Gymnastics injuries are an unavoidable aspect of the sport, with the frequency and the severity of these occurrences rising in proportion to the ascent of an athletes towards elite status. The causes of gymnastics injuries are usually interrelated. The physics of the sport dictates that the athlete will sustain significant forces during every gymnastics routine, particularly during the landing sequence of a particular maneuver. Gymnastics is a sport where competitive success is built upon the precise movements that are developed through intense and repetitive practice, a circumstance which lends itself naturally to overuse and repetitive strain injuries that may potentially occur in every joint of the body. Less frequently, an athlete will make an error during a routine that results in a fall or other trauma.
In gymnastics, the object in every dismount from an apparatus or concluding movement is to "stick the landing," the colloquial expression where the athlete is able to land emphatically on both feet in one stride or bound, without the need to steady themselves through the taking of an additional stabilizing step. In many routines, the athlete lands on a mat that provides a measure of cushioning, this does not absorb all of the landing forces generated by the athlete. Where the athlete lands with legs angled in an position where the landing forces will be distributed unevenly, or with their legs rigid, the landing forces pose a significant risk of injury to gymnasts, primarily to the feet, ankles and knees of the athlete.
The gymnasts are subject to long workouts that tax every joint and muscle structure in the body. The hands and wrists absorb significant forces in floor exercises and all work involving devices such as the horizontal bar, the vault, or the parallel bars. All other musculoskeletal joints from the hips through to the toes are involved to some extent in every gymnastics routine. The most common injuries are those to connective tissue structures, particularly muscle strains and ligament strains.
Studies conducted by the National Collegiate Athletic Association (NCAA) determined that the most common form of shoulder injury occurs in relation to the parallel bars and horizontal bar, as a result of the athlete performing handstands on the bars during the routine. Both rotator cuff damage, the structure of four muscles positioned at the top of the shoulder responsible for much of the rotation available in the joint, and clavicle (collarbone) fractures are common injuries among gymnasts at the NCAA level.
Elbow injuries are usually a result either a ring routine or a floor routine, where the elbow becomes hyper extended (forced more than 10° past its maximum range of straightening motion) on landing. The other joint most susceptible to hyperextension is the knee, usually as a result of a missed landing where the leg strikes the landing mat in a fully extended (straightened) position.
Forearm injuries are most often observed in young gymnasts whose bone structure is not completely formed. The repetitive stress of landing that are absorbed in the forearm distresses the bone's growth plate, the softer area located at the epiphysis of both the ulnar and radial bones of the forearm.
Foot and ankle injuries are the most common of gymnastics injuries. These may also be repetitive strain or chronic injuries, as well as the result of a single incident, such as the athlete landing awkwardly at the edge of the mat, causing the ankle to twist. The longer bones of the foot, the metacarpals, are vulnerable to stress fractures through overuse, as is the lower shin of the tibia.
As with every other sport where athlete's must generate sudden and explosive movement through leg drive, an anterior cruciate ligament injury (ACL) is a risk in gymnastics participation. Consistent with the research conducted with respect to ACL injuries in other sports, female gymnasts are between two to six times more likely to sustain an ACL injury than a male gymnast, primarily due to the relative width of the female pelvis in relation to femur length. This structural factor creates greater pressure upon the knee as the athlete jumps or accelerates. The nature of the gymnastics landing, where the athlete is under competitive pressure to "stick the landing" directs greater pressure into the knee joint.
Spinal injuries are less common but often ones that serve to destroy the career of a gymnast. The lumbar spine region (the low back) is a frequent location of sprains and contusions, most often as a result of chronic stress. The cervical spine, the seven vertebrae complex that extends from below the base of the skull, forming the spine of the neck, is most often injured during a fall or other accident involving a piece of apparatus.
A significant contributing factor in the cause of gymnastics injuries, particularly among less organized gymnastics activities, is the absence of a proper spotter, a person stationed near to the performing or landing area to assist in the event of an athlete having trouble with a routine.
A thorough and focused warm-up and cool-down period is fundamental to gymnastic injury prevention. Most warm-ups will include exercises to elevate the heart rate, followed by a series of both static and dynamic stretches aimed at the stretching every muscle group. Stretching and flexibility are so crucial to gymnastic health and competitive success that most serious gymnasts will undertake their personal stretching regimen on days away from training and whenever they feel the need to loosen their muscles.