Gymnastics
Single Sport / Multi Sport
A sports medicine challenge
Julie Sparrow MSc MCSP Grad Dip Phys
National Lead Physiotherapist British Gymnastics
Artistic Gymnastics
Men
Women
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Floor
Pommel
Rings
Vault
Parallel bars
High bar
Vault
Bars
Beam
Floor
Core components of all gymnastics
skill
• Body positions (in all swing and flight elements)
– Open – trunk extension
– Closed – trunk flexed – “dish”
– Straight
• Hand stand
• Splits – “side” and “box”
• “Bridge”
Core components continued
• Support - weight taken by hands or feet
• Swing* – in which the body travels about a fixed point
• Flight – with or without directional change
• Balance
• Rebound
Rhythmic gymnastics
• Women only
• Use of small apparatus
– Ball
– Ribbon
– Hoop
– Club
– rope
Rhythmic Gymnastics
Flexibility
Co-ordination
Flight
Expression
Elegance
Dance
‘Hypermobile’
Tall and slender
Balance on large base of support
Making of a gymnast
• Many will start working on gymnastic related skill
elements by the age of 6
• Naturally self selecting based on skill confidence
and courage
• Women peak in the mid to late teens
• Men peak in late teens into early 20’s
The influence of the growing
skeleton
• Growth plate injury
– Compression – load bearing in support
– Shear – rotational stress
– Traction – take off landing and swing.
• Trauma
– Ligamentous
– Bony
Epiphyseal (Salter Harris) fracture
Avulsion fracture
Buckle (Torus) fracture of the
proximal radius
Plastic Bending
fracture
The At
Risk
Spine
Source of back pain
• Bone
stress reaction – pars stress # - end
plate #
• Spondylolysthesis
• Ligamentous stress
• Annular stress and loss of disc integrity
• Zygapophyseal stress
• Muscle strain
Shoulder and upper quadrant
Shoulder and upper quadrant
• Impingement
– Labral
– Rotator cuff
• Tendon rupture
– Rotator cuff
– Biceps
– Pectoralis major
Elbow wrist and hand
Clinical problems at the wrist
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Physeal stress
Physeal arrest
Scaphoid impaction
Scaphoid stress #
Ulnar impaction
Avascular necrosis of the
capitate
• Carpal chondromalacia
• Dorsal
impingement/capsulitis
• Tears of the triangular
fibro cartilage
• Carpal instability
• Distal radio ulnar
instability
Anterior
Posterior
Forearm
• Pommel arm
– Compartment like syndrome of the forearm
Injury potential in the lower limb
• Take off
• Landing
• Rebound
Soft tissue
• Achilles tendon
• Anterior knee pain syndromes
• Muscle trauma
Bony Injury
• Traction apophysisitis
• Bone bruising
• Osteochondritis dissecans
• Chondral defect
Bone bruise of the femoral
condyle
Chondral defect of the talus
Summary
• Gymnastics is a potentially a high risk
sport
• The growing body is at risk of injury if
progression is not judiciously managed
• Gymnastics can provide positive benefits
for motor skills and bone health