Gymnastics

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Gymnastics

• Single Sport / Multi Sport
• A sports medicine challenge
• Julie Sparrow MSc MCSP Grad Dip Phys
• National Lead Physiotherapist British Gymnastics

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Artistic Gymnastics

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

• Women
• Vault
• Bars
• Beam
• Floor

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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

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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

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Rhythmic gymnastics

• Women only
• Use of small apparatus
• Ball
• Ribbon
• Hoop
• Club
• rope

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Rhythmic Gymnastics
Flexibility Co-ordination Flight Expression
Elegance Dance
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Hypermobile Tall and slender Balance on
large base of support
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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 20s

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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

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Epiphyseal (Salter Harris) fracture
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Avulsion fracture
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Buckle (Torus) fracture of the proximal radius
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Plastic Bending fracture
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The At Risk Spine
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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

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Shoulder and upper quadrant
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Shoulder and upper quadrant

• Impingement
• Labral
• Rotator cuff
• Tendon rupture
• Rotator cuff
• Biceps
• Pectoralis major

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Elbow wrist and hand
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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

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Anterior
Posterior
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Forearm

• Pommel arm
• Compartment like syndrome of the forearm

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Injury potential in the lower limb

• Take off
• Landing
• Rebound

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Soft tissue

• Achilles tendon
• Anterior knee pain syndromes
• Muscle trauma

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Bony Injury

• Traction apophysisitis
• Bone bruising
• Osteochondritis dissecans
• Chondral defect

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Bone bruise of the femoral condyle
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Chondral defect of the talus
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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