Shoulder Injuries and Gymnastics

The problem with habitual hollowing of the chest in gymnastics is that it causes very tight pectorals, front deltoids, biceps, lats and teres major. Apart from the excessive training and overdevelopment it gives the rectus abdominus, poor shoulder flexibility in female gymnasts and zero external rotator work can lead to bad shoulder injuries.

Focusing more on dynamic “flexibility” training offsets the possibility of discovering shoulder limitations until the injury actually occurs. One solution to avoid shoulder injury is to perform slow stick dislocates to condition and add shoulder flexibility.

For male gymnasts, inflexible shoulders are not the main concern. Training and performance on the rings opens up the shoulders, but this can bring about totally different shoulder problems relating to extreme rom and excessive rotator cuff motion.

A male gymnast performing on the rings puts a huge strain on his shoulder girdle. Doing isolation rotator training with bands and dumbbells, working the transverse, sagittal and frontal planes, will help in stabilizing the shoulders. Adding exercises targeted at the rear deltoid and rhomboid also aids in counterbalancing gymnastics training and lessens the risk of injury.

Speaking from his experience as a gymnast during the 1970’s, Mark Alexander once recalled acquiring chronic shoulder bursitis and tendonitis, before fully dislocating his shoulder while working the rings, effectively ending his gymnastics career. He recommends that coaches take injuries more seriously, as a lot of the injuries in young athletes show up later as arthritis in their thirties and forties.

Types of Injury

The two main types of shoulder injuries gymnasts suffer from are inflammation supraspinatus tendon and rotator cuff injuries. The supraspinatus tendon runs along the top of the shoulder blade and inserts via the tendon at the top of the arm (humerus bone). This muscle is used to lift the arm up sideways and is used extensively in gymnastics.

The rotator cuff is a group of muscles which work together to provide the Glenohumeral (shoulder) joint with dynamic stability, helping to control the joint during rotation (hence the name). Due to the function of these muscles, gymnastics which involves a lot of shoulder rotation often puts the rotator cuff muscles under a lot of stress.

Symptoms of an inflamed supraspinatus tendon include:

• When the gymnast lifts the arm sideways and rotates the arms he/she will complain of pain and weakness.
• The gymnast will complain of pain when you press in at the inside front of the upper arm.
• A useful test to establish if it’s the tendon that is damaged rather than the bursa is the gymnast is more likely to get more pain when the arm is lifted sideways against resistance.
Symptoms of a rotator cuff injury include:
• The gymnast will know about a rotator cuff injury! He/ She will experience sudden excruciating pain in the shoulder and they will "feel" a tearing feeling in the muscle.
• Limited movement of the shoulder due to pain or muscle spasms.
• The first few days the gymnast will be in severe pain for a few days which is because of the bleeding and muscle spasm.
• Their will be tenderness in a specific place on the shoulder rather than the entire shoulder and the gymnast will find it virtually impossible to raise their arm to the side without assistance
What can the gymnast do for an inflamed supraspinatus tendon?
• Rest until there is no pain.
• They must however continue pain free mobility exercises to keep the full range of movement in the shoulder.
• Apply heat and use a heat retainer.
• See a sports injury specialist or doctor who can advise on rehabilitation.
What can a sports injury specialist do for an inflamed supraspinatus tendon?
• Prescribe anti-inflammatory medication.
• Recommend a full rehabilitation programme consisting of mobility, stretching and strengthening exercises.
• If it is bursitis the doctor can drain the bursa.
You can return back to gymnastic training in about 3 to 4 weeks but if you do not rest and follow the rehabilitation programme while you are injured, it could become a chronic problem and affect you sporadically for many years.

When should I seek medical attention for my Rotator Cuff Injury?

Seek medical attention if:
• The pain persists for more than 2-3 days
• You are unable to do daily activities due to the pain.
• You are unable to reach up or to the side with the affected arm after 2-3 days
• You are unable to move the shoulder and arm at all.

What should I expect when I visit a healthcare professional with a possible Rotator Cuff problem?

• Both shoulders will be looked at and compared both visually and using physically.
• Your neck, elbows and wrists will be checked to make sure they are not contributing to the problem
• Range of movement will be assessed, you'll be asked to do certain movements and the clinician will observe and ask you to report any pain (but will not be done if a fracture is suspected)
• Passive range of movement will be assessed, you will be asked to lie on a couch while the clinician moves your shoulder (but will not be done if a fracture is suspected)
• Sensation and strength in the arm will be assessed
• Some specific tests will be done which can help to identify which tendon is causing the problem and confirm if it is a rotator cuff tear, or due to inflammation or some other cause.

Treatment for an Acute Rotator Cuff Injury

• Apply ice to reduce swelling. Shoulders supports that have ice packs built into them provide a better alternative.
• Control the pain with appropriate medications
• Rest the arm, a sling can sometimes be quite useful if you still need to go to work/school, which can be removed at night
• A shoulder support will reduce pain, inflammation and speed up healing (view below).

Vulkan Sports Shoulder

5 Star Rating

This high quality neoprene shoulder strap helps reduce shoulder pain, reduce swelling and accelerate healing. Custom fits the shoulder itself.

How does it work?

The Vulkan Neoprene range features premium quality neoprene. This offers support, compression, heat retention and comfort. Vulkan Neoprene has a unique spiral lining for removing excess perspiration, which avoids skin problems and is more comfortable to wear.

Retaining heat and providing support is helpful for the treatment and prevention of shoulder pain. By increasing local blood flow, healing and recovery times can be reduced following a shoulder injury. The Vulkan Shoulder Strap applies uniform compression around the 'ball' of the shoulder (Deltoid and Rotator cuff region). Women often find that the Vulkan Shoulder Strap is very comfortable to wear as the strap does not cut across the breast region.

Anytime for therapeutic heat and pain relief for shoulder bursitis, rotator cuff injury or impingement syndrome. It is Ideal for sports, where a restriction of shoulder movements is not desirable Unrestricted arm movement.

View the shoulder support which is ideal for gymnasts who wish to treat or prevent an shoulder injury

• You may require imaging studies (X-ray, MRI, CT Scan) to identify what the problem is and rule out any fractures
• Consider consulting a physiotherapist who can assist you with rehabilitating the injury
• If the injury is quite severe and you are young and active, you might require an operation to fix the tear.