Gymnastics

Single Sport / Multi Sport

A sports medicine challenge

Julie Sparrow MSc MCSP Grad Dip Phys

National Lead Physiotherapist British Gymnastics

Artistic Gymnastics

Men

• Floor • Pommel• Rings• Vault• Parallel bars • High bar

Women

• 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

• 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