Generally injuries in youth sports can either result from a traumatic event or from overuse. Gymnastics injuries are no different. A young gymnast can land awkwardly on the dismount from the balance beam and sprain her ankle. She could land badly from a vault and injure her knee. Those gymnastics injuries are unfortunate and can keep a young athlete out of training and competition for months.
On the other hand, a large number of gymnastics injuries do not result from a specific event and instead develop over time as the result of overuse. Essentially a gymnast might put too much stress on one part of her body doing the same motions over and over, day after day. That repetitive stress can lead to soreness before becoming a more serious injury if she does not take enough time to rest that part of her body.
The following five injuries are relatively common in gymnastics. In Part 2 of this series on gymnastics injuries, I’ll share five tips to prevent or decrease the risk of suffering these injuries.
Gymnastic injury #1: Osgood-Schlatter disease
This is an overuse injury involving the growth center at the tibial tubercle, where the patellar tendon attaches to the front of the tibia just below the knee. Typically this problem causes pain in a young athlete in a running or jumping sport like gymnastics. Usually it develops during the adolescent growth spurt, so it often affects girls around the age of 12 and boys around the age of 13. Pain is usually felt at the tibial tuberosity, although a patient often presents complaining of more diffuse pain throughout the front of the knee. X-rays often show widening of the growth center at the tibial tuberosity. Treatment usually consists of a short period of rest and activity modification and occasionally physical therapy.
Gymnastic injury #2: Sever’s disease
This is an overuse syndrome involving the growth center of the calcaneus (heel bone). It also commonly occurs during adolescent growth, and it can affect both heels. Jumping and running athletes often develop Sever’s disease. The gymnast might complain of pain in the back of the heel where the Achilles tendon attaches to the calcaneus. X-rays often show thickening or fragmentation of the growth center in the posterior aspect of the calcaneus. Treatment involves rest, Achilles and calf stretching and occasionally heel cups or orthotics.
Gymnastic injury #3: Spondylolysis
This is a stress fracture of the pars interarticularis, part of the bone in the lumbar spine. Gymnasts develop it due to the repetitive hyperextension of the lumbar spine from vaults and dismounts. The gymnast often complains of low back pain, especially on the side of the bony injury. Side bending might be painful as well. Rest and wearing a brace are often the first-line treatments.
Gymnastic injury #4: Osteochondritis dissecans of the capitellum
This is an overuse injury to the lateral (side away from the midline of the body) side of the elbow. Gymnasts can develop this bony injury due to repetitive compression of the elbow from bearing weight through the arm. X-rays or MRIs show varying levels of abnormalities of a small part of the humerus at the elbow. With progression of the injury, the fragment of bone and cartilage can actually break off and cause locking of the elbow. If the problem is caught early, stopping gymnastics and the compression of the bone with weightbearing activities can be enough to resolve the pain. In older athletes or those in whom the lesion has broken off, surgery is often needed.
Gymnastic injury #5: Distal radius epiphysitis
Gymnasts often develop this overuse wrist injury as well due to the use of the wrist for weightbearing activities like vaulting and tumbling passes. The gymnast often notices pain on the radial (side of the wrist closest to the thumb) side of the wrist that is worse with gymnastics moves placing stress on the wrist. X-rays might show widening of the growth plate of the radius at the wrist. Rest and avoiding stress on the wrist is key to healing, so many orthopaedic surgeons recommend placing the gymnast in a cast.
In Part 2, I’ll share five tips to prevent these and other overuse gymnastics injuries.
Frush TJ, Lindenfeld TN. Peri-epiphyseal and Overuse Injuries in Adolescent Athletes. Sports Health: A Multidisciplinary Approach. May 2009 1:201-211.