Physical Therapy for Gymnastics Injuries
Gymnastics is an incredibly demanding sport that requires extreme strength, power, flexibility, and mobility of the entire body. Due to the extraordinary physical demands, high impact forces on the body, and rigorous training schedule of the sport, acute and overuse injuries can occur, most commonly in the ankle, knee, wrist, elbow, and low back. Physical therapists work closely with gymnasts to restore function, mobility, strength, and flexibility after an injury, ensure a safe return to sport, and prevent recurrent injuries.
Common Gymnastics Injuries
Gymnastics requires exceptional strength, agility, flexibility, balance, endurance, and control. During gymnastics, the body moves through extreme ranges of motion with high impact forces, loading the entire body. Gymnastics has one of the highest injury rates among girls’ sports with nearly 100,000 gymnasts injured each year. Among younger gymnasts, the risk of injury is higher as their skeletal and muscular systems are still developing and due to the stress of the volume of training hours and speed of progression towards elite levels in gymnastics.
Gymnastics injuries can be acute due to a fall or traumatic impact to the body or due to overuse from repetitive jumping, landing, and hard impact. Injuries can result from insufficient flexibility, decreased strength in the arms, legs, or core, poor balance, muscle imbalances in strength and flexibility, repetitive movement, and incorrect jumping and landing technique.
Upper body injuries can include shoulder impingement or labral tears, shoulder tendinitis or rotator cuff strain, elbow hyperextensions and instability, and wrist sprains. Lower body injuries can include patellar tendinitis, patellofemoral pain syndrome, ACL injury, hip impingement, low back pain, and spondylolisthesis.
Common gymnastics injuries include:
Ankle Sprains: Ankle sprains are the most common gymnastics-related injury. When the ankle is rolled during training, the ligaments that hold the bones of the foot together are stretched beyond their capacity, which leads to instability and tearing. It is essential to receive proper ankle rehabilitation the first time an ankle sprain occurs as the risk of a potential ankle sprain increases significantly for each sprain that occurs.
Wrist Sprains: During gymnastics, the wrist is used as a weight-bearing joint and is subjected to forces that are twice its body weight, leading to injury due to impact and repetitive strain. It’s important to avoid extensive pressure on the wrist after a sprain for six weeks.
Patellar Tendinitis: The patellar tendon is one of the strongest connective tissues that connects the kneecap to the shin bone and allows the kneecap to track up and down the patellar groove when bending or extending the knee. The repetitive jumping, landing, and hard impact of gymnastics can cause the patellar tendon to become inflamed and irritated, leading to impaired knee movement.
Achilles Tendinitis: Irritation and inflammation of the Achilles tendon can result from the repetitive stress of jumping and landing, leading to calf soreness, swelling and pain at the tendon, and limited ability to walk, jump, and run.
ACL Injury: An injury to the ACL, one of the primary ligaments of the knee, can occur when a gymnast lands short or is over-rotated when tumbling, vaulting, or dismounting. A pop may be heard and swelling will occur within hours, leading to an inability to place weight on the leg and requiring extensive rehabilitation and often surgery for athletes.
Spondylolisthesis: This is a very common spinal condition in young female gymnasts that occurs when the vertebrae lose stability and begin to slide forward on the vertebrae below it, causing low back pain. This can result from repetitive spinal extension without proper hip and core strengthening.
Physical Therapy for Gymnastics Injuries
Physical therapists work with injured gymnasts to restore function, mobility, strength, and flexibility after an injury, ensure a safe return to sport, and prevent recurrent injuries. Initially, the physical therapist performs a thorough evaluation to assess the condition of the gymnast and the injury and identify other areas of weakness or limitation that could affect the gymnast’s recovery, stability, and strength. From there, the therapist designs a customized treatment program specific to the injury.
Physical therapy treatment for gymnastics injuries include:
Pain management
Manual therapy range-of-motion exercises: hands-on techniques and soft tissue mobilizations to improve mobility and range of motion in the affected muscle, tendon, ligament, or joint and reduce tightness.
Balance & proprioceptive training to retrain muscles to adjust to uneven and unstable surfaces while maintaining balance and muscle control.
Core strengthening: targeted strengthening of the abdominal, trunk, and low back muscles to prevent low back injuries as gymnasts are hypermobile in the lumbar spine.
Targeted strengthening exercises of the affected area and addressing muscle imbalances or weakness: wrist, hip, knee, ankle, and shoulder strengthening is completed to reduce stress on the joint.
Aerobic conditioning to improve stamina and endurance, particularly during floor routines.
Functional training: jumping and landing technique modifications to decrease impact and stress on the body and decrease the risk of injury.
