Gymnastics is a great sport to develop strength, coordination, agility and discipline. It requires extreme flexibility, strength, core control, and proprioception. It also demands long training hours of 15-30 hours/week. These high demands and the fact that gymnasts mostly being children or adolescents makes the gymnasts more susceptible to certain injuries. Gymnasts must consistently prepare for the rigorous physical and emotional toils that the sport requires.
Causes of Gymnastic injuries
With the complexity of routines, the risk of potential injury increases. Injuries most commonly occur in ankles, feet, lower back, knees, wrists, and hands, often from overuse or simple stress. Injuries are rarely severe, but if left unnoticed they can lead to chronic pain and stress fractures. An increase in risky maneuvers makes head and neck injuries a real concern for athletes, parents, and coaches.
Gymnastic injuries can be overuse injuries, overstrain injuries or traumatic injuries. A large majority of reported gymnastics injuries include overuse injuries from long hours of practice and wear and tear on the joints, poor balance or imbalances in strength and flexibility. However severe, catastrophic and traumatic injuries can occur when performing risky acrobatic maneuvers during gymnastics. Head injuries can range from mild to severe.
Diagnosis and Treatment
Early diagnosis and treatment can prevent many more serious problems and enable a much quicker return to pain-free training and competition. The Physiotherapist may refer the gymnast on to a sports doctor for scans or XRAY depending on the injury condition.
Truecare Physiotherapy for Gymnastics and Dance injuries
Truecare Physiotherapy has a long history of treating gymnasts. We have a dedicated physiotherapist in Bhaumic Patel who has specialized in injury prevention and treatment for young gymnasts. Bhaumic completed his Masters of Sports Physiotherapy in 2009. Bhaumic has worked with athletics at both elite and amateur levels in various sports such as football, soccer, cricket and rowing. He is passionate about sports specific rehabilitation prior to returning to sport to minimize the chance of reoccurrence. He uses a collaborative approach to achieve the best possible outcome in the shortest possible time.
Common gymnastics injuries and for treatment
Lower back pain:
Lower back pain is very common in gymnastics. Landing in arched position or landing short with twisting movements can jam joints in the lower back. The great flexibility of the gymnasts can also be a problem if they do not have adequate core control to be stable in these extreme positions. Physiotherapy is crucial as this will determine whether the gymnast needs to rest and how long it will take to get better.
Ankle sprains often occur in gymnastics particularly in tumbling or landing from jumps and leaps that requiring twisting. Ankle sprains are usually a ligament injury but more severe ones can result in fracture. Physiotherapy determines whether XRAY is required, helps speed up the healing process and gives specific exercise(s) to prevent the injury from recurring.
The knee is the most commonly injured part in gymnastics. The injury occurs when landing goes wrong and can cause damage to the ligaments or cartilage. Some knee injuries do not cause pain and hence there may be no detectable symptom while some other injuries may require a short period of relative rest while a more serious ligament or cartilage damage may require surgery. Hence assessment of injuries is crucial to for exact diagnosis and further course of treatment.
Shin splints is an umbrella term used for shin pain, it can actually be a variety of different diagnoses. These include stress fracture, tibial traction, periostitis and compartment syndrome. Shin pain is caused by repetitive high impact loading. Muscle tightness around the calf and shin and poor foot biomechanics can also cause shin pain. Shin splints needs to be addressed to avoid fractures in the long run and generally requires a period of rest along with physiotherapy treatment to correct muscle tightness.
Wrist pain is common in gymnastics due to the repetitive high impact weight bearing particularly with tumbling. Any wrist pain should be checked for a fracture immediately. Wrist pain that comes and goes or develops gradually can be caused by the bones in the wrist jamming against one another when the hand is bent backwards such as in a handstand. This can also cause elbow injuries such as dislocation and shoulder pain.
Common dance injuries include sprains and strains, where your muscles and ligaments are overstretched or twisted. Additionally dancers can also sustain impact injuries – such as bruises caused by falling, collisions or trips and slips. Ill-fitting shoes can cause foot and toes injuries. Dance injuries and prevention strategies are best developed with the assistance of a dance physiotherapist.
Spondylolisthesis refers to the displacement of one vertebrae in relation to the one below. The displacement can be forward (anterior) (anterolisthesis) or backwards (posterior) (retrolisthesis) displacement.
Causes of Dance injuries
The defect in the vertebrae occurs at birth.
Can be caused by repetitive trauma and is more common in athletes exposed to hyperextension motions.
Occurs due to arthritic changes in the joints of the vertebrae due to cartilage degeneration. This is more common in older patients.
Caused due to direct trauma or injury to the vertebrae.
Caused by a defect in the bone such as tumor.
Dancers with a Splonylolisthesis will usually have pain with extension leaning back in extreme cases, where the spinal cord is affected, they may experience numbness or tingling in both feet or legs. The condition can be easily identified using a plain film X ray. An X-ray taken from the side will show if one of the vertebrae has slipped forward compared to the neighboring vertebrae and the magnitude of the slippage.
Sometimes the patient with pain does not exhibit any symptom at all. Young students may be dancing with an unstable vertebrae without even knowing it. The most common symptom of a low grade slippage is that of lower back pain. Early detection is very important in preventing the injury from progressing, so if pain prevails, it is better to get it checked as soon as possible.
Other common symptoms include tightness of the hamstrings and decreased range of motion and stiffness of the lower back. Changes in gait and posture as well as an increased lumbar curve can be quite common. If the severity of the slippage is greater , then the symptoms can include pain, numbness, tingling or weakness in the legs due to nerve compression and irritation. Severe compression of the nerves can even cause loss of control of bowel or bladder function which is very serious and requires immediate medical attention.
Postural correction needs to be addressed for any injury. The body has to be brought into a more optimal neutral alignment both statically and dynamically. Improving mobility of the upper back (Thoracic spine) and the front of the hip (Hip Flexors) is essential in helping to reduce the load on the low back in extended positions. Regaining normal flexibility, especially the hamstrings and posterior chain, is important to reduce the strain on the lower back and help to obtain more normal movement.
Other Acrobatic injuries
Circus has a unique place in sports physiotherapy as it combines many of the aspects of gymnastics and dance training with very abstract tricks and types of movement that extend beyond the usual scope of the sports world. Contemporary circus combines traditional skills with theatrical techniques and has been established as a modern performing art form encompassing high level skills including acrobatics, aerial acts, contortion, manipulation, equilibristic, and clowning. Often associated with rigorous, ongoing training, circus artists must maintain high levels of strength, balance, power, flexibility, neuromuscular control and general fitness.
The amount of physical training and performing that a circus artist may undertake can range from a couple hours a week up to 40 hours per week in which the artists are essentially treated as elite athletes. We at TrueCare Physiotherapy provide Musculoskeletal injury prevention screenings, treatment and rehabilitation of existing acute or chronic circus-related injuries, prevention of injuries through an appropriate review and education on how to best protect your body while training outside the normal parameters of movement.