Bill Sands on Achilles

The Chinese women’s gymnastics team was dealt a major blow on Thursday morning when four-time world champion Cheng Fei tore her Achilles tendon during a training session, rendering her unable to compete in the London Olympic Games. …

Team leader Ye Zhennan criticized the Games’ preference for high-difficulty routines, saying it’s the reason competitors get hurt more often.

… Ye wrote on his micro blog on Friday. “The development of the game’s difficulty has gone beyond the female athletes’ physical limits, causing a lot of injuries that will cut their careers shorts.”

Ye said FIG (Federation Internationale de Gymnastique) should take Cheng’s injury seriously and revise its rules. …

China Daily

Not surprisingly, it was triple twist on Floor. Extreme ankle dorsiflexion.

She’s smiling. Click PLAY or watch Cheng from her hospital bed on YouTube.

Seems it takes a serious injury to a major player to get any attention from mainstream media. Gymnastics is dangerous. FIG’s new Code rewards most whomever has the highest start score. Many times that requires athletes to risk more dangerous routines.

I previously said there’s not much we can do to reduce Achilles injury. But perhaps I’m wrong. Here’s full commentary from Dr. Bill Sands on the topic:

I’m really sorry to see another ruptured Achilles tendon. Sadly, I do know the mechanism that causes these injuries …

I have a presentation that I hope to do at the USECA meeting at Congress. The research involving two types of springs is complete. One equipment company has taken the information and redesigned their floor due to the results that I shared with them some months ago.

Achilles tendon ruptures have occurred on foam and spring floors, so it’s not the spring system alone that “causes” the problem. And, herein lies much of the complexity. Again sadly, Achilles tendon ruptures are due to the interaction of “worn” connective tissues from the triceps surae group (e.g. too much training with insufficient recovery), concentration of forces in one of the bundles of connective tissues in the tendon (from Bruggemann, anatomical loading factors), foot position (increased pronation) during takeoff (athletes generally don’t take off symmetrically), and the way the spring floors recoil and move during a take off (causing sudden increased stretch of the triceps surae complex).

Interestingly, I had the first American girl to do a full-in on floor exercise (Christa Canary, I know ancient history) and she did it on two inches of ethafoam over concrete (I’m so old there were no spring floors then). In fact, with a lengthy list of excellent tumblers – I never had a single Achilles tendon rupture. However, we monitored training repetitions of skills very closely using (then) very primitive computers. In my view, there needs to be a paradigm shift in thinking to “preserve the skeleton and connective tissue while training the muscle.” Of course, there are a variety of ways to do this, but monitoring is crucial.

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1. Sands WA. National women’s tracking program pt. 2 – response. Technique. 1990;10(1):23-7.
2. Sands WA. Fragen zum training der nationalmannschaft der US-Junioren (Frauen) im kunstturnen. In: Gohner U, editor. Leistungsturnen im kindesalter. Stuttgart, Germany: Internationaler Turnerbund (FIG) und das Organisationskomitee Weltmeisterschaften im Kunstturnen Stuttgart 1989; 1990. p. 81-96.
3. Sands WA. Monitoring the elite female gymnast. National Strength and Conditioning Association Journal. 1991;13(4):66-71.
4. Sands WA. Monitoring elite gymnastics athletes via rule based computer systems. Masters of Innovation III. Northbrook, IL: Zenith Data Systems; 1991. p. 92.
5. Sands WA. AI and athletics. PC AI. 1992;6(1):52-4.
6. Sands WA. How can coaches use sport science? Track Coach. 1995;134(winter):4280-3.
7. Sands WA. Monitoring power. In: Bardy BG, Pozzo T, Nouillot P, Tordi N, Delemarche P, Ferrand C, et al., editors. Actes des 2Šmes Journ‚es Internationales d’Etude de l’AFRAGA. Univerist‚ de Rennes, Rennes, France: L’Association Fran‡aise de Recherche en Activit‚s Gymniques et Acrobatiques (A.F.R.A.G.A.); 2000. p. 102.
8. Sands WA, editor. Monitoring gymnastics training. 3èmes Journées Internationales d’Etude de l’AFRAGA; 2002 7-9 November 2002
2002; Lille, France. Lille, France: AFRAGA.
9. Sands WA, Henschen KP, Shultz BB. National women’s tracking program. Technique. 1989;9(4):14-9.
10. Sands WA, Shultz BB, Newman AP. Women’s gymnastics injuries. A 5-year study. American Journal of Sports Medicine. 1993;21(2):271-6.
11. Sands WA, Stone MH. Are you progressing and how would you know? Olympic Coach. 2006;17(4):4-10.
12. Sands WA, Stone MH. Monitoring the elite athlete. Olympic Coach. 2006;17(3):4-12.
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Interestingly, I co-hold a patent on a device to prevent extreme ankle dorsiflexion. Feel free to look it up and see if it might help your athletes. The device was required for some of my former gymnasts.

Patent Number #4,227,321. Device called the “Safe-T-Strap” designed to prevent extreme ankle dorsiflexion in gymnasts and other athletes.
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I’ve been studying the spring floor now since about 1994, and even back then the old 2 inch spring floor showed the same problems. I will be submitting the results and manuscript for publication after Olympic Trials. The work includes high-speed video (500-2000 Hz), Vicon kinematics (200 Hz), and the accumulation of work from myself and others for almost 20 years.

Certainly, considerably more research remains to be done. I believe I know the mechanism, but then comes the hard part, how to change apparatuses to reduce or eliminate this problem.

Modeling is going to be needed, and my ability to do that level of work is very limited (I’m a physiologist, although most seem to think I’m a biomechanist). I hope that Maurice Yeadon, Peter Bruggemann, and Jeroen Van der Eb, along with the FIG Scientific Committee will take up this issue. This work is long overdue, and current means and methods of certifying a spring floor are pretty good for engineering, but do nothing to look at the athlete-apparatus interactions. I’ve been preaching this for almost 20 years now. But, then again, who listens to me.

We do, Doc.

Thanks for your work ongoing.