Category: sport medicine

REPOST with comments from Dr. Bill Sands included.

… Utah’s gymnastics team was dealt its second major blow of the season when freshman Kim Tessen tore her Achilles last Saturday. Tessen had strung together a solid debut season and was coming off her best meet of the year before the injury.

Tessen’s season-ending injury follows up Sabrina Schwab’s season-ending ACL tear. …

Tessen is the fifth Red Rock to tear her Achilles in as many years. But Utah isn’t unique, as several other teams have watched athletes succumb to the same injury this season and over the years.

“I think last year we (NCAA teams) had 16 Achilles tears reported, and this year we are already at eight or nine,” said Farden. …

Utah gymnastics still focused despite second season-ending injury

Leave a comment if you have ANY idea how we might reduce the number of Achilles ruptures.

Read a thread on the topic on College Gymnastics Board.

William A Sands, PhD, FACSM:

The Achilles tendon injuries, particularly ruptures are complex. Having studied this problem for over 20 years, I believe there is a small constellation of causative factors working separately and together. However, prediction and prevention remain elusive. I have several presentations with high-speed video of athlete and spring floor interactions, but the files are quite large. I’ve presented at the USAG Congress on this very topic more than once. Seems like it always falls on deaf ears. Well, one more try…

James Linderholm alerted me to a recent discussion on Achilles tendon injuries. I saw a list of these injuries on Rick McCharles site. Below are some references to which you might want to refer when describing and discussing what is known about these injuries and some potential causative factors.

In my view, there are several potential causes, almost impossible to tease apart.

1. The wear-and-tear of long years of training is certainly a factor. Countermeasures for this include the use of ultrasound to examine the tendon and other local structures.

2. We can probably infer from a number of studies that injury incidence and rate are linked to body composition and anthropometry (ie weight and size). Countermeasures for this can include technique alterations, nutritional interventions, and reduction of training load.

3. Floroquinolones are known to cause problems with connective tissue strength and load characteristics. I will assume that most, if not all, sports medicine professionals are aware of this problem and no longer use these types of antibiotics. However, it may be worth a check to ascertain the role(s) of these medications, history of use, and so forth. The evidence, in my view, is pretty clear. Unfortunately, long-term use has not been investigated sufficiently for determination of whether historical use may cause problems. I’m not a physician, so please check with your team doctors.

4. Technique may be involved in that anecdotal discussions have indicated that athletes with low take-off impact angles may be more vulnerable. Most, but not all, Achilles tendon injuries occur during take-offs when ground reaction forces can exceed 15-22 times body weight. Work by Bruggemann and colleagues has shown that the bundles of the tendon are load differentially depending on placement of the feet, ankle and foot anatomy, and other factors.

5. The spring floor may contribute. I have made efforts for more than 20-years to study the spring floor and its relation to take-off injuries. AAI and Whitey Anson have been very generous in helping me work on this problem. There are some interesting aspects that are addressed in citations below, and on my website: http://www.advancedstudyofgymnastics.com. Interestingly, Achilles tendon injuries have occurred on coil spring floors and foam-type floors. I believe that the natural frequency responses (rates of vibration from depression to rebound) are not consistent between the gymnast’s lower extremities and the spring floor. Unfortunately, equipment companies must follow FIG specifications and I believe these specifications, while ensuring some uniformity in design, do not take enough account of biological factors. It is also interesting to note that when T&T coaches are queried about Achilles tendon injuries – these injuries are practically unheard of. Note that the tumbling apparatuses are very different from the artistic gymnastics spring floors. On querying T&T coaches I found that only one Achilles tendon rupture was recalled, and this athlete was a former artistic gymnast and approximately 35-years old. High-speed videography of T&T tumbling surfaces has shown that the lower extremity mechanics are quite different from those used on artistic gymnastics spring floors. T&T tumbling strips are simply more forgiving than artistic gymnastics spring floors.

6. EVERYONE wants to reduce or eliminate these injuries. I hope the information below will enhance discussions that lead to countermeasures that work.