Understanding “Skill Profiles” To Reduce Overuse Injury Risk

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I forget where I first heard the term “movement profile,” but it’s always been something that has stuck with me.

My take on a movement profile is that it entails the overall picture you put together in your mind after studying someone doing certain things, whether they be athletic skills or just basic movement patterns.  A gymnast being known as a “flipper” or “twister” is one example of this idea. Off of this movement profile concept I have always had the idea of a “skill profile” developing for a gymnast based off of where their gymnastics training has taken them through the years.
For compulsory gymnast, their skill profile is relatively similar between athletes as their fundamental skills are selected for them in different levels. However, the skill profile that develops through years of optional level gymnastics training can be drastically between athletes. With a natural propensity towards one skill type a gymnast may start to work variations of the skill on multiple events and create increased injury risks for certain body parts (lower back with lots back handspring type skills). Understanding that different gymnasts may develop different profiles, and also tracking how much of a certain movement patterns they may average (hyper extending, landing impacts, etc) in my mind is crucial for combatting overuse injury risks during training.
From a healthcare point of view I think it’s equally as important as someone may be recovering from an overuse injury related to high volume of that type of skill. I always have a long talk with any gymnastics patients inquiring about what skill first created pain, as well as cataloging all the skills they compete/are working in relation to their complaints. This helps me put together a picture of their skill profile and typical training volume in relation to why they may have gotten injured. It also helps to eventually create a return to gymnastics program that can slowly reintroducing volume to promote tissue adaptation, as well as address skills that may have caused the issue originally. Here are a few examples of what I mean.

Higher Volume Hyper Extension Skills and Lower Back Injury Risk 
A gymnast who naturally develops a great back handspring early on or is more “bendy” may drift towards learning more of these types of skills because they have a natural disposition to them. Their powerful floor back handspring may lead them to training Yurchenko’s on vault. Take for example the gymnast that is tumbling on floor, working Yurchenko’s on vault, does 2 back handsprings for a beam series, and is working drills for an upgraded layout step. If that gymnast eventually starts working Tkachevs or Shaposhnikova’s then that means all 4 events have some form of hyper extending. This makes logical sense and helps them continue to progress based on their strengths, but at the same it has to be monitored over time. They are definitely doing more lower back hyper extending per practice/week/month than other gymnasts with different skill profiles.
This gymnast’s skill profile and possible lower back injury risk is much higher in my mind than a gymnast that say does a Tsuk type vault, back tuck flight on beam, and works overshoot handstand/Geinger drills that aren’t as much hyperextending based. The differentiation in optional gymnastics is half of what makes gymnastics such a great sport, but at the same time we have to be thinking about the overall volume that goes with it. Regular proactive care against for their lower back, screening, and additional adjunctive work may be warranted especially if they are young and approaching a rapid growth spurt or peak height velocity.
Also, in someone who does so much global hyper extending skills it’s especially important that thequality of their extending pattern is sound. We have to make sure that they are spreading out load through their body versus overloading one spot ( lower back , shoulders, etc.).On the rehab and return to sport side, this is extremely important as we don’t want to have the person end up with a re-injury. I think this is a big step to making a dent in their injury risk over years of training.
Standing Extension and Rotation Screening Test
Standing Extension and Rotation Screening Test
Higher Volume Impact Skills and Ankle Injury Risk 
Just as someone may naturally move to more hyper extending type movements, someone who is more powerful may go into the realm of double backs on floor and more impact based tumbling work on beam. Just as with the concept above that gymnast may be doing Tsuk’s on vault, using back/front tucks on beam, and one if not two double flipping skills on floor (double pike, double back, full in, etc). Again, that puts quite a higher load onto the ankles of that gymnast as they are taking many more impacts per day/week/month in training than the gymnast in the hyperextension example. Due to this drastically different skill profile, they may need more thought into their foot/ankle injury risk.
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This gymnast’s skill profile bias towards impacting may require more regular attention to their landing mechanics, being aware of their surface distribution per day/week (use of mats and softer landing vs all hard), making sure they are aware of the starting signs to an overuse injury, ensuring adequate leg strength/control, and a more individualized pre-hab program based around regular care for their feet/ankles. Over a long competition season and through years of training, these impacts can take quite a toll (remember some research suggests between 10x – 17x body weight depending on skill/event/leg symmetry). Then like I mentioned above, should they have an ankle injury and go through rehab we have to consider this when developing a return to sport program. When they are looking to get back to full tumbling/vaulting/dismounts, we have to wean them in progressively based on the surface type and the volume of impact they are taking so we don’t overload the still adapting foot/ankle tissue.
Higher Volume Shoulder Rotation Skills and Shoulder Injury Risk 
Although the two examples above are more for the women’s side of gymnastics, the same concepts apply to men’s gymnastics. Male gymnasts typically tend to have more shoulder injuries due to the inherent nature of their 6 events being more upper body dominant. The young male gymnast who has naturally flexibility shoulders may gravitate towards more in-bar work on high bar (more eagle skills and jams), more one arm end range pbar work like Diams and Healys, or possible more rolling strength skills like Azarians down the road, all in addition to the normal shoulder loading. In my mind this gymnast may be much more at risk for shoulder problems than someone who has a more diverse skill profile that may not include these shoulder intensive skills on each event. Again, it’s not a bad thing I just feel as a coach it’s important to understand this to possible give them additional preventative shoulder work, or monitor how much of these skills are done in a training session and/or week.
Photo Credit: http://www.intlgymnast.com/image/chapot_greg.jpg
Photo Credit: http://www.intlgymnast.com/image/chapot_greg.jpg

Concluding Thoughts 
Gymnast’s are naturally going to gravitate towards their strengths, which is what we want them to do in order to be successful in the sport. However at the same time we have to realize that a tendency towards certain groups of skills or movement patterns can lead to high repetition and as a result possible increased injury risk for certain areas of the body. Being aware of it, taking proactive steps, or introducing some more variability into their training to reduce overload may be important for long term gymnastics outlooks. This conversation has seem to come up a lot with both our own gymnastics team and also gymnastics patients/parents I work with. Just wanted to share and hopefully spark some thought for readers out there. Take care,
P.S. If you enjoy this type of content be sure to sign up for Dr. Joshua Eldridge and I’s upcoming Gymnastics rEvolution Seminars where we will go in depth to these ideas plus so much more!


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