Last week Okanagan Peak Performance Inc hosted a seminar for the gymnastics community. The title was The Most Important Ability for Gymnasts - What it is and how to improve it. Below is a brief recap of the seminar.

Probably about 15 years ago I did a clinic for Pacific Sport on speed and agility. This was a short clinic for a number of athletes in their teens from a variety of sports. One of the athletes, Jordy, really stood out during the clinic and later I began coaching her and she eventually came to work for us.

That was the first time I had worked with a gymnast. And a few things stood out right away.

1. Gymnasts are really hard working.
2. Gymnasts have really high relative strength. In other words their strength per body mass is excellent.
3. Gymnasts tend to be hyper-mobile.
4. Gymnasts tend to injured quite often.

It was this last feature of gymnasts that was the inspiration for this presentation.

You see, gymnasts tend to get injured. A lot.

It's especially high when you consider gymnastics is a non-contact/non-collision sport it's unfortunate to see the high injury rate among gymnasts. You might expect to see injured athletes in football, rugby or hockey where an opponent is trying to run through you.

In terms of gymnastics injuries, these are more commonly chronic rather than acute. This means the injury is the result of a pattern over time. Acute injuries can be traced back to a specific episode such as a fall or awkward landing.

With male gymnasts the hands and wrists are the more commonly injured joints. This can the result of high speeds and loads being borne by the hands and wrists in an awkward position. Sometimes landings or transitions are one hand at a time doubling the force on these joints compared to when both limbs are involved. Think of the pommel horse, high bar and rings and you can picture the stresses with these events.

Female gymnasts tend to injure their feet and ankles. This can be from tumbling, landing, jumping and dismounts. As the foot and ankle are the points of the body contacting the ground it is imperative they are properly aligned to prevent injury further up the chain.

A study (1) at the U of Iowa looked at gymnastics injuries over a 10 year period. Females were more likely to get injured and were their injuries were more severe. Almost 1/4 of the injuries suffered by female gymnasts required surgery compared to about 9% of the injuries suffered by their male team-mates.

So what accounts for the degree of injuries? And why are females more often injured?

Part of this may be explained by the hyper-mobility of the gymnast.

Some features of hyper-mobile individuals include:

• hyper mobile parents
• more common with females than males
• more common in younger athletes
• more common with ethnic versus Caucasian populations
• may involve a high Beighton score (4-5 or higher)

Sometimes joint architecture can also account for joint mobility or laxity. Imagine a golf ball sitting on a golf tee. The ball can move easily in all planes, and even fall off the tee. If the golf is in the hole however the ball cannot move as much and can't fall out of the hole. This can be similar to the hips of some athletes. If the socket is shallow and flat at the edges the femur can move more easily i.e. to allow for the splits. Another individual with a deep hip socket would have a lot more difficulty rotating the leg through all ranges of motion.

In terms of what we're looking with the Beighton Mobility this involves 5 tests, 4 of which are done on both sides of the body. This results in a total of 9 possible points. Below is a representation of the 5 tests.

[caption id="attachment_5603" align="aligncenter" width="300"] The 5 Beighton Mobility Tests. Score 1 if able to do the movement. Total possible score is 9.


Once we've identified whether the gymnast is hyper-mobile we should be thorough and check stability as well. At the seminar we had a few volunteers perform a trunk stability and rotational stability test.

To bring this all home I presented a study (2) where athletes with hyper mobility tended have instability. The instability resulted in less evertor strength. As a result these these athletes had poor joint position sense. In other words, these athletes would not do a good job finding a neutral foot position. We can then see how this could lead to injury with a poorly aligned foot and ankle.

What we do know however is that strength training helps decrease ankle instability. Willems et al (2002) trained 20 athletes 3 times per week for 6 weeks. Study subjects got stronger as expected. But the interesting finding was that joint position sense improved as well. So not only does does strength help stabilize and provide support to a lax joint it also improves the positioning of the joint. Both of these should help reduce the incidence of foot and ankle injuries among female gymnasts.

References

1.Westermann, RW. Giblin, MS. Vaske, A. Grosso, K andWolf, BR. 2015. Evaluation of Men’s and Women’s Gymnastics Injuries: A 10-Year Observational Study. Sports Health. 7(2): 161-165

2. Docherty, CL. Moore, JH and Arnold, BL. 1998. Effects of Strength Training on Strength Development and Joint Position Sense in Functionally Unstable Ankles. J Athl Train. 33(4): 310-314.

3. Willems, T. Wityrouw, e. Verstuyft, J. Vaes P and De Clercq, D. 2002. Proprioception and Muscle Strength in Subjects With a History of Ankle Sprains and Chronic Instability. J Athl Train. 37(4): 487–493.