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Elbow Injuries In Tumbling Athletes

Elbow Injuries In Tumbling Athletes

by Tara Hackney, PT, DPT, OCS, KTTPLeave a Comment

Tumbling athletes, which include gymnasts and cheerleaders, have unique demands placed on their upper body. When tumbling, the athlete places not only their entire body weight through their hands but can have up to 16 times their body weight in force going across the wrist and arm. For that reason, the elbow can be injured more often in these athletes. In this blog, we will take a closer look at several types of injuries that can occur in tumbling athletes, along with symptoms and treatment options.

OCD Lesion

What is it: Osteochondritis Dissecans (OCD) lesions can be found in the elbows of adolescent athletes. The exact cause of OCD in the elbow is unknown, but repetitive microtrauma and decreased blood flow to the area are believed to play a role2. Due to this, a piece of cartilage separates from the bone3. OCD lesions in tumbling athletes may be caused by repetitive weight bearing on the hands with the elbow in extension such as during tumbling passes.

Symptoms: Symptoms of OCD in the elbow can vary widely. There is usually pain, tenderness, and swelling near the elbow. The athlete may not be able to extend their elbow fully. Sometimes it is difficult to distinguish OCD from tendinitis type pain; OCD lesions are more often found in specific patient populations such as adolescent and teen gymnasts.

Treatment: Treatment for OCD can be non-operative which would include rest and restrictions from sport. For tumbling athletes that means no weight bearing and no tumbling. Physical or occupational therapy for muscle strengthening of both the elbow and surrounding areas is also recommended. In some cases, the OCD lesion requires surgery which would be followed by physical or occupational therapy to regain range of motion and strength.

UCL Tear

What is it: The ulnar collateral ligament (UCL) is located on the inner portion of the elbow. The UCL helps provide stability to the elbow joint. An injury to the UCL can occur due to overuse and repetition such as with throwing sports or can be due to trauma such as a fall onto an outstretched arm which can happen during tumbling sports.

Symptoms: Symptoms of a UCL tear include pain, swelling, and tenderness over the inner elbow. There may be a pop heard or felt in the inner elbow when the injury occurs, as well as elbow stiffness. Occasionally, athletes report numbness or tingling into the thumb side and pinky.

Treatment: Treatment may consist of a more conservative approach such as physical or occupational therapy or surgery might be required depending on the severity of the tear. MRI imaging is needed to confirm the diagnosis and determine the severity. Often a brace is used to immobilize the elbow shortly after injury. Physical or occupational therapy would help with recovery to work on range of motion, flexibility, and strength of the entire arm, as well as help with the return to tumbling when they are cleared to do so.

Elbow Tendinitis (“Tennis Elbow” Or ”Golfer’s Elbow”)

What is it: Tendinitis is caused by repetition or overuse of a certain muscle or area. In the elbow, this can occur on either the inner (“golfer’s”) or outer (“tennis”) portion of the elbow. Tumbling athletes place their entire body weight through their arms repetitively during their sport. If the athlete has recently increased their activity level or increased their skill level, they can be at an increased risk of developing tendinitis in the elbow.

Symptoms: Symptoms of tendinitis include tenderness, pain in the elbow, pain with gripping, and possible swelling over elbow. Tumbling is often painful and difficult to perform.

Treatment: Treatment for elbow tendinitis may include rest from aggravating activities or modifying the number of repetitions to avoid a flare up of symptoms. Physical or occupational therapy may be helpful to treat tendinitis to help with stretching and strengthening the elbow and surrounding muscles. The length of treatment depends on the severity of the tendinitis; the sooner you can start treating the pain, usually the quicker you can get back to all your activities. Athletes should also be sure to have a good shoulder, elbow, and wrist strengthening program to perform regularly to prevent re-occurrence of tendinitis.

Options For Strengthening While Allowing Your Elbow To Rest

If you have an injury to your elbow and are not allowed to tumble, there are still many activities you can do to stay active while you are letting your elbow heal. Core strengthening is vital to tumbling athletes as well as lower body strengthening. Athletes can work on improving lower extremity flexibility and they can perform cardio exercise to maintain their fitness. Generally, shoulder and wrist strengthening can also be performed but may be at the discretion of the doctor or physical/occupational therapist during the initial healing phase.

Athletico provides rehabilitation services to gymnasts and cheerleaders at all levels and abilities. Our goal is to evaluate, treat, and educate athletes in the prevention of practice and competition-related injuries. Technical evaluations can be performed to improve postural awareness and maximize the function of each athlete. We have physical therapists, occupational therapists, and athletic trainers, including former gymnasts and cheerleaders at the high school, collegiate, and Olympic levels, involved with our Gymnastics and Cheerleading Program. Our clinicians understand the demands of the sport and use their personal and professional experience to effectively address the physical and psychological needs of each athlete.

If aches, pain, or injury is holding you back in practice or competitions, schedule a free assessment with one of our movement experts who can assess your current condition and recommend the best treatment option to help you feel your best. Free assessments are available in-person and virtually through our telehealth platform.

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*Per federal guidelines, beneficiaries of plans such as Medicare, Medicaid, Tricare, VHA and other federally funded plans are not eligible for free assessments.

The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

1. Webb BG, Rettig LA (2008) Gymnastic wrist injuries. Curr Sports Med Rep 7:289–295
2. Kajiyama S, Muroi S, Sugaya H, et al. Osteochondritis Dissecans of the Humeral Capitellum in Young Athletes: Comparison Between Baseball Players and Gymnasts. Orthopaedic Journal of Sports Medicine. 2017;5(3):2325967117692513. doi:10.1177/2325967117692513.
3. Van Bergen CJ, van den Ende KI, ten Brinke B, Eygendaal D. Osteochondritis dissecans of the capitellum in adolescents. World Journal of Orthopedics. 2016;7(2):102-108. doi:10.5312/wjo.v7.i2.102.

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About the Author:
Tara Hackney, a physical therapist in Marion, IA, enjoys working with all patient types, especially gymnasts, cheerleaders, and dancers. She is the prominent blogger for Athletico's Gymnastic/Cheer Program. With an orthopedic specialization and training in dry needling and Graston technique, Tara hopes to answer your questions about injuries and injury prevention in an easy-to-understand manner. She hopes to ease fears surrounding pain and injuries, address concerns about recovery, and provide tips to prevent injury. In her free time, she enjoys spending time with her dog, reading, and watching her nephews play sports.

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