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Injury incidence and characteristics for elite, male, artistic USA gymnastics competitions from 2008 to 2018
  1. David William Kruse1,
  2. Andrew Seiji Nobe2,
  3. John Billimek2
  1. 1 Primary Care Sports Medicine, Orthopaedic Specialty Institute, Irvine, California, USA
  2. 2 Department of Family Medicine, University of California Irvine, Irvine, California, USA
  1. Correspondence to Dr David William Kruse, Orthopaedic Specialty Institute, Irvine, CA 92868, USA; krusedw{at}


Objectives To determine the injury incidence and characteristics for elite, male, artistic USA gymnasts during gymnastics competitions, held in the USA, from 2008 to 2018.

Methods Injury documentation performed by lead physician and certified athletic trainers at elite junior and senior USA Gymnastics competitions from 2008 to 2018 were reviewed and compiled into an excel database. Injury incidence was computed per 1000 registered gymnasts by competition setting as well as injury location, type, cause, severity, and setting.

Results From 2008 to 2018, 180 injuries were reported in a total of 2102 gymnasts with injury incidence of 85.6 per 1000 gymnasts (95% CI 73.4 to 97.8). The most common injury site was at the ankle (16.7 per 1000 gymnasts, 95% CI 10.9 to 22.4), and muscle strain/rupture/tear was the most common type of injury (28.5 per 1000 gymnasts, 95% CI 21.2 to 35.9). The most common cause was contact with surface (56.1 per 1000 gymnasts, 95% CI 46.1 to 66.2), and the event where most injuries were sustained was the vault (21.9 per 1000 gymnasts, 95% CI 15.4 to 28.4). Incidence of time loss injuries was 38.5 per 1000 gymnasts (95% CI 30.1 to 47.0). Injury incidence was higher during competition (58.5 per 1000 gymnasts, 95% CI 48.2 to 68.8) than during training (27.1 per 1000 RG, 95% CI 19.9 to 34.3; RR 2.16, 95% CI 1.59 to 2.94, p<0.001); injury incidence was greater at Olympic Trials (RR 3.23, 95% CI 1.24 to 8.47, p=0.017) than at National Qualifier meets. We report concussion incidence in gymnastics (5.7 per 1000 gymnasts, 95% CI 2.3 to 9.2).

Conclusions This is the largest injury study to date for male artistic gymnasts (180 injuries, 2102 gymnasts, 11 years).

  • gymnastics
  • injuries
  • concussion
  • injury prevention

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  • DWK and ASN are joint first authors.

  • Contributors DWK: Substantial contributions to the conception and design of the study, collection and interpretation of data, drafting, writing, and revision of the manuscript and final approval of the version to be published. ASN: Substantial contributions to the conception and design of the study, analysis and interpretation of data, drafting, writing and revision of the manuscript, and final approval of the version to be published. JB: Substantial contributions to analysis and interpretation of the data and revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by Memorial Care Research Administration Human Research Protections Programme.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Deidentified injury data that underlie the results reported in this article are available on reasonable request to primary author’s email address with researchers who provide a methodologically sound proposal and can be used to achieve the aims in the approved proposal. Data will be available immediately after publication with no end date.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.