This blog is the first post in a multi-series blog on sports most common injuries and how we can avoid and even prevent them. Today’s focus is on gymnastics.
I spoke with Sara Jane Moffei, a former gymnast, and current PT at Cooper Bone and Joint at Inspira, about gymnastics and why athletes develop common problems. Together we listed these common challenges and injuries in gymnastics and what should be done to correct these issues.
Using the preseason to assess athletes could be a crucial point to identify weaknesses that may lead to future injuries in-season. Sara states that it would benefit athletes to receive a movement screen before the season begins to access the athlete for any muscular imbalances, or specific athletic limitations. Pre-season identification can help identify any weaknesses the athlete already has, once deficiencies are identified programming to strengthening the weaknesses and lower the chance of injury related to the assessed vulnerability is beneficial.
Back, Knee, & Ankle
There are different common injuries in gymnastics, but Sara believes that the biggest issue most gymnasts face is lower back pain. Low back pain can occur from the regular hyperextension of the lower lumbar. When a gymnast extends it is predominantly through the lower lumbar when the focus should be on the thoracic spine, this new extension point is key for pain relief. (Moffei) When a gymnast extends their back, a focus should be on extending through the t-spine, not the low back as well as activating the core as they extend and press tall through the hip
Knee injuries are common amongst gymnasts as well, however, why the damage is occurring can be different. Sara thinks that knee issues in younger gymnasts mostly comes from Osgoodslaughters disease which is when the patella tendons pull on the tibial tuberosity causing the bone to pull out further which causes pain. Avoiding repetitive jumping can aid in solving the pain these younger athletes experience.
Knee and ankle injuries for more advanced gymnasts come from the extreme force placed on the joint during high impact landings, especially when the knee moves laterally. Sara and I both believe that injuries to these joints occur when the athlete has poor control in lateral movement or cannot resist a valgus force. To prevent these types of injuries from happening the athletes should be doing exercises that work on lateral movement and resistance of valgus forces.
Athlete Proprioception & Strength/Stability At Joint End Ranges
Gymnasts are very flexible, and they need to have strength and stability at the joint end ranges not just the ability to get there. (Moffei) When athletes cannot control their range of motion because they lack strength and stability, this is where injuries can occur. To prevent this athlete should go through accessory training where they can develop the strength and stability at these end ranges that they require to perform their movements and avoid injury. The athlete will be able to perform and remain healthy when their proprioception, strength, and stability in these joints improve.
Coaching Knowledge & Return To Play Protocol
Some coaches are not aware that when different planes of movement are not trained the athlete develops muscular imbalances and movement deficiencies, this increases the chance of injury. If a coach is aware of why these injuries happen then, they can train athletes accordingly and lower the chance of injuries occurring.
When an athlete is injured they go through a rehab process, often the rehab they are doing is good but basic and problems can arise when you get a gymnast who goes from basic rehab movements right into advanced gymnastics movements. (Moffei) Simply put, there is a gap between rehab and return to play.
To avoid this problem from happening, they need to bridge the gap and see the difference between rehabbing the average person vs. rehabbing a gymnast. (Moffei) Also, they may even move through segments of their usual routine so they can be assessed to see if there is still a problem. I understand at a higher level of competition the athlete may not always be 100% healthy, but coaches should be cautious. Moreover, coach’s need to be competent in training the athletes to prevent injury as well as understanding how to work them back into training once they return from injury.