Foot and ankle injuries in elite female gymnasts.

BACKGROUND: Gymnastics is a competitive and popular sport that is started at an early age, and elite female gymnasts reach their prime in mid-teenage years. The level of intensity of practice and competition, the number of events, and the degree of difficulty of the maneuvers make gymnastics one of the most injury-producing sports. METHODS: Over a 3-year period, 14 elite, female gymnasts were seen in one foot and ankle center. The mean age was 17 (range 14 to 21) years. All gymnasts sustained acute or sub-acute injuries to the foot or ankle requiring surgery. The mechanism of injury, the type of injury, operative repair, and followup were recorded. RESULTS: There were five Lisfranc fracture-dislocations, and five talocalcaneal, two multiple metatarsal, one medial malleolar, one phalangeal, and one sesamoid fracture. All injuries had operative repair. One gymnast with a Lisfranc injury was able to return to full competition; all others with a Lisfranc injury retired from gymnastics, were lost to followup, or graduated from college. One gymnast with a talar osteochondral injury was not able to return to competition but all other injured gymnasts were able to return to gymnastics at the same level or higher. CONCLUSION: Elite female gymnasts can sustain significant injury to the foot and ankle region. In our study, Lisfranc injuries were most likely career-ending.

Gymnastics injuries.

OBJECTIVE: The purpose of this chapter is to review the distribution and determinants of injury rates as reported in the pediatric gymnastics injury literature, and to suggest measures for the prevention of injury and directions for further research. DATA SOURCES: An extensive search of Pubmed was conducted using the Text and MeSH words "gymnastics" and "injury" and limited to the pediatric population (0-18 years). The review focused on studies using denominator-based designs and on those published in the English language. Additional references were obtained from hand searches of the reference lists. Unpublished injury data from the USA Gymnastics National Women's Artistic Gymnastics Championships during 2002-04 were also analyzed. MAIN RESULTS: Comparison of study results was compromised due to the diversity of study populations, variability of injury definition across studies, and changes in rules and equipment across years. Notwithstanding, this review of the literature reveals a reasonably consistent picture of pediatric gymnastics injuries. The incidence and severity of injuries is relatively high, particularly among advanced level female gymnasts. Body parts particularly affected by injury vary by gender and include the ankle, knee, wrist, elbow, lower back, and shoulder. Ankle sprains are a particular concern. Overuse and nonspecific pain conditions, particularly the wrist and low back, occur frequently among advanced-level female gymnasts. Factors associated with an increased injury risk among female gymnasts include greater body size and body fat, periods of rapid growth, and increased life stress. CONCLUSIONS: Above all, this overview of the gymnastics injury literature underscores the need to establish large-scale injury surveillance systems designed to provide current and reliable data on injury trends in both boys and girls gymnastics, and to be used as a basis for analyzing injury risk factors and identifying dependable injury preventive measures.