Technique Selection 'the Coaches Challenge' Influencing Injury Risk During the First Contact Hand of the Round off Skill in Female Gymnastics

The Relationship of Shoulder and Elbow Stresses and Upper Limb Contact Order During a Round-Off Back Handspring

INTRODUCTION

Despite high injury incidence rates in gymnastics, there is a paucity of data characterizing upper extremity injury causation and biomechanical risk factors. This study investigated contact forces across multiple joints in both upper extremities during a round-off back handspring (ROBHS), a fundamental gymnastics tumbling maneuver.

OBJECTIVE

(1) To characterize the three-dimensional (3-D) biomechanics of the sequential, asynchronous contact of each upper extremity with the ground during a ROBHS using 3-D motion capture, and (2) to evaluate potential correlations to upper extremity injury risk.

DESIGN

Observational cross-sectional study.

SETTING

Controlled laboratory environment.

PARTICIPANTS

Fourteen competitive female gymnasts aged 10-21 years (mean age: 16.6 ± 3.1 years) (1) participating on a competitive gymnastics team; (2) capable of successfully completing a ROBHS; and (3) free of reported injury at enrollment.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Variables evaluated include joint angle, torque, compression force, ground reaction force (GRF), time to peak GRF, and limb loading rates. Variables were analyzed at the wrist, elbow, and shoulder of both limbs at ground contact. The hypothesis that these dependent variables would differ by ROBHS upper extremity contact order was formulated retrospectively after data collection.

RESULTS

The first contact limb experienced significantly greater extension torque at the elbow (first: 48.89 ± 18.01 Nm, second: 22.49 ± 9.19 Nm; P = .014; CI 95% [14.83, 37.97]) and faster time to peak GRF (P < .001, CI 95% [-1.79, -0.99]). The second limb of contact experienced significantly greater abduction torque at the shoulder (P = .007; CI 95% [-21.58,-8.08]) and anterior-posterior GRF at contact (P = .007; CI 95% [-1.06,-0.26]).

CONCLUSIONS

The biomechanical differences between contact limbs during the ROBHS may lead to different injury risk. Recognition of the stresses at the elbow and shoulder for both limbs also provides new insight for rehabilitation clinicians to consider when guiding patients to return to gymnastics activity after injury.

A systematic review of injuries in gymnastics

OBJECTIVES

To identify all studies of gymnastics injuries and assess injury rates, types, locations, and causes.

METHODS

Seven electronic and two grey literature databases were searched. Two reviewers independently assessed titles/abstracts, abstracted data, and calculated average rates weighted by study size.

RESULTS

One study (n = 963) of three Olympic games (2008,2012,2016) provided injury rates for females of 86.4/1000gymnasts and males 79.9. For 29 databases one study of males (n = 64) provided a rate of 8.8 injuries/1000hours/AE (AE = athletic-exposure) and three of females varied rates (8.5, 9.4, and 91). Three studies for males (n = 153) provided a weighted average rate of 1.4 injuries/1000hours/training, and for females six studies (n = 476) 1.5 injuries. Four studies of males (n = 286) provided a weighted average of 678 injuries/1000gymnasts per year and eight studies of females (n = 1,764) a rate of 306. Of 19 surveys, eight provided rates for females (n = 1,463) of 596 injuries/gymnast per year and two for males (n = 40) a rate of 1,036. In the Olympics injuries were preponderately lower limb (63%) then trunk (23%) and upper limb (14%); injury type was sprains (35%) followed by tendinopathy/arthritis/impingements (17%), contusions (10%), and fractures (7%). Five database studies provided injury location data for 274 males: averages weighted by study size were upper extremity 42.8%, lower extremity 33.6%, torso/spine 11.8%, and head/neck 4.9% and 12 studies with 843 females provided average rates for lower extremity 51%, upper extremity 30.8%, torso/spine 13% and head/neck 0.8%. Official gymnastics organizations' websites provide no readily available data about injury rates or methods of prevention.

CONCLUSIONS

Studies need to collect comprehensive data for injury rates by training/competitions, gender, age, injury location/type/cause. Studies could assess whether trainers and physiotherapists monitoring gymnasts closely for injury risk would reduce injuries. Studies including randomized controlled trials (RCTs) of interventions in training, videotaping and performance feedback to reduce injury rates would be helpful.