17 Common Gymnastics injuries (Prevention & Treatment)

All 17 common gymnastics injuries, from wrist fractures and ankle sprains to ACL tears, Achilles strains, low back pain and spinal injuries.

Repeated landings also cause cartilage damage, elbow dislocations, hip strains and impingement, stress fractures and herniated discs, each with its causes and how coaches keep athletes safe.

Knowledge is power, and power, dear gymnasts, is what keeps you in the game and performing at your best.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
US children treated in emergency departments for gymnastics injuries sustained 4.8 injuries per 1000 gymnastics participants per year.	US children and adolescents ages 6 to 17 in gymnastics (NEISS/CPSC data), 1990-2005 (published 2008)	Pediatrics (American Academy of Pediatrics), Loud et al.
The gymnastics injury rate was higher for older children, 7.4 per 1000 for ages 12 to 17 versus 3.6 per 1000 for ages 6 to 11.	US children and adolescents ages 6 to 17 in gymnastics (NEISS/CPSC data), 1990-2005 (published 2008)	Pediatrics (American Academy of Pediatrics), Loud et al.
The upper extremity was the most commonly injured body region in gymnastics ED visits, accounting for 42.3 percent of injuries.	US children and adolescents ages 6 to 17 in gymnastics (NEISS/CPSC data), 1990-2005 (published 2008)	Pediatrics (American Academy of Pediatrics), Loud et al.
An estimated 425,900 US children were treated in emergency departments for gymnastics injuries over 16 years, averaging 26,600 cases a year.	US children and adolescents ages 6 to 17 in gymnastics (NEISS/CPSC data), 1990-2005 (published 2008)	Pediatrics (American Academy of Pediatrics), Loud et al.
In NCAA women’s gymnastics, non-fatal traumatic catastrophic injuries occurred at a rate of 4.69 per 100,000 participant-seasons.	NCAA women’s (college) gymnastics, 1982/83 to 2023/24 academic years (report published September 2025)	National Center for Catastrophic Sport Injury Research (NCCSIR), 42nd Annual All Sport Report

Overview

Injury	Body area	Typical time out
Sprains and Strains (ankles, wrists, etc.)	Ankle and wrist	1 to 8 weeks, 3 months+ if torn
Wrist Fractures	Wrist	6 to 12 weeks, longer if scaphoid
Finger and Hand Injuries	Hand and fingers	1 to 3 weeks, 8+ if tendon involved
Knee and Low Back Pain	Knee and lower back	4 to 12 weeks, 3 to 6 months if bone
Anterior Cruciate Ligament (ACL) Tears	Knee	9 to 12 months after reconstruction
Achilles Tendon Strains or Tears	Ankle and calf	3 to 6 months, 9 to 12 after rupture
Ankle Sprains	Ankle	1 to 6 weeks, up to 12 if severe
Cartilage Damage	Knee, ankle and elbow	3 to 6 months, 6 to 12 after surgery
Spinal Injuries	Spine	2 to 6 weeks, 3 to 6 months if bone
Elbow Dislocations and Fractures	Elbow	6 to 12 weeks, 4 to 6 months if surgery
Hip Strains and Impingement	Hip	2 to 6 weeks, 3 to 6 months for FAI
Spinal Fractures and Herniated Discs	Lower back	3 to 6 months, 6 weeks+ for a disc
Stress Fractures	Lower leg and foot	6 to 8 weeks, 3 to 6 months high risk
Muscle Strains	Thigh, calf and trunk	1 to 8 weeks, 3 months+ if torn
Contusions (Bruises)	Whole body	Days to 2 weeks, up to 6 if deep
Labral Tear (Hip)	Hip	3 to 6 months, 6 to 9 after surgery
Spondylosis (Degeneration of the Intervertebral Disks)	Spine	6 to 12 weeks per flare, ongoing
Cervical Strain and Stinger	Neck	1 to 3 weeks, longer if repeated
Concussion	Head and brain	2 to 4 weeks, longer if symptoms last
Facial and Scalp Lacerations	Head and face	Days to 2 weeks, 6+ if fracture
Sever’s Disease (Calcaneal Apophysitis)	Foot and heel	4 to 12 weeks of modified training

Sprains and Strains (ankles, wrists, etc.)

A sprain damages a ligament, the short band that holds two bones together, most often the anterior talofibular ligament on the outside of the ankle or the scapholunate ligament between two small wrist bones. A strain damages muscle fibers or the tendon that anchors them to bone. In gymnastics both happen in the same instant of force: the ankle rolls inward on a short landing, or the wrist is driven into full extension under body weight during a back handspring or a vault block.

Symptoms

• Sudden pain at the moment of the landing or block, sometimes with a pop or tearing sensation.
• Swelling that builds over the first few hours and often spreads below the joint.
• Bruising that appears a day or two later, sometimes lower than the painful spot.
• The joint feels loose, unreliable, or gives way when you load it.
• Pain when you push into the exact position that caused it, such as wrist extension in a handstand.

How serious it is: Both follow the same three grades: grade 1 stretches the tissue with pain but no real instability, grade 2 is a partial tear with visible swelling and a joint that feels unsteady, grade 3 is a complete tear that leaves the joint clearly unstable. A grade 3 wrist ligament injury and any inability to bear weight on the ankle should be imaged, since fractures hide behind the same symptoms.

Typical time out: One to three weeks back to modified training for a grade 1, four to eight weeks for a grade 2, and three months or more for a grade 3 or a repaired ligament. The range is wide because a gymnast can walk long before the wrist tolerates a handstand, so the return date is set by the loaded skill, not by daily comfort.

See a doctor if: See a doctor if you cannot put weight on the ankle for four steps, if the wrist or ankle looks crooked, or if the area goes numb or cold.

What helps

• Start moving the joint within pain limits in the first days instead of resting it fully, which speeds the return of range of motion.
• Load progressively: bodyweight balance work for the ankle, then hops, then landings; for the wrist, fists and forearm support before an open palm handstand.
• Use a lace-up ankle brace or taping for the first months back on tumbling and vault, which measurably lowers the chance of a repeat sprain.
• Short cooling in the first hours if pain is high, but do not let it replace early controlled movement.
• Get imaging if pain sits directly on bone, if swelling stays hard after a week, or if the joint still feels unstable after six weeks of rehab.

Wrist Fractures

The break usually runs through the far end of the radius, the thicker forearm bone, or through the scaphoid, a small boat shaped carpal bone at the base of the thumb. In growing gymnasts the injury often sits in the growth plate of the radius instead of the bone shaft. The mechanism is the same in all cases: the full body mass lands on an extended wrist during a vault block, a tumbling pass, or a fall from bars.

Symptoms

• Immediate sharp pain and a wrist you do not want to load at all.
• Swelling across the back of the wrist within the first hour.
• Marked tenderness at one exact point, often in the hollow at the base of the thumb.
• Weak grip and pain when turning the palm up or down.
• In severe cases an obvious step or bend in the line of the forearm.

How serious it is: The distinction that matters is whether the fragments are still in line. An undisplaced fracture is treated in a cast, a displaced or angled one needs to be set and often fixed with wires or a plate. Scaphoid fractures are a separate problem because the blood supply enters from one end, so they heal slowly and can fail to heal at all if missed.

Typical time out: Six to twelve weeks for an undisplaced radius fracture before weight bearing on the hand, three to six months after surgery or for a scaphoid fracture. Scaphoid injuries stretch the range because the bone may need three months in a cast before it shows any healing on imaging.

See a doctor if: Any visible deformity, numbness in the fingers, or pain in the base of the thumb that is still there after a week needs imaging, even if the first x-ray was called normal.

What helps

• Splint the wrist and get an x-ray the same day rather than treating it as a sprain.
• Ask specifically about the scaphoid if the tender spot is in the thumb side hollow, since early scaphoid fractures often do not show on the first film and need a repeat film or MRI.
• Keep the shoulder, elbow and fingers moving while the wrist is immobilized so you lose less than you think.
• Restore full wrist extension and forearm rotation with a therapist before any handstand, then rebuild loading in stages from forearm support to full weight.
• Treat repeat wrist pain in a young gymnast as a growth plate problem until proven otherwise, since chronic overload there can shorten the radius permanently.

Finger and Hand Injuries

Most of these are injuries to the small collateral ligaments and the volar plate at the finger joints, or to the flexor tendon pulleys that hold the tendon against the bone. They happen when a finger catches in a bar grip, snags on the beam, or is bent sideways in a fall. Ring gymnasts and bar workers also load the pulleys heavily during grip changes.

Symptoms

• Pain and swelling around one finger joint that make a full fist impossible.
• A finger that sits at an angle or looks shortened after a jam.
• Stiffness that is worst in the morning and lasts for weeks after the swelling settles.
• A snapping sensation at the front of the finger during a hard grip.
• Difficulty holding the bar or gripping the beam without pain.

How serious it is: A simple jammed finger with a sprained collateral ligament is mild and settles with taping. A dislocation, a tendon avulsion where the fingertip will no longer straighten, or a pulley rupture is a different category and needs a hand specialist. Rotation of the finger when you make a fist points to a fracture.

Typical time out: One to three weeks for a jammed finger with taping, four to eight weeks after a reduced dislocation, and eight to twelve weeks or more for a tendon or pulley injury. The swelling and stiffness usually outlast the pain by months, which surprises most gymnasts.

See a doctor if: Go to a doctor if the finger is visibly out of line, if you cannot straighten the last joint yourself, or if the fingers cross over each other when you close a fist.

What helps

• Buddy tape the injured finger to its neighbor and keep moving it, since strict immobilization of a finger joint causes lasting stiffness.
• Get an x-ray for any dislocation before you or anyone else pulls it back into place.
• Start gentle bending and straightening within days, aiming at full motion in the first three weeks.
• Modify grip work rather than stop it: chalk and grips reduce friction and shear on the skin and pulleys.
• See a hand therapist if the joint is still thick and stiff after six weeks, which is common and treatable.

Knee and Low Back Pain

In the knee the pain usually comes from the patellar tendon just below the kneecap or from the cartilage under it, both loaded hard by repeated landings that the quadriceps has to absorb. In the lower back it usually comes from the small facet joints and the pars interarticularis of the lower lumbar vertebrae, which are compressed each time the spine goes into extension for a walkover, a back handspring, or a beam dismount.

Symptoms

• Aching below the kneecap that starts after training and later appears during it.
• Pain in the knee going down stairs or on the first landings of a session.
• One sided low back pain that is worse when arching backward and eases when bending forward.
• Stiffness in the back in the morning or after sitting through school.
• Pain that returns each time the training volume goes up.

How serious it is: Mild cases hurt after training only and settle with a lighter week. The important line is pain during and after activity, or one sided back pain on extension in a young gymnast, which raises the suspicion of a stress reaction in the pars and needs imaging rather than patience.

Typical time out: Four to twelve weeks for a load related knee or back complaint managed with a proper loading program, three to six months if a bone stress reaction is found in the spine. The range depends almost entirely on whether the training load that caused it actually changes.

See a doctor if: Back pain that wakes you at night, pain that runs down a leg, or any numbness or weakness in the legs should be assessed promptly instead of managed at home.

What helps

• Cut the number of impacts per session rather than stopping everything, and count landings so the load is visible.
• Heavy slow resistance work or eccentric decline squats for patellar tendon pain, done every second day for at least three months.
• Build hip and trunk strength so the back is not the only structure absorbing extension, including hip flexor and gluteal work.
• Coach the landing: knees tracking over the toes, hips back, ankles and hips sharing the shock instead of a stiff leg.
• Get an MRI for one sided low back pain in a young gymnast that has lasted more than two to three weeks, since a pars stress reaction seen early heals well.

Anterior Cruciate Ligament (ACL) Tears

The anterior cruciate ligament runs diagonally inside the knee and stops the shin bone from sliding forward and rotating on the thigh bone. In gymnastics it usually tears without any contact, on a landing where the knee is nearly straight, the foot is planted, and the body keeps rotating, most often on a floor tumbling pass or a vault landing that is short or long. The meniscus and the collateral ligaments are frequently damaged in the same instant.

Symptoms

• A pop that you hear or feel at the moment of landing.
• The knee swells within a few hours, not days.
• A feeling that the knee gave way and cannot be trusted.
• Deep pain and an inability to fully straighten or bend the knee.
• Later, the knee buckles on turns and pivots even though walking is fine.

How serious it is: Tears are partial or complete. A complete tear leaves the knee unstable during cutting, twisting and landing, which is exactly what gymnastics demands, so reconstruction is usually recommended for athletes who want to return to the sport. A tear with a locked knee suggests a torn meniscus caught in the joint and needs earlier surgical review.

Typical time out: Nine to twelve months before full return to tumbling and vault after reconstruction, sometimes longer if the meniscus was repaired and weight bearing had to be restricted. Returning before nine months clearly raises the risk of a second tear, which is why the range starts where it does.

See a doctor if: A knee that swells within hours of a landing, or that locks and will not straighten, should be seen the same week rather than waited out.

What helps

• Get the swelling down and the knee straightening fully before any surgery, since a stiff knee before the operation stays stiff after it.
• Follow a criteria based rehab that measures single leg strength and hop symmetry rather than counting months alone.
• Include neuromuscular landing training with the whole squad, since programs of this kind reduce ACL injuries in jumping and landing sports.
• Rebuild quadriceps strength deliberately, because the deficit on the injured side is what predicts a poor return.
• Return to tumbling in stages: two footed landings on soft surfaces, then hard surfaces, then twisting and single leg landings.

Achilles Tendon Strains or Tears

The Achilles tendon joins the calf muscles to the heel bone and carries several times body weight during a punch off the floor. Repeated tumbling produces tendinopathy, a thickened painful section a few centimeters above the heel, while a sudden explosive push can rupture the tendon completely. Ruptures in gymnastics typically happen on the take off, not the landing.

Symptoms

• Morning stiffness in the tendon that eases after a few minutes of walking.
• A tender, thickened spot above the heel that hurts when you squeeze it.
• Pain that warms up during tumbling and returns worse afterwards.
• With a rupture, a sudden blow to the back of the ankle as if someone kicked you.
• After a rupture, you cannot push off or rise onto that toe at all.

How serious it is: Tendinopathy runs from pain that only appears after training to pain that limits every push off. A rupture is either partial or complete, and a complete rupture leaves a palpable gap with no push off strength. Any suspected rupture is an urgent assessment, since the choice between cast and surgery depends on how the tendon ends sit.

Typical time out: Three to six months of loading work for tendinopathy before symptoms are reliably gone, and nine to twelve months after a complete rupture whether it was repaired surgically or treated in a boot. Tendinopathy varies widely because the tendon only adapts if load is added steadily rather than removed.

See a doctor if: If you felt a sudden snap and cannot rise onto the toes of that leg, treat it as a rupture and be seen the same day.

What helps

• Progressive calf loading is the core treatment: heavy slow calf raises, including eccentric lowering, done daily or every second day for at least twelve weeks.
• Do not stop tumbling entirely for tendinopathy; keep pain during and after training below a tolerable level and adjust volume by that.
• Add heel raises inside shoes for daily wear during the painful phase to reduce tension on the tendon.
• Look above and below the tendon: stiff ankles and weak hips push more work onto the calf.
• Corticosteroid injection into an Achilles tendon is not a routine option, since it can relieve pain short term while making the tendon weaker, so it stays an exception decided by a specialist.

Ankle Sprains

The classic gymnastics sprain tears the lateral ligaments on the outside of the ankle, above all the anterior talofibular ligament, when the foot rolls inward under a landing. Short landings on tumbling passes, dismounts from beam and bars, and stepping off the edge of a mat are the usual settings. A less common but slower healing version damages the high ankle ligaments between the two shin bones when the foot is forced outward.

Symptoms

• Pain on the outside of the ankle right at the moment of landing.
• Rapid swelling over the outer ankle bone, often within an hour.
• Bruising spreading into the foot over the following days.
• Difficulty walking normally, particularly pushing off.
• A feeling that the ankle rolls again easily on uneven ground.

How serious it is: Grade 1 is a stretched ligament with mild swelling and near normal walking, grade 2 a partial tear with clear swelling and limping, grade 3 a complete tear with a visibly unstable ankle. High ankle sprains hurt when the leg is twisted rather than rolled and take considerably longer than their grade suggests.

Typical time out: One to two weeks for a grade 1, three to six weeks for a grade 2, and eight to twelve weeks for a grade 3 or a high ankle sprain. The spread is large because returning before balance and strength are restored is the main reason ankles sprain again.

See a doctor if: If you cannot take four steps on it, or the bone at the back edge of either ankle bone is tender to a fingertip, get an x-ray to exclude a fracture.

What helps

• Begin gentle ankle movement and walking within pain limits in the first days rather than immobilizing it.
• Train balance deliberately, single leg stance progressing to unstable surfaces and eyes closed, since the reflex control is what is actually lost.
• Use a lace-up brace or taping for the first six to twelve months back on impact skills, which halves the repeat sprain rate in landing sports.
• Rebuild calf and peroneal strength to full symmetry before landings from height.
• If the ankle still swells and gives way after three months of proper rehab, get imaging for cartilage damage inside the joint.

Cartilage Damage

This means damage to the smooth articular cartilage that lines the joint surfaces, sometimes together with the bone directly beneath it, which is then called an osteochondral lesion. In gymnastics it follows repeated high impact loading of the knee and ankle on landings, and of the elbow in the capitellum when the arm is used as a weight bearing limb on vault and floor. Unlike muscle, this tissue has almost no blood supply and repairs poorly.

Symptoms

• Deep aching in the joint that is hard to point at with one finger.
• Swelling that comes back after every hard session.
• Catching, clicking or a sense that something is caught in the joint.
• Loss of the last few degrees of bending or straightening.
• Pain that persists long after a sprain should have settled.

How serious it is: Lesions are graded from softening of the surface to a defect that reaches bare bone, with loose fragments as the severe end. A stable lesion in a young athlete with an intact surface can heal with time off impact, while a detached fragment usually requires surgery. The elbow form in young gymnasts is particularly important to catch early.

Typical time out: Three to six months off impact for a stable lesion treated without surgery, six to twelve months after cartilage repair or fragment fixation. The wide range reflects how slowly this tissue responds and how strictly impact has to be avoided in the first months.

See a doctor if: A joint that locks, catches, or repeatedly swells for months after an injury should be imaged rather than trained through.

What helps

• Replace impact with loading that does not pound the joint, such as cycling, swimming and controlled strength work.
• Get an MRI early for persistent joint swelling, since plain x-rays miss most cartilage lesions.
• Strengthen the muscles around the joint so the surface sees a better distributed load.
• Review technique and equipment: how landings are absorbed and how much matting is used changes the peak forces directly.
• Take elbow pain in a young gymnast seriously and stop weight bearing on the arm until it has been assessed.

Spinal Injuries

The term covers everything from a muscular strain of the erector spinae to injury of the facet joints, the pars interarticularis, or in rare severe cases the vertebral bodies and the spinal cord itself. Gymnastics loads the spine in repeated extension and rotation, and in compression at the moment of landing, which concentrates force on the back elements of the lower lumbar vertebrae. Catastrophic spinal injuries are rare but are recorded in the sport, particularly with failed landings on the head or neck.

Symptoms

• Back pain that is worse when arching backward and better when bending forward.
• Muscle spasm and a back that feels locked after training.
• Pain concentrated on one side rather than spread across the back.
• Pain, tingling or weakness that travels into a leg.
• Difficulty holding an arched shape that used to be easy.

How serious it is: A muscular strain settles within weeks and hurts everywhere. Bone stress in the pars is typically one sided, provoked by extension, and needs weeks of load reduction. Any injury with numbness, weakness, or loss of bladder or bowel control belongs in a different category entirely and is an emergency.

Typical time out: Two to six weeks for a muscular strain, three to six months for a bone stress injury of the pars, and considerably longer where the vertebra or the cord is involved. The range widens because bone stress injuries only heal if the extension load actually stops for the first phase.

See a doctor if: Numbness, weakness in a leg, loss of bladder or bowel control, or neck pain after a fall on the head means stop and get emergency care.

What helps

• Take one sided extension pain in a young gymnast to imaging early rather than waiting a season.
• Remove the provoking movement first, then rebuild: trunk and hip strength, control of the hip versus the lumbar spine in arched positions.
• Improve hip extension and shoulder flexibility so the back does not have to supply the missing range.
• Return to skills in a fixed order, from low extension to full walkovers and dismounts, rather than all at once.
• Keep general training going during the break, since deconditioning is what makes the eventual return risky.

Elbow Dislocations and Fractures

The elbow dislocates when the forearm bones are forced backward off the end of the humerus, typically in a fall onto an outstretched hand from bars or beam. Fractures in the same fall may involve the supracondylar region of the humerus in children, the radial head, or the olecranon at the tip of the elbow. Both damage the collateral ligaments on the sides of the joint at the same time.

Symptoms

• Immediate severe pain and an elbow you cannot bend or straighten.
• A visibly deformed elbow with the tip pushed backward.
• Rapid swelling around the whole joint.
• Pain when turning the palm up, which points to the radial head.
• Numbness or tingling in the hand or fingers.

How serious it is: A simple dislocation without fracture is put back in place and usually does well. A dislocation combined with fractures of the radial head and the coronoid is far more serious and unstable, and childhood supracondylar fractures can compromise blood supply to the forearm. Any elbow injury with a cold, pale or numb hand is urgent.

Typical time out: Six to twelve weeks before weight bearing on the arm after a simple dislocation, four to six months after fracture surgery. The gap is large because full elbow extension often returns slowly, and gymnastics needs the joint fully straight to hold a handstand.

See a doctor if: A deformed elbow, a cold or pale hand, or numbness in the fingers is an emergency and needs a hospital, not a splint at home.

What helps

• Do not attempt to relocate the elbow yourself; immobilize it as it lies and get it x-rayed.
• Start early controlled movement once the joint is stable, since the elbow stiffens faster than almost any other joint.
• Work on extension actively, because losing the last ten degrees ends handstand work.
• Follow the surgeon’s guidance on which arc of movement is safe in the first weeks, then broaden it steadily.
• Rebuild weight bearing gradually: forearm support, then hands on an incline, then a wall handstand, then free.

Hip Strains and Impingement

Strains affect the hip flexors, especially rectus femoris and iliopsoas, and the adductors on the inside of the thigh, all loaded hard by leaps, split positions and leg lifts. Femoroacetabular impingement is a bony shape problem in which extra bone on the femoral neck or the socket rim contacts the joint edge at end range, which gymnastics reaches constantly in splits, straddles and pikes. Repeated contact irritates the labrum and the cartilage.

Symptoms

• Pain deep in the front of the hip or groin, often described by cupping the hip with a C shaped hand.
• Pain at the end of a split, a straddle or a deep squat.
• A pinching feeling when the knee is drawn to the chest and turned inward.
• Aching in the groin after sitting for a long period.
• Loss of the last part of the range you used to have.

How serious it is: Muscle strains follow the usual three grades, with a grade 3 involving a full tear or an avulsion of the tendon from the pelvis, which is not rare in adolescents. Impingement is graded by how much the shape restricts movement and whether the labrum and cartilage are already damaged, which changes the treatment from rehab to a surgical discussion.

Typical time out: Two to six weeks for a grade 1 or 2 strain, three months or more for an avulsion, and three to six months of rehab for impingement, longer after arthroscopy. Impingement varies most because the bone shape does not change and the outcome depends on how well the muscles control the hip.

See a doctor if: Sudden severe groin pain in a teenager during a leap, with an inability to lift the leg afterwards, may be a tendon avulsion from the pelvis and needs an x-ray.

What helps

• Strengthen the hip in the range you actually use, including hip flexor work at long lengths and adductor work such as the Copenhagen exercise.
• Stop stretching into the pinch: forcing more range in an impinging hip makes the labrum worse rather than better.
• Adjust technique so that split range comes from the pelvis tilting and both hips sharing, not from one joint jamming.
• Use imaging if deep groin pain, clicking and lost range persist beyond three months of good rehab.
• Return leaping volume in stages, since the hip flexors are usually the first structure to be overloaded again.

Spinal Fractures and Herniated Discs

The typical gymnastics fracture is a stress fracture through the pars interarticularis, the narrow bridge of bone at the back of a lumbar vertebra, known as spondylolysis. If it occurs on both sides, the vertebra can slip forward on the one below. A herniated disc is different: the soft center of a disc pushes through its outer ring and presses on a nerve root, which is more often a compression and flexion injury from landing than an extension injury.

Symptoms

• One sided low back pain that sharpens when you arch backward.
• Back pain that has slowly grown over weeks of hard training rather than starting in one moment.
• With a disc, pain running down the back of the leg past the knee.
• Tingling or numbness in a defined strip of the leg or foot.
• Weakness such as difficulty pushing the foot down or lifting the toes.

How serious it is: A pars stress reaction seen on MRI before the bone actually cracks has a good chance of healing, an established fracture with a slip does not close again and is managed rather than cured. Disc herniations range from a bulge that irritates a nerve to a large fragment that causes real weakness, which is the point where surgery is discussed.

Typical time out: Three to six months for a pars stress injury, with early stress reactions at the shorter end and established fractures at the longer end. Six weeks to three months for most disc herniations, since the majority settle without surgery, but a herniation with progressive weakness follows the surgical timeline instead.

See a doctor if: Numbness around the groin or saddle area, loss of bladder or bowel control, or a foot you cannot lift is an emergency and needs immediate care.

What helps

• Get an MRI early for one sided extension pain in a young gymnast, because a stress reaction caught before the crack heals far better.
• Remove extension loading completely for the first phase, then reintroduce it in a planned order under supervision.
• Build hip flexibility and gluteal strength so the lumbar spine is not the only source of arch.
• For a disc, keep walking and moving early rather than lying still, and use a physiotherapy program based on which direction eases the leg pain.
• Epidural injection or surgery for a disc stays reserved for pain that will not settle or for real nerve weakness, not as a first step.

Stress Fractures

A stress fracture is a crack that forms because bone is being loaded faster than it can rebuild, most often in the tibia, the metatarsals of the forefoot, the navicular in the midfoot, and the pars of the lumbar spine. In gymnastics the driver is the sheer number of landings per session on firm surfaces. Low energy availability and disrupted menstrual cycles make the bone far less able to keep up, which is why nutrition is part of the diagnosis.

Symptoms

• Pain that you can cover with one fingertip, always in the same spot.
• Pain that begins late in a session, then earlier, then during walking.
• Tenderness when you press directly on the bone.
• Mild swelling over the bone, especially on the top of the foot.
• Pain that eases with a few days off and returns immediately when you resume.

How serious it is: Sites differ more than grades do. The shaft of the tibia and the outer metatarsals are low risk and heal reliably with load reduction. The navicular, the front of the tibia, the femoral neck and the base of the fifth metatarsal are high risk sites that heal poorly and may need immobilization or surgery.

Typical time out: Six to eight weeks for a low risk site with the load properly reduced, three to six months for a high risk site such as the navicular. The range is driven by location and by whether the underlying energy and calcium problem is corrected, since otherwise a second fracture follows.

See a doctor if: Pain over the midfoot or the front of the shin that hurts when hopping on the spot needs imaging rather than another week of trying.

What helps

• Reduce impact to a level that is painless, and keep fitness with cycling, swimming or pool running instead of stopping completely.
• Get an MRI rather than an x-ray, since x-rays miss early stress fractures entirely.
• Address the cause honestly: total energy intake, calcium and vitamin D, menstrual regularity, and the number of landings per week.
• Return by adding one variable at a time, usually volume before height and height before twisting.
• Treat a stress fracture as a warning about the whole training plan, not as one injured bone.

Muscle Strains

A strain tears fibers at the junction between muscle and tendon, most commonly in the hamstrings at the back of the thigh, the rectus femoris at the front, the calf, and the adductors. In gymnastics they occur during explosive leaps, split leaps, sprint approaches to vault, and end range kicks where the muscle is contracting hard while being lengthened. The hamstring near the sitting bone is the classic gymnastics site because of repeated stretching at end range.

Symptoms

• A sudden grabbing pain during a leap or a sprint, with an immediate stop.
• Tenderness at one point along the muscle when you press it.
• Pain when you contract the muscle against resistance.
• Bruising appearing over the following days below the injured spot.
• Pain sitting on a hard surface, in the case of a high hamstring injury.

How serious it is: Grade 1 involves a few fibers with minimal strength loss, grade 2 a partial tear with clear weakness and a visible gap in performance, grade 3 a complete tear or an avulsion of the tendon from the bone, which needs a surgical opinion. High hamstring tendon injuries take much longer than the grade alone suggests.

Typical time out: One to three weeks for a grade 1, four to eight weeks for a grade 2, and three to six months for a grade 3 or a surgical repair. Proximal hamstring tendon injuries sit at the long end because the tendon reloads slowly and reinjury is common when the return is rushed.

See a doctor if: A pop with immediate inability to walk, or a visible dent in the muscle belly, means it should be assessed rather than rehabbed at home.

What helps

• Start gentle isometric holds within pain limits in the first days, since early loading shortens the return compared with rest.
• Progress to eccentric strength work at length, such as Nordic curls for hamstrings, which reduces reinjury clearly.
• Rebuild sprinting and leaping speed gradually, because most reinjuries happen at high speed rather than in the gym.
• Check the whole chain: limited hip extension and weak gluteals load the hamstring more.
• Use full strength symmetry and pain free end range as the return criteria, not the calendar.

Contusions (Bruises)

A contusion is bleeding within muscle or under the skin after a direct blow, with no tear of the fibers by traction. In gymnastics they come from hitting the beam with the thigh or shin, catching the bar on the hip, striking the vault table, or landing on the tailbone. A deep thigh contusion is the one that matters most, because bleeding inside the tight muscle compartment can limit knee bending for weeks.

Symptoms

• Immediate localized pain at the point of impact.
• Swelling and a firm lump under the skin within hours.
• Discoloration that turns from red to purple to yellow over a week or two.
• Stiffness and lost bending range if the thigh is involved.
• Pain that is worse when the muscle is stretched than when it is contracted.

How serious it is: Mild contusions leave range of motion intact. A deep thigh contusion is graded by how far the knee still bends after 24 hours: past 90 degrees is mild, well under 45 degrees is severe. Increasing pain and tightness rather than improvement over hours is the sign of a serious complication and needs emergency assessment.

Typical time out: A few days to two weeks for a mild contusion, three to six weeks for a severe deep thigh contusion. The range depends mostly on how much knee bending was lost in the first day, which is the best early predictor.

See a doctor if: A limb that becomes tighter, more painful, numb or tense over hours instead of easing may be a compartment syndrome and is an emergency.

What helps

• Keep the knee bent in the first hours after a thigh contusion, using a wrap that holds the position, which limits the bleeding and preserves range.
• Restore range of motion gently and early rather than waiting for the bruise to fade.
• Short cooling in the first hours helps the pain, but avoid deep massage of a fresh contusion.
• Use padding on the shin or hip for the skills that caused it during the return.
• Get imaging if a hard lump in the muscle persists and range stops improving after several weeks, since bone can form inside the muscle.

Labral Tear (Hip)

The labrum is a rim of fibrocartilage around the edge of the hip socket that deepens the joint and helps seal the fluid inside it. It tears from repeated contact at end range, so the split, straddle and deep flexion positions of gymnastics are the setting, and it is often accompanied by the bony impingement shape described above. A single forceful twist on a landing can also tear it outright.

Symptoms

• Deep pain in the front of the hip or groin, hard to point at precisely.
• Clicking, catching or locking sensations at the front of the hip.
• Pain at the end of a split or when pulling the knee up and across.
• A hip that feels like it wants to give way on turns.
• Aching after sitting for long periods or after a hard leaping session.

How serious it is: Small degenerative tears cause symptoms that settle well with strength work and adjustments, while a detached or bucket handle tear that mechanically catches usually does not. Whether the underlying bone shape impinges strongly affects both the severity and whether surgery is offered.

Typical time out: Three to six months of structured rehab if treated without surgery, six to nine months after hip arthroscopy before full gymnastics loading. The range is wide because the labrum itself heals slowly and the return depends on regaining hip control at end range.

See a doctor if: A hip that locks or catches so that a movement cannot be completed, or groin pain that does not improve after three months of rehab, should be imaged.

What helps

• Start with strength and control rather than surgery: deep gluteal, hip flexor and rotator work, plus trunk control.
• Avoid forcing range into the painful pinch, since the tear is caused by end range contact.
• Use an MR arthrogram if a tear is suspected, because a standard MRI can miss it.
• Modify skills that require extreme flexion with rotation while the hip is irritated.
• Discuss arthroscopy only after a proper rehab trial, and expect a staged return over months afterwards.

Spondylosis (Degeneration of the Intervertebral Disks)

Spondylosis describes age and load related change in the discs and the small facet joints of the spine, where the disc loses height and the joints thicken. In gymnasts the lower lumbar segments carry the most repeated compression and extension, so change appears earlier there than in the general population. The term is often confused with spondylolysis, which is a stress fracture of the pars and a separate problem.

Symptoms

• Stiffness in the lower back in the morning and after sitting.
• Aching that builds through a training session rather than starting suddenly.
• Pain when arching backward and when standing for long periods.
• Reduced range when trying to reach a full bridge or arch.
• Occasional pain spreading into the buttock, but usually not below the knee.

How serious it is: The visible degree of change on imaging matches symptoms poorly, since many people with clear changes have no pain. What separates mild from serious is function: stiffness that settles with movement is mild, whereas pain with nerve symptoms in the leg suggests the narrowing is affecting a nerve and changes the management.

Typical time out: This is a long term condition rather than a healing injury, so training usually continues in modified form. Expect six to twelve weeks to settle a flare with load adjustment and strength work, and longer if nerve symptoms are involved.

See a doctor if: Pain radiating below the knee with numbness or weakness, or night pain that wakes you, should be assessed rather than accepted as normal wear.

What helps

• Keep training, adjusted: continued loading maintains the back far better than avoidance does.
• Build trunk and hip strength so the lumbar segments share force with the hips.
• Distribute arch across the whole spine and the hips instead of hinging at one segment, which is a coaching point as much as a medical one.
• Use heat and movement for morning stiffness, and short cooling only if a flare is acutely painful.
• See a clinician if leg symptoms appear, since that changes the problem from stiffness to nerve involvement.

Cervical Strain and Stinger

A cervical strain damages the small muscles and ligaments that hold the neck vertebrae together, usually when the head is loaded or whipped in a failed landing, a short back handspring, or a fall from bars. A stinger is a different injury in which the nerve roots leaving the neck or the brachial plexus are briefly stretched or compressed, sending a burning line down one arm. Both often occur in the same incident, and both must be separated from a fracture before anyone moves the athlete.

Symptoms

• Neck pain and stiffness that make turning the head difficult.
• Muscle spasm along the side or back of the neck.
• A burning or electric feeling shooting down one arm after the impact.
• Temporary numbness or weakness in one hand or arm.
• Headache at the base of the skull after a hard landing.

How serious it is: A simple muscular strain settles over one to three weeks. A stinger that clears within minutes and affects only one arm is usually mild, but symptoms lasting more than a few minutes, recurring, or affecting both arms or the legs points to a spinal cord or nerve root problem that needs urgent imaging.

Typical time out: One to three weeks for a strain and days to a few weeks for a single short stinger, with return only once strength and full pain free movement have come back. Repeated stingers extend this considerably because they suggest an underlying structural issue.

See a doctor if: Symptoms in both arms or in the legs, midline neck tenderness, or any weakness that lasts more than a few minutes means immobilize the neck and call emergency services.

What helps

• Do not move an athlete with neck pain after a head or neck landing until a fracture has been excluded.
• For a simple strain, restore gentle neck movement within days rather than wearing a collar.
• Strengthen the neck and the muscles between the shoulder blades, since a stronger neck absorbs more of the force.
• Review the skill and the spotting: stingers and strains cluster around specific failed elements.
• Get imaging and a specialist opinion before returning after a second stinger in the same season.

Concussion

A concussion is a functional disturbance of the brain caused by a force transmitted to the head, either from a direct blow or from the head being rapidly accelerated in a fall. In gymnastics it typically follows an under rotated tumbling pass, a fall from bars or beam onto the head or upper back, or a collision with equipment. There is no structural damage visible on a standard scan, which is why the diagnosis is made from symptoms and testing rather than imaging.

Symptoms

• Headache, pressure in the head, or feeling dazed and slowed down.
• Dizziness, unsteadiness, or nausea after the fall.
• Sensitivity to light and noise in the gym.
• Difficulty concentrating at school or remembering the incident.
• Sleep changes and unusual irritability in the days afterwards.

How serious it is: Concussions are not usefully graded at the moment of injury, since severity is judged by how long symptoms last. Loss of consciousness happens in a minority and its absence does not mean the injury is mild. Symptoms that worsen, repeated vomiting, or increasing drowsiness point to a more serious brain injury and are an emergency.

Typical time out: Most young athletes are symptom free within two to four weeks and return to full gymnastics after a graded step by step progression, but a minority take three months or longer. The range depends heavily on whether a second impact is avoided during recovery.

See a doctor if: A worsening headache, repeated vomiting, increasing confusion or drowsiness, seizure, or weakness in an arm or leg means emergency care immediately.

What helps

• Remove the gymnast from training the same day and do not let them return that day under any circumstance.
• Take 24 to 48 hours of relative rest, then reintroduce light activity, since prolonged dark room rest delays recovery.
• Return through the standard graded stages, moving up only if the previous stage caused no symptoms.
• Treat persistent dizziness with vestibular physiotherapy rather than waiting it out.
• Manage school before sport, with reduced screen time and workload while symptoms persist.

Facial and Scalp Lacerations

These are cuts to the scalp, eyebrow, lip or chin caused by direct contact with the beam, the uneven bars, the vault table, or the floor edge. The scalp has a rich blood supply, so even a small cut bleeds heavily and looks worse than it is. What matters is not the cut itself but the force that caused it, since the same impact can concuss the athlete or fracture a facial bone.

Symptoms

• An open cut with bleeding out of proportion to its size, especially on the scalp.
• Pain and swelling around the eye, nose or jaw.
• A nose or cheek that looks out of shape.
• Double vision or numbness across the cheek.
• Teeth that no longer meet correctly when the mouth closes.

How serious it is: A shallow cut that stops bleeding with pressure and has edges that sit together needs cleaning and a dressing. A gaping cut, a cut through the lip border or the eyebrow, or one with anything embedded in it needs professional closure within hours. Facial deformity, double vision or a changed bite indicates a facial fracture.

Typical time out: A few days to two weeks for a simple laceration, so long as the wound can be protected and no concussion occurred. Longer where a facial bone was fractured, since those need six weeks or more before any risk of a second impact.

See a doctor if: Double vision, a changed bite, numbness in the face, or bleeding that does not stop with ten minutes of firm pressure needs medical care now.

What helps

• Apply firm direct pressure with a clean dressing for a full ten minutes without lifting it to check.
• Have any cut through the lip border, the eyebrow or the eyelid closed by a clinician, since alignment matters there.
• Assess for concussion in the same examination, because the cut draws attention away from the head injury.
• Keep the wound clean and covered during return to training, and avoid chalk contact with an open wound.
• Check tetanus vaccination status for any dirty or deep wound.

Sever’s Disease (Calcaneal Apophysitis)

Sever’s disease is irritation of the growth plate at the back of the heel bone, where the Achilles tendon pulls on bone that has not yet fused. It affects growing gymnasts, typically between the ages of eight and fourteen, and it is driven by repeated impact from tumbling and landings on hard surfaces combined with a tight calf during a growth spurt. It is not a disease in any meaningful sense and it resolves once the growth plate closes.

Symptoms

• Pain at the back and sides of the heel, worse during and after tumbling.
• Limping at the start of a session or after sitting.
• Pain when the heel is squeezed from both sides.
• Relief when standing on the toes or wearing a slight heel lift.
• Both heels affected in many cases, not just one.

How serious it is: Mild cases hurt only after training and settle with a lighter week. More severe cases cause limping in daily life and pain at the first landing of every session. Pain that continues at rest or at night, or that sits on the bone above the heel rather than at the growth plate, points to another diagnosis and needs imaging.

Typical time out: Rarely a full break from the sport. Expect four to twelve weeks of modified training to settle it, and recurring episodes across one to two years until the growth plate fuses. The range depends on how consistently impact volume is controlled during growth spurts.

See a doctor if: Heel pain that wakes the child at night, comes with swelling and fever, or persists past the growth years is not Sever’s and should be examined.

What helps

• Reduce the number of hard landings per week rather than stopping gymnastics entirely.
• Use a soft heel cup or cushioned shoes for daily wear outside the gym.
• Stretch and strengthen the calf, since a tight calf during a growth spurt is the main driver.
• Build ankle and calf strength with calf raises once the acute pain has eased.
• Reassure the family: this condition is self limiting and does not damage the bone permanently.

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in Gymnastics

• Count and cap the number of impacts per week, since the total landing volume rather than any single skill is what produces most gymnastics overuse injuries. Rotate hard tumbling days with lighter days.
• Build dedicated wrist strength and mobility: wrist extension and flexion loading, forearm work, and progressive hand weight bearing, because the upper limb takes the load in this sport in a way it does in few others.
• Coach the landing shape explicitly. Land on the feet with hips back and knees and ankles bending to absorb, never with locked knees or elbows, and keep the trunk from collapsing into a deep arch.
• Develop hip mobility and gluteal strength so that arched shapes come from the hips as well as the spine, which takes repeated extension load off the lower lumbar vertebrae.
• Match food to training. Growing gymnasts training many hours need enough energy and calcium for bone to keep up, and low energy availability is a direct route to stress fractures.
• Progress skills in one variable at a time, adding height, then twist, then a harder surface, and use pit and soft mats for the first hundreds of repetitions of a new element.

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• A visible deformity in a limb or joint, or a bone that looks out of line.
• Numbness, tingling or weakness anywhere, particularly in both arms or in the legs after a fall.
• Neck pain after landing on the head or upper back: do not move the athlete, call emergency services.
• Any head impact with confusion, memory loss, vomiting, a worsening headache or loss of consciousness.
• A joint that cannot be moved at all or that is locked in one position.
• Inability to put any weight on a leg, or a limb that becomes tighter, colder or paler over the following hours.

Sources

• Pediatrics (American Academy of Pediatrics), Loud et al.
• National Center for Catastrophic Sport Injury Research (NCCSIR), 42nd Annual All Sport Report

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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