The Future of Medical Care in Gymnastics

From competing barefoot to absorbing impact in unique parts of the body, gymnasts push their bodies in ways that demand specialized care. Fueled by personal experience as both a competitor and a doctor, sports medicine physician Emily Sweeney, MD, is striving to ensure gymnastics receives the subspecialty recognition she believes it deserves through advocacy and research.

Understanding the need for gymnastics medicine

Just like kids who participate in running or dance, gymnasts require particular care when it comes to proper nutrition, niche injuries, return-to-play protocols and mental health. Alongside other gymnastics-centered healthcare providers around the country, Dr. Sweeney published a paper that outlined how having gymnastics as a concentrated field could help clinicians collaborate in research and at the bedside to improve the safety and health of these athletes.

“It’s important that gymnasts, coaches and parents all feel comfortable coming to a medical provider and knowing that they'll have some education or some awareness of the sport,” Dr. Sweeney says. “Maybe not everyone will have the same level, but more education means we can identify injuries better and get them back to their sport safely.”

Research and gymnastics medicine

This push for a gymnastics subspecialty is backed by research specific to injury prevention, treatment and the effects sports can have on female athletes, in particular.

For example, Sever’s disease (calcaneal apophysitis), a common foot injury in gymnasts that occurs when the growth plate at the back of the heel becomes inflamed, is often treated by adding heel cups to an athlete’s shoes. However, gymnasts don’t wear shoes. This prompted Dr. Sweeney to compare braces for barefoot athletes that could help treat the condition.

Over a three-month period, gymnasts diagnosed with Sever’s disease were randomly assigned one of two brace types. They then went back to their sport, with monthly check-ins to measure pain and functionality. Researchers found that while there wasn’t a difference between the two braces, both groups showed better ankle and foot function. From this, the team concluded that gymnasts with this injury can use either type of brace to reduce pain and improve performance.

“I think that highlights the needs of these barefoot athletes,” Dr. Sweeney says. “We can't always just treat them the way we treat every soccer player and basketball player.”

In another study, Dr. Sweeney highlighted the association between the female athlete triad and gymnastic injuries in retired collegiate athletes. The female athlete triad is a syndrome that is characterized by low energy availability with or without disordered eating, menstrual dysfunction and low bone mineral density, such as osteoporosis. Participants were grouped based on self-reported eating disorders and menstrual irregularity while competing at a collegiate level. Researchers then compared injuries that took athletes out of their sport, injuries that resulted in surgery and injury locations between the groups.

Dr. Sweeney found college gymnasts with disordered eating were more likely to miss time with injuries and have back problems than those with menstrual issues. This study identified that the female athlete triad can raise injury risks in different ways. And for gymnastics, a sport that puts heavy stress on the body, it’s important for sports medicine providers to look beyond bone injuries to keep athletes healthy.

“In our gymnast population, being aware that it's not normal to not have your period or disordered eating can help prevent injuries,” Dr. Sweeney says. “Bringing awareness to the uniqueness of the sport can not only help providers but also athletes to get the extra help they need.”

Helping gymnasts in the future

In the future, Dr. Sweeney plans to investigate conditions such as spondylolysis and gymnast wrist to ultimately help prevent these injuries from occurring. She hopes formalizing gymnastics medicine as a subspecialty will further collaboration among all providers who treat gymnasts to improve the future of athlete care.

“How can we all serve our athletes or serve our gymnasts holistically and work together to make sure we're getting them the best care?” Dr. Sweeney asks. “That's where I would like to see it go.”