The problem of injuries in artistic and rhythmic gymnastics is not as acute as in other, more traumatic sports. When we watch how easily girls and boys flutter on the court, uneven bars or crossbar, we don’t even want to think that every performance or training is a risk of serious injury. In the United States alone, nearly 100,000 injuries are reported annually among gymnasts. Fortunately, most of them are lightweight. But there is another problem here: the accumulation of damage.
Injury Statistics in Gymnastics The
average for the American professional team was one injury episode per athlete in each training session. At the amateur level, this figure is likely to be much higher.
Types of injuries and provoking factors
Gymnastics is characterized by one feature that is not characteristic of other sports. This is the prevalence of chronic (fatigue) injuries over acute ones.
Chronic (or fatigue) injury
They account for about 75% of all injuries sustained by athletes. There are two reasons for this phenomenon:
1. Features of training. Repetition of the same movements, exercises with shells, until the formation of automatism. As a result, certain parts of the musculoskeletal system are overloaded and damaged.
2. Accumulation of microtraumas. Striving to achieve better results, athletes ignore minor (in their opinion) pain and other micro-injuries. As a result, the body’s compensatory capabilities are exhausted, and a serious problem develops.
It is chronic injuries that are the reason that in professional gymnastics there are very few athletes under the age of 30. A typical chronic process in gymnasts is osteochondrosis and the phenomena caused by it (up to 80% of all fatigue injuries).
Their share in the structure of injuries is “only” 25%. These are typical damages arising from “short-term influences or circumstances, as a result of which the human body is exposed to excessive impact and leading to a violation of its integrity, function.”
Such sharp injuries occur in the “usual” order: unsuccessful movement, fall, etc. The structure of injuries is represented by a typical set:
1. Sprains of ligaments – 29.7% and muscles – 23.2%.
2. Damage to growth plates – 12.3%.
3. Fractures – 8.3%.
4. Dislocations – 0.6%.
5. Concussion – 6%.
6. Acute tendinitis – 6.9%.
Fortunately, severe acute injuries with disabilities are rare.
There are a lot of risk factors. Moreover, they are not always obvious. The somatotype is of the greatest importance: an overweight, albeit strong gymnast is more often injured and recovers longer than a thin one.
The second serious point is periods of rapid growth, due to which an imbalance arises between the capabilities of the muscles and the complexity of the elements performed. The peak of the human body’s capabilities occurs during puberty. After that, the complexity of the elements must be adjusted.
External factors are less significant: the complexity of the exercises, the athlete’s psychoemotional fatigue, recovery from previous injuries (too early resumption of training and performances). Localization of injuries Depends on the type of gymnastics, the gender of the athlete. In gymnasts, most of the injuries occur on the lower extremities, less on the upper ones, even less often the back is injured, and after them – the head and neck. Damage to the ankle and knee joints is typical. Male athletes are more likely to injure their hands, then their legs. Shoulder, wrist and ankle injuries are common. Back and trunk injuries The spine is under severe stress. Jumping, jumping off shells, pushing off, etc. – these elements require a serious margin of safety from the spine. Typical back injuries are bruises and muscle sprains. Neck On the bar, rings, sometimes injuries of the cervical spine occur. When a simple athlete does not have time to grab the projectile and falls on his head. Gross injuries, fractures and dislocations of the neck are rare, mostly soft tissues (sprains) are affected. Chest Suffers more and more often. One study indicates that 75% of athletes show degenerative changes in the intervertebral discs of the thoracic spine. In case of incidents on the uneven bars and the crossbar, fractures of the sternum and I rib occur. Loins Perhaps the most suffering part of the body in gymnasts. The reason is the desire for even more flexibility. Overextension, twisting of the lumbar spine leads to chronic trauma to the discs and intervertebral ligaments (facet joints). Typical pathological processes: 1. Spondylolysis – fracture of the vertebral arch. It can be acute and chronic (fatigue). 2. Spondylolisthesis – displacement of the vertebrae, sliding them relative to each other. 3. Compression fractures of the vertebral bodies. As a rule – due to excessive axial loads. They are also sharp and fatiguing. Even the initial stages of problems with the spine are accompanied by pain and require attention. If you ignore them, there is a high risk of developing severe radiculopathy, a spinal fracture. Injuries to the girdle of the upper extremities Almost all departments suffer. Shoulders Men put a lot of stress on their shoulders, usually on rings. Traditionally, the rotator cuff of the shoulder suffers: the tendons of the supraspinatus muscle of the scapula are stretched with the formation of tendinitis. In difficult cases, the rotator cuff breaks. Such an injury is characteristic of young gymnasts, which is associated with insufficiently developed muscles. In addition, gymnasts are characterized by: • infringement between the bones of the shoulder and scapula of ligaments, muscle fibers; • chronic subluxation of the shoulder – lead to acute and / or chronic instability of the shoulder joints; • dislocation of the shoulder. Elbows Elbow joints are often damaged on rings, a log, due to unsuccessful movements, falls, rebounds from the projectile. Dislocations and fractures often occur in these places. Chronic injuries to the elbow area are represented by the following processes: • tendonitis of the triceps tendons; • epicondylitis; • osteochondrosis dissecans; • fatigue processes of the olecranon. Excessive, explosive loads on the muscles of the forearm and shoulder sometimes lead to fractures of the epiphyses of the bones. The reason is that young people have strong ligaments and flexible bones. Chronic muscle tension leads to vasospasm at the site of attachment of the tendon to the olecranon, which causes foci of aseptic necrosis in it. Hands and wrists To one degree or another, these areas of the body injure up to 88% of gymnasts and gymnasts. The prevalence is such that many athletes regard hand pain as inevitable. The key damaging factor is overextension of the wrist under stress (handstand, landing on the wrist, etc.). Among the pathological processes prevail: • stress response of the radius; • osteochondral phenomena of the beam head; • impression of the scaphoid into the radius; • early closure of the growth zone of the ulna; • fatigue fractures of the beam head; • ruptured wrist ligaments; • etc. Sometimes injuries are caused by gymnastic pads, when the wrist or the lower third of the forearm breaks due to the “locking” of the hand on the bar. Lower limb girdle injuries These are quite common. The predominant mechanism of damage is the final part of the exercise, dismount. The knees are heavily loaded at the moment of twisting the hip with a strong contraction of the quadriceps against the background of a tightly fixed foot and lower leg. A common occurrence is subluxation or dislocation of the knee pad. Women, due to anatomical features, dislocate the knee pad more often than men. Tears of the external and internal ligaments of the knee joint are not typical for gymnastics. Stretching of the hind thigh muscles involved in leg flexion is common. And it is associated with insufficient warm-up, as it occurs at the very beginning of the performance or training. Jumper’s knee or patellar tendonitis is a chronic injury. It arises as a result of the accumulation of fatigue and microtrauma of the ligament of the knee pad. If the pain is ignored, it breaks. In young athletes, the tibial tuberosity may come off. Ankle joints Typical injuries are acute and are represented by the following injuries: • sprain of the ankle ligaments due to tucking of the foot; • impingement syndrome, when, due to the accumulation of damage to the ligaments, when bending the foot, a fragment of the deltoid ligament is infringed; • fractures of the fibula and tibia, usually in the ankle; • rupture of the Achilles tendon is not typical for gymnastics. Feet Bones are rarely affected, more often the ligamentous structures are damaged: • plantar fasciitis (inflammation of the plantar fascia); • contusion of the heel area (broken heel); • stretching of the capsule of the metatarsophalangeal joint of the first toe. Sometimes, on a failed landing, this joint breaks. Features of injuries in children’s gymnastics There is another problem with regard to children. To achieve outstanding results, training should be started as early as possible, from the age of 4-5 years. At this time, the cartilaginous growth zones on the bones of the limbs have not yet been closed in children. If they are overloaded during training, then chronic cartilage injury occurs. Madelung’s deformity is the result of chronic trauma to the radial growth zone. It occurs as a result of loads on the hand (bars, logs, somersaults, etc.). As a result, the radius stops growing early, is shortened relative to the ulna, the hand is shifted to the palmar side. The second name for such a deformity is “gymnast’s wrist”. Treatment is only operative, at the age of 13-14 years. It will no longer be possible to fully engage in gymnastics with such a deformation. With regard to acute injuries, due to the relatively low body weight, fractures in children are less common than in adults. There are still no reliable statistics on sprains and dislocations. Prevention and treatment of gymnasts’ injuries Injury must be prevented. Otherwise, after it, the path to sports heights may be closed. The very first thing is to develop an adequate training program, taking into account the age characteristics of the athlete. Comparison of loads with the capabilities of the body will help to reach great heights and continue a sports career longer. The second most important is high-quality and properly selected equipment. These are suitable size wrist restraints, shoes (for each type of activity – its own), gymnastic pads on the hands and even just magnesium for the hands. And the third is the so-called sports medical examination. This is a periodic medical examination aimed at maintaining the health of the athlete. Ideally, every club or gymnastics section should have a sports medicine physician on staff. The main tasks of such a specialist: 1. Identification of chronic injuries in their infancy and their treatment before serious consequences arise. 2. Establishment of elements of training and exercises potentially dangerous for traumatism. 3. Monitoring the recovery of gymnasts after injuries or treatment of chronic injuries. 4. Educational work with athletes and coaches regarding the prevention of injuries and injuries.