Which Equipment Injures More Gymnasts?

Most shoulder injuries in high level gymnasts occur during forced flexion-rotation using suspension equipment, according to a new study.

“Weightbearing and traction-suspension movements with the upper limbs put considerable demands upon the shoulder region of high-level gymnasts,” the researchers of “The Injured Shoulder in High-Level Male Gymnasts, Part 1: Epidemiology and Pathoanatomy of Surgically Treated Lesions,” wrote.

“The diagnosis of instability in these gymnasts may be difficult because voluntary inferior shoulder subluxation is part of their training and is needed to perform some acrobatic figures.”

The study, which was published online on October 4, 2021, in the Orthopaedic Journal of Sports Medicine, analyzed the epidemiology of shoulder lesions requiring surgery in order to offer a pathoanatomic classification of the injured shoulder in high-level male gymnasts.

The researchers assessed 26 high-level male gymnasts who had shoulder surgery during a 20-year period between 1994 and 2014. The mean age was 22 years. Four of the gymnasts had surgery performed on both shoulders.

Eighteen of the injured shoulders were caused by chronic overuse while 27 of the shoulder injuries were caused by traction of the arm in force flexion-rotation while using suspension equipment with locked hands on the bars or rings.

In the other 3 shoulders, the traumatic position was one of an isometric muscle contraction during strength-and-hold positions on the rings.

Based on symptoms and main anatomic lesions found during arthroscopy, the injured gymnasts’ shoulders were classified into 2 categories: painful shoulders with no clinical, radiological, or arthroscopic findings of instability (n = 13) or unstable shoulders (n = 17) with isolated inferior capsule labral tears or mixed lesions, tendinous and capsulolabral).

The researchers reported that some of the gymnasts with inferior labral tears didn’t remember having experienced a dislocation or subluxation.

“The majority of injuries requiring surgery in this population occurred during traction in forced flexion-rotation using suspension equipment. Injured shoulders were classified as either painful or unstable shoulders,” the researchers wrote.

The researchers involved in the study included Patrick Gendre, M.D., of Polyclinique Saint Jean, Cagnes-Sun-Mar, France and Pascal Boileau, M.D., Ph.D. of the Institute de Chirurgie Réparatrice, Nice, France.