MUSCULOSKELETAL INJURIES IN GYMNASTICS: A REVIEW OF EPIDEMIOLOGY, ETIOLOGY, AND ASSOCIATED FACTORS

Gymnastics encompasses various disciplines, including artistic gymnastics, rhythmic gymnastics, trampoline gymnastics, acrobatics, aerobic gymnastics, parkour, and gymnastics for all. While there are many differences in characteristics, movement execution, and equipment, all disciplines involve brief and high-intensity movements. Athletes achieve extreme ranges of motion and generate and absorb significant forces while performing gymnastic elements. Consequently, gymnasts are prone to numerous injuries, with frequencies ranging from 0.5 to 9.4 injuries per 1000 hours of athlete exposure. The most common types of gymnastics injuries are sprains and strains. In females, lower limb injuries prevail, whereas males predominantly experience upper limb injuries. Specifically, the ankle, knee, and foot are frequent sites of injury in the lower limb, while the shoulder joint, wrist, and elbow are commonly affected in the upper limb. Spinal and head injuries occur less frequently. Identifying factors associated with injuries is important for their prevention. They can be classified as non-modifiable, potentially modifiable, and modifiable. By addressing the latter two groups of factors, we can contribute to reducing the incidence of injuries. The main intrinsic factors linked to injury onset include age, a rapid growth period, previous injuries, joint laxity and instability, limb asymmetry, abnormal muscle stiffness, stress, fear, and lack of focus, while the main extrinsic factors are early specialization, training volume and duration. Most injuries occur during artistic gymnastics routines, especially during the floor exercise. Although more injuries happen during training sessions, the injury rate is higher during competitions. Furthermore, a higher number of injuries is associated with less experienced coaches and inadequate equipment. Preventive measures for gymnastics injuries revolve around training equipment, and healthcare modifications. Optimal landing technique, balanced workload, and comprehensive rehabilitation are crucial, alongside addressing mental and emotional strain.