Objective

This study sought to describe the incidence and characteristics of injuries in male and female collegiate gymnasts and to provide prognostic information in the form of return to play (RTP) and re-injury rates.

Methods

A retrospective review of the Pac-12 Sports Injury Research Archive (SIRA) from 2017 to 2020 was performed. This database encompasses all injuries that resulted in missed or limited days of play for both male and female gymnasts within the Pac-12 conference, a total of 310 athletes over the study period (244 female, 66 male). Injury outcomes were classified as “RTP, same season”, “RTP, following season”, “returned to limited play”, or “did not RTP”.

Results

Over the 4-year study period, 983 injuries were recorded in 179 athletes. The annual incidence of injury was 57.4%, which was slightly higher in females (58.5% vs 53.1%). The overall injury rate was 1.46 injuries per athlete per season, which was also higher in females (1.48 vs 1.39). While female gymnasts most commonly sustained injuries of the foot/ankle (26.2%, 205/782), male gymnasts most commonly sustained shoulder injuries (26.9%, 54/201). The overall most common injury was an ankle sprain (21.9% incidence, 68/310), though shoulder tendinopathy was the most common injury in males (24.2% incidence, 16/66). Overall, 1.7% of injuries were career ending (17/983), while 6.0% were season ending (59/983), and 3.5% were activity restricting (35/983). Injuries in female gymnasts were significantly more likely to be career ending (2.2% vs. 0.0%, p=0.030). Achilles tendon rupture, ACL tear, and shoulder instability or dislocation were the most likely injuries to be season ending (63.6%, 53.8%, and 33.3% of injuries were season ending, respectively). Aside from patellar tendon rupture, of which there was only 1 during the study period (100% career ending), the most likely injury to be career ending was an ACL tear (46.2% career ending, 6/13). Female athletes were significantly more likely to suffer ligamentous knee injuries (11.1% vs 1.5%, p=0.014). Injuries with the highest rate of re-injury included meniscal tears (4/12, 33.3%), patellar dislocations (1/4, 25.0%), and ankle sprains (17/68, 25.0%). The overall RTP rate following any injury was 98.3%, with 94.0% of injuries allowing RTP the same season and 96.4% of injuries allowing RTP at the pre-injury level. Concussions were common, occurring at an incidence of 23.9% (26/310). 11.5% of concussions were season ending (3/26), while 7.7% were career ending (2/26). The incidence of re-injury following concussion was 19.2% (5/26).

Conclusions

Injuries are common in collegiate level gymnasts, but most allow for return to play at a pre-injury level. In our dataset, female athletes were more susceptible to foot and ankle and ligamentous knee injuries, while male athletes were more susceptible to shoulder injuries. Concussions were observed to be more common among gymnasts in our series than has been previously described. The results of this study can be used to guide injury prevention protocols and provide important prognostic information for athletes.