Artistic Gymnastics Injuries

Epidemiology, Evaluation, and Treatment

Natasha Desai, MD; Danica D. Vance, MD; Melvin P. Rosenwasser, MD; Christopher S. Ahmad, MD


J Am Acad Orthop Surg. 2019;27(13):459-467. 

In This Article

Abstract and Introduction


Artistic gymnastics is a physically demanding sport that requires flexibility, agility, and extreme upper and lower body strength. The specific biomechanics of the sport leads to a unique injury profile. Gymnastic skills require intense upper body weight-bearing, placing unusual forces across the upper extremity joints and predisposing them to injury. In addition, the required body control during air aerobatics (tumbling, twisting, flipping) necessitates precise landing techniques to avoid spine and lower extremity injury. Common gymnastic injuries include those of the spine and upper extremity such as spondylolysis, shoulder instability, ulnar collateral ligament injuries, capitellar osteochondritis dissecans, and several wrist pathologies. Understanding the injury etiology, prevention, and treatment protocols is important for a successful recovery and return to sport.


Artistic gymnastics is known for its high-flying acrobatics and feats of strength. Competitive gymnastics is divided into two categories; artistic and rhythmic gymnastics. Artistic gymnastics became a part of the Olympics in 1896 and consists of four events for women (vault, uneven bars, balance beam, and floor exercise) and six events for men (floor, pommel horse, still rings, vault, parallel bars, and horizontal bar). This article will focus on the injury profile of artistic gymnastics. Each event is scored on difficulty and performance execution. The men's events all heavily rely on upper body strength and upper extremity weight-bearing and double leg landings. The women's events entail more skills demanding extreme flexibility and more single leg landings compared with men. Both men and women gymnasts do a notable amount of tumbling, which includes both upper and lower extremity rebounding, flipping, twisting, and hard landings.

The sport involves rigorous year-round training that is started as early as 4 years of age. On average, gymnasts are reported to train 5.36 days per week and 5.04 hours a day.[1] Elite-level gymnasts tend to specialize in their sport by the age of 12 years with peak training intensity occurring at 18 years of age.