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Lower back pain is common in gymnastics. In the July 2011 issue of Technique, Dr. David Kruse stated that up to 80 percent of all gymnasts will experience low back

pain at some point. In this article, we will look at some of the causes of back pain and discuss exercises that can be used to prevent back injuries with athletes.

First, back pain can be serious and the athlete should be seen by a physician or another medical professional if the pain is causing apprehension when performing a skill or is chronic and not improving with decreased activity. Many times it is possible to prevent serious injury by identifying poor mechanics and correcting them before the pain becomes a problem.

A significant cause for low back pain that we have identified is chronic hyperextension of the lumbar spine. Gymnastics skills require significant spinal extension. This motion should be distributed throughout the hip, lumbar and thoracic spine.

Problems begin when the majority of extension comes from the lumbar region due to poor hip extension and poor thoracic extension. This is seen in the athletes that have a “V” appearance in the lumbar spine instead of a “C” appearance (See picture 1 and 2). Increasing hip extension begins with stretching the hip flexors without allowing excessive lumbar extension often

Darrell Barnes, LAT, ATC, CSCS

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Darrell Barnes, LAT, ATC, CSCSDarrell Barnes, LAT, ATC, CSCS

PREVENTING

IN GYMNASTICS

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“V” APPEARANCE (INCORRECT)

“C” APPEARANCE (CORRECT)

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seen in the split stretch (picture 3). Hip extension is also increased by strengthening with a glute bridge while not allowing the back to hyperextend. (picture 3 and 4).

Thoracic extension is commonly limited due to poor anterior shoulder posture. Thoracic mobility exercise begins with the athlete seated with knees higher than hips to decrease lumbar movement. Clasp hands behind the neck and squeeze elbows together. Instruct them to lift elbows to the ceiling and push the chest up and out. Hold 3–5 seconds and repeat 10 times. Increasing thoracic rotation helps to improve extension and will decrease the torque on the lumbar spine with rotational skills. Rotation is improved by placing an arm behind the neck and rotating toward that side while being in a plank and quadruped position (“all fours”) (picture 5, 6, 7).

The key is to limit lumbar motion and accentuate thoracic motion (hold 3–5 seconds 10 times each).

Core strengthening is essential to stabilize the lumbar spine throughout the entire range of motion needed in gymnastics. Core strengthening exercises are commonly done poorly, which can lead to overactive hip flexors and add to hyperextension of the lumbar spine. Exercises should focus on stabilizing the spine first, then large movements second, and should include lower and upper abdominals, trunk rotation and back strengthening. Included are pictures of a few basic exercises (pictures 8, 9, 10, 11, 12).

...continuedDarrell Barnes, LAT, ATC, CSCS

throughout the entire range of throughout the entire range of motion needed in gymnastics. motion needed in gymnastics. Core strengthening exercises are Core strengthening exercises are commonly done poorly, which commonly done poorly, which can lead to overactive hip flexors can lead to overactive hip flexors and add to hyperextension of the and add to hyperextension of the and add to hyperextension of the and add to hyperextension of the lumbar spine. Exercises should lumbar spine. Exercises should focus on stabilizing the spine first, focus on stabilizing the spine first, focus on stabilizing the spine first,

behind the neck and squeeze elbows behind the neck and squeeze elbows

The key is to limit lumbar motion The key is to limit lumbar motion and accentuate thoracic motion and accentuate thoracic motion

Core strengthening is essential Core strengthening is essential to stabilize the lumbar spine to stabilize the lumbar spine throughout the entire range of throughout the entire range of throughout the entire range of throughout the entire range of

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PREVENTING

IN GYMNASTICS

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S E P T E M B E R / O C T O B E R 2 0 1 1 • T E C H N I Q U E 31

Name State Name State Name State

IMPORTANT NOTICEThe following Membership Statement has been adopted by the USA Gymnastics Board of Directors:

• Membership in USA Gymnastics is a privilege granted by USA Gymnastics. That privilege can be withdrawn by USA Gymnastics at any time where a member’s conduct is determined to be inconsistent with the best interest of the sport of gymnastics and of the athletes we are servicing.

The following former professional members are permanently ineligible for membership within USA Gymnastics:

Julian Amaro CA Charles Theodore Bates MN James Bell WA Kristopher Berry SC Phillip Bishop MI Patrick Bogan MD Douglas Boger CA Joseph Bowers OH Shawn Bowlden IL Vince Brown SC Edward Trey Coniff TX James Craig III CO Thad Cypher MI Steven Elliott TX Anthony Engelke PA Matthew H. Erichsen WA Rick Feuerstein CA William Foster AL Joseph Fountain MD Roy Larry Gallagher PA Robert Allen (Bob) Garner TN Sean Gilham CA Timothy Glas NE Ricardo “Chico” Goddard NY Marcelo Guimaraes TX Vernor Gumila ILPaul Hagan MI

Robert Dean Head KYTed Hicks TN Michael Hinton TN Nicholas Hitchcock MI Robert Hoefer FL Frank Hohman, Jr. PA Milos Hroch CA Steven L. Infante (197212, 197213, 197214) CT Dana Koppendrayer FL Ronnie Lewis AR William McCabe GA Robert Mollock OR John S. Moore WV Gregory Muller IDWilliam Munsinger MN Jeena Nilson UT Paul O’Neill CA Patrick Okopinski WI Marian Penev NY William M. Permenter FL Timothy Picquelle CA David Pyles AZ Jeffrey Richards FL Rudy Rodriguez CA John H. Row DE Gabriel Salazar TX

Mark Schiefelbein TN Robert Shawler CA Steve Shirley MO Steven Todd Siegel CO Blake Steven Starr UT Paul Summers OK Mark Swift FL Freddie Eugene Tafoya, Jr. CAJay Thomas LAJon Oliver Kenneth Thomas VABrent Trottier WAJon Valdez IL Anthony Van Kirk CA Joel Velasquez OR David Paul Waage OR Chris Wagoner TXJeremy Waldridge ORRussell Wallace CT Brooklyn Walters IN Steve Waples TX Donald Watts KY Mike West WA Jonathan White CA Lyf Christian Wildenberg MN Bill Witthar MO Joel Woodruff TX

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As hip and thoracic spine mobility improve and the ability to stabilize and control lumbar mobility increases, put them all together. Ball bridging and wall drills (picture 13, 14, 15) allows the teaching of proper mechanics and decreases excessive hyperextension of the lumbar spine. Ball bridging puts the athlete in a supported position and allows them to practice bridging while focusing on pushing through the hips and thoracic spine. The wall drill is similar, but is from a standing position and is a good transition from the ball to actual skills. Achieving good, pain-free mechanics allows for progression to trampoline, tumble track and floor tumbling.

Back pain is such a common occurrence in gymnastics but can

St. Vincent Hospital and St. Vincent Sports Performance in Indianapolis, Ind., are official service providers to USA Gymnastics. Call 317-415-5747 or visit sportsperformance.stvincent.org

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St. Vincent Hospital and St. Vincent Sports Performance in Indianapolis, Ind., are official service providers to USA Gymnastics. St. Vincent Hospital and St. Vincent Sports Performance in Indianapolis, Ind., are official service providers to USA Gymnastics. St. Vincent Hospital and St. Vincent Sports Performance in Indianapolis, Ind., are official service providers to USA Gymnastics.

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Call 317-415-5747 or visit sportsperformance.stvincent.org

15be limited by improving hip/thoracic mobility and developing core strength and proper tumbling mechanics.