Epidemiology and patterns of gymnastics-related head & neck trauma injuries: A NEISS database study

OBJECTIVE

To describe the epidemiology and patterns of gymnastics-related Head & Neck trauma injuries using the NEISS database from 2001 to 2020.

STUDY DESIGN AND SETTING

Cross-sectional analysis of a national database.

METHODS

Gymnastics-related ED visits between 2001 and 2020 were queried from the NEISS database. Bivariate chi-squared analyses were used to compare injury demographics, location, type, and disposition. Fracture location was identified using the narrative description of each case and were divided into subtypes for further analysis.

RESULTS

1455 gymnastics-related head and neck traumatic injuries were identified. The majority were in females (65.8%). The most common presenting age group was pediatric (≤18 years) (92.7%), and the largest racial group was Caucasian (51.5%). Of all location subtypes, facial injuries were the most common presenting injury type overall (45.2%). Regarding injury types, lacerations were most common (36.8%), followed by dental injury (30.7%) and fractures (21.2%). The most common location of head and neck fractures was the nose (45.8%), followed by cervical spine (16.7%) and orbit (13.3%). The majority (95.7%) of gymnastics-related head and neck traumatic injuries presenting to the ED were treated and discharged.

CONCLUSION

This study characterizes gymnastics-related head and neck injuries which is a topic that is under-studied. The findings from this study are helpful for gymnasts and those who care for them including providers, coaches and guardians, and this data may help inform future guidelines for treatment and injury prevention.

Current issues and future directions in gymnastics research: biomechanics, motor control and coaching interface

The sport of gymnastics is undergoing a global examination of its culture and the relationship between the gymnast, coach and environment is a central focus. The aim of this review is to explore biomechanics and motor control research in skill development and technique selection in artistic gymnastics with a focus on the underlying concepts and scientific principles that allow performance enhancement, skill development and injury risk reduction. The current review examines peer reviewed papers from 2000 onwards, with a focus on contemporary approaches in the field of gymnastics research, and highlights several key directions for future gymnastics research. Based on our review and the integration of the models of Newell (1986) and Irwin et al. (2005), we recommend that future gymnastics research should embrace at the very least a multidisciplinary approach and aim for an interdisciplinary paradigm.

Effect of hip flexibility on optimal stalder performances on high bar

In the optimisation of sports movements using computer simulation models, the joint actuators must be constrained in order to obtain realistic results. In models of a gymnast, the main constraint used in previous studies was maximum voluntary active joint torque. In the stalder, gymnasts reach their maximal hip flexion under the bar. The purpose of this study was to introduce a model of passive torque to assess the effect of the gymnast's flexibility on the technique of the straddled stalder. A three-dimensional kinematics driven simulation model was developed. The kinematics of the shoulder flexion, hip flexion and hip abduction were optimised to minimise torques for four hip flexion flexibilities: 100 degrees, 110 degrees, 120 degrees and 130 degrees. With decreased flexibility, the piked posture period is shorter and occurs later. Moreover the peaks of shoulder and hip torques increase. Gymnasts with low hip flexibility need to be stronger to achieve a stalder; hip flexibility should be considered by coaches before teaching this skill.

Optimization of Backward Giant Circle Technique on the Asymmetric Bars

The release window for a given dismount from the asymmetric bars is the period of time within which release results in a successful dismount. Larger release windows are likely to be associated with more consistent performance because they allow a greater margin for error in timing the release. A computer simulation model was used to investigate optimum technique for maximizing release windows in asymmetric bars dismounts. The model comprised four rigid segments with the elastic properties of the gymnast and bar modeled using damped linear springs. Model parameters were optimized to obtain a close match between simulated and actual performances of three gymnasts in terms of rotation angle (1.5°), bar displacement (0.014 m), and release velocities (<1%). Three optimizations to maximize the release window were carried out for each gymnast involving no perturbations, 10-ms perturbations, and 20-ms perturbations in the timing of the shoulder and hip joint movements preceding release. It was found that the optimizations robust to 20-ms perturbations produced release windows similar to those of the actual performances whereas the windows for the unperturbed optimizations were up to twice as large. It is concluded that robustness considerations must be included in optimization studies in order to obtain realistic results and that elite performances are likely to be robust to timing perturbations of the order of 20 ms.

Consistency of performances in the Tkatchev release and re-grasp on high bar

The Tkatchev on the high bar is a release and re-grasp skill in which the gymnast rotates in a direction during flight opposite to that of the preceding swing. Since the release window is defined as the time during which the gymnast has appropriate linear and angular momentum to ensure the bar can be re-grasped, it was speculated that the release windows for this skill would be smaller than for dismounts that are less constrained. One senior male gymnast competing at national standard performed 60 Tkatchev trials. A four-segment planar simulation model of the gymnast and high bar was used to determine the release windows in 10 successful and 10 unsuccessful performances of the Tkatchev recorded using a Vicon motion analysis system. Model parameters were optimized to obtain a close match between simulations and recorded performances in terms of rotation angle (1 degree), bar displacements (0.01 m), and release velocities (1%). Each matched simulation was used to determine the time window around the actual point of release for which the model had appropriate release parameters to complete the Tkatchev successfully. The release windows for the successful trials were small compared with those of dismounts. The unsuccessful trials were associated with later release and later timing of the actions at the shoulders and hips.