. An MRI or a bone scan are often helpful to rule out more significant injuries.
Many gymnastics injuries can be prevented by following proper training guidelines, using safety equipment, and incorporating the following tips:
The following expert consultants contributed to the tip sheet:
Grant L. Jones, MD
Brian R. Wolf, MD, MS