Emily Sweeney, MD, knows gymnastics from just about every angle. A former level 10 gymnast, NCAA gymnastics judge, and current team physician for the USA Gymnastics Junior Women’s national team, Dr. Sweeney understands what it takes for athletes to perform their best and stay safe and healthy along the way. Now, as a sports medicine physician in the Sports Medicine Center, she shares expert advice to help gymnasts do both.

Common gymnastics injuries

Unlike some other sports, gymnastics has a high risk of overuse injuries compared to acute injuries — or ones that occur over time versus suddenly from a specific incident. This can be due to gymnasts' year-round training and competition schedules and the way they use their bodies differently.

“Gymnasts get a lot of upper extremity injuries because they use their arms like legs,” Dr. Sweeney says. “So, they're walking on their hands and doing things that maybe your arms weren't meant to do. It’s something unique to the sport.”

With that repetitive stress, gymnasts often suffer from specific injuries, including:

• Gymnast wrist: an overuse injury that affects the growth plate in the wrist, often caused by repeatedly putting weight and impact through the hands
• Osteochondritis dissecans (OCD) of the elbow: a condition where repeated stress damages the bone and cartilage in the elbow joint
• Spondylolysis: a stress fracture in a vertebra in the lower back that can develop from repetitive movements like arching, twisting and landing

Gymnastics injury prevention

While many sports injuries can’t be avoided, it’s important to prepare to perform to help prevent them.

Warm up and strength training

Preparing the body for practice can help gymnasts move safely through skills. Starting with dynamic stretches, such as arm circles or walking lunges, active movements increase blood flow and prepare muscles and joints for exercise. Warming up can also create flexibility that helps gymnasts master skills or learn new ones.

Strength training can also play an important role in injury prevention. Adding age-appropriate strength and conditioning, such as weightlifting, can help gymnasts build the strength needed to support their bodies through repetitive skills and high-impact movements.

Don’t ignore pain

Soreness can be a normal part of training, but ongoing or unexplained pain shouldn’t be ignored. Pain that persists without a clear cause or causes an athlete to change how they move, such as limping or adjusting how they complete a skill, may be a sign of injury.

Dr. Sweeney recommends monitoring pain or discomfort for a week, and if it lasts longer or begins affecting how an athlete trains, they should be evaluated by a sports medicine professional.

Prioritize rest, recovery and nutrition

The demands of gymnastics extend beyond time in the gym, making intentional rest, recovery and nutrition an important part of keeping athletes healthy.

“If athletes are feeling more tired or not wanting to go to the gym, then they need to take a break,” Dr. Sweeney says. “Not only for their body, but for their mental health as well.”

To help athletes balance the demands of training, Dr. Sweeney suggests:

• Keeping at least one full day a week as a “rest” day away from the gym
• Taking time away, possibly a week or more after the last competition of the season to recuperate
• Incorporating a snack break during longer training days (3 hours or more) to stay fueled
• Preventing under fueling by optimizing meals and snacks throughout the day and eating a variety of foods like fruits and vegetables

Learn new skill safely

Whether at sleepovers or school, gymnasts often “throw” or perform skills they’ve learned with friends. While fun, it can often be unsafe, especially if the skill is new or not fully learned. Building new gymnastics skills takes time and practice in a safe, supervised environment. To do so, Dr. Sweeney recommends gymnasts:

• Build up to new skills gradually by practicing drills and progressions first.
• Work with a coach or spotter who can provide corrections and help if something goes wrong.
• Use the right training environment such as a foam pit, soft mats or a low beam.
• Save new skills for the gym, even if you have the equipment at home.
• Stay focused during practice and avoid attempting difficult skills when you’re distracted.

Returning to gymnastics post injury

Returning to gymnastics after an injury can take time. Even when an athlete is feeling better, jumping back into a full training schedule or difficult skills too quickly can increase the risk of reinjury.

Athletes should work with their care team and coach to gradually return to sport. Depending on the injury, this may mean starting with conditioning and basic skills before progressing to more difficult movements and full routines. A safe return to gymnastics may include:

• Increasing training time and intensity slowly rather than returning to a full schedule
• Paying attention to pain or changes in movements as skills are added back
• Communicating with coaches about any restrictions or modifications needed during practice

Returning gradually gives athletes time to focus on rebuilding their strength, confidence and skills while reducing the risk of another injury.

When to see a gymnastics medicine specialist

If pain lasts longer than a week and affects how a gymnast moves or prevents them from participating normally, it may be time to see a sports medicine specialist.

At the Children’s Hospital Colorado Gymnastics Medicine Clinic, our experts understand the unique demands gymnastics places on growing athletes. This specialty clinic not only evaluates injuries, but also addresses nutrition, growth and the whole athlete. Our team assesses and treats gymnastics-related injuries and works with athletes and families to create a plan with the goal of keeping gymnasts healthy and competing in the sport they love.