Our knowledge of orthopaedics. Your best health.

• Warm up and stretch. Always take time to warm up and stretch. Research studies show that cold muscles are more prone to injury. A five-minute warm up at the gym might include jogging the perimeter of the floor mat and some passes with knee lifts, butt kicks, prancing, and power skips. A good gymnastics stretch routine should include the neck and back, shoulders, forearms and wrists, hips, thigh and calf muscles, ankles, and feet. Be sure to perform stretches slowly and gently, holding each stretch for 30 seconds. The warm up and stretch period may take about 20 to 30 minutes at the start of practice.
• Cool down and stretch. Stretching at the end of practice or competition is too often neglected because of busy schedules. Stretching can help reduce muscle soreness and keep muscles long and flexible. Be sure to stretch after each training practice to reduce your risk for injury.
• Hydrate. Even mild levels of dehydration can hurt athletic performance. If you have not had enough fluids, your body will not be able to effectively cool itself through sweat and evaporation. A general recommendation is to drink 24 ounces of non-caffeinated fluid 2 hours before exercise. Consider a water break between events, especially on those hot summer days.

• Avoid loose fitting clothing as this can interfere with safe spotting by your coach or your own visualization.
• A range of safety gear is available for young gymnasts. These include:
  • Hand grips — not mandatory but can help reduce frequency of "rips" (torn blisters on hands)
  • Heel pads can be used to protect the feet from hitting the low or high bar when training new skills like release moves or giant swings on bars
  • Wrist braces can be worn to reduce pain with tumbling (called “tiger paws”)

• Always check the equipment to make sure it is properly maintained.
• Equipment must be placed far apart to prevent gymnasts from colliding with other athletes or equipment.
• The training facility should have appropriate floor padding to help reduce the force from a landing. Mats must be placed under the equipment and must be secured properly.

• Before attempting any new move, a gymnast should talk to a coach. The coach must make sure the gymnast is physically prepared for the move and understands how to safely execute it.
• Spotting (watching and monitoring) is essential. A coach should spot gymnasts during all practice sessions, especially when complex or challenging routines are being performed.
• Safety harnesses, foam pits, and various training mats can be used when a gymnast is learning new, complex skills.

• Coaches should be knowledgeable about first aid and be able to administer it for minor injuries, such as facial cuts, bruises, or minor strains and sprains.
• Be prepared for emergencies. All coaches should have a plan to reach medical personnel for help with more significant injuries such as concussions, dislocations, contusions, sprains,  and fractures.

An injured athlete's symptoms must be completely gone before returning to gymnastics. For example:

• In case of a joint problem, the gymnast must have no pain, no swelling, full range of motion, and normal strength.
• In case of concussion, the gymnast must have no symptoms at rest or with exercise, and should be cleared by the appropriate physician or medical provider.

Because many young athletes are focusing on just one sport and are training year-round, doctors are seeing an increase in overuse injuries. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. Specific tips to prevent overuse injuries include:

• Limit the number of teams in which your child is playing in one season. Kids who play on more than one team are especially at risk for overuse injuries.
• Do not allow your child to play one sport year round — taking regular breaks and playing other sports is essential to skill development and injury prevention.
• Because gymnastics tends to be a year-round sport at higher levels, it may be more feasible to take time off and try other sports earlier in a child’s gymnastics career. Gymnasts who are participating nearly year-round should be watchful for common overuse conditions such as persistent back pain or elbow pain/catching/swelling. These could be signs of a stress fracture in the back or a cartilage injury in the elbow and may warrant a visit to the doctor.