Tumbling Can Lead to Ankle Sprains and Lateral Ankle Instability in Gymnasts

Tumbling Can Lead to Ankle Sprains and Lateral Ankle Instability in Gymnasts

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This summer, millions of people turned their eyes and screens to Paris to watch the 2024 Summer Olympics. Of the 32 sports featured in the games, gymnastics consistently takes top billing in the ratings.³ This year was no different, with the 4 most-watched days coinciding with women's gymnastic events.⁴

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But gymnastics isn’t just popular among TV watchers: according to USA Gymnastics, the sport’s national governing body, there are over 169,000 gymnasts across the US, from beginner youth participants to elite, world-class competitors.⁵

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It’s no surprise the sport attracts fans. The physical prowess gymnasts display as they leap, flip, vault, and sprint is awe-inspiring. But unfortunately, these demands on gymnasts’ bodies also contribute to injury at all levels of competition.

Gymnasts at High Risk for Ankle Injuries

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It’s very common for athletes to suffer from ankle sprains, which are caused when the ankle ligaments are overstretched or torn, since their activities include a lot of running, jumping, twisting, and other movements that can cause stress on the ankle. About 40% of the athletes who suffer a lateral ankle sprain, one of the most common types, develop what’s called chronic ankle instability or CAI.⁶
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Now think about watching a gymnast, whether it’s a young child practicing tumbling or a member of the US Olympic team reaching new heights in her vault routines: no matter who it is, they’re bouncing and landing on their ankles. Part of what gymnasts are judged on is sticking their landings!

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A review of injuries that occurred in gymnasts during the 2008, 2012, and 2016 Olympic Games found that 8.4% of competitors suffered an injury during their time competing.¹ Ankle sprains were the most commonly diagnosed injury, accounting for 14% of all injuries and 23% of the injuries that caused gymnasts to miss time practicing their sport.²

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Many sports fans probably recall, even decades later, when 1996 US women’s gymnastics team member Kerri Strug overcame a severe mid-meet ankle injury to help the US bring home the team gold medal.⁷

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Another study of gymnasts ages 8-26 found half of the study’s 73 participants had incurred an injury in the past 12 months related to their acrobatic gymnastics training.² Over 28% of those gymnasts reported a chronic injury. And just like in Olympian athletes, one of the most common injury sites is the ankle.²

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It makes sense, then, that one review of chronic ankle instability studies found that gymnasts had the highest percentage of ankles with persisting symptoms following an initial ankle sprain.

The InternalBrace™ Ligament Repair Procedure Helps Gymnasts With Ankle Sprain Histories and CAI

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For some people, repeated ankles sprains and chronic ankle instability can be painful, frustrating, and limiting to their favorite activities. Leah D. recalls her competitive gymnastic days fondly—but also the frustration she felt when a chronic ankle injury sidelined her from competition for good.

When she was 11, Leah rolled her ankle after a teammate accidentally cut her off while running. She was diagnosed with an avulsion fracture and a grade 3 ankle sprain. She says her ankle “was never the same” after this injury.

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Unfortunately, it wasn’t the last ankle injury she would experience. Leah kept rolling and spraining her ankle, even after undergoing an ankle reconstruction surgery. She ultimately wasn’t able to practice gymnastics anymore.

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“Gymnastics was a really, really big part of my life at that point… It was very frustrating that I couldn’t do a sport that I loved because I was held back by chronic ankle instability,” Leah says.

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Leah had decades of instability and ankle pain, in addition to a second surgery that still didn’t help.

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Finally, Leah—who works as a college athletic trainer—learned of Brostrom repair with the InternalBrace procedure from an athlete with similar ankle sprain and chronic ankle instability issues.

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That athlete underwent the procedure and felt her repaired ankle was more stable than her uninjured ankle. So Leah decided to discuss her issues with a surgeon and, ultimately, undergo surgery.

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The InternalBrace procedure augments, or enhances, the standard surgical repair by providing a greater surface area where the damaged ankle ligament is compressed back to the bone. This helps secure the primary repair and prevent excess range of motion, which may reduce the chances of re-injury during the healing process. Most importantly, the procedure is designed to help patients get back to activity faster.

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Nicholas T. Gates, MD, an orthopedic surgeon in the Cincinnati, OH, area, has performed the InternalBrace surgical technique for several years to treat patients with chronic ankle instability.

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Dr. Gates shared one example of a 17-year-old competitive gymnast who came to him with a history of ankle sprains and ankle instability, which were impacting her ability to train and compete.

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Particularly with athletic people and competitive athletes, the quicker return to sport is a huge benefit, he says. “The competitive athletes I have treated are very pleased with the earlier return to play compared to protocols I used before adopting InternalBrace augmentation,” Dr. Gates says.⁹

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In the case of this 17-year-old gymnast, the biggest postoperative challenge was keeping her from returning to her sport even faster than Dr. Gates’ 8-week recommendation, due to the fact she was feeling stronger after just a few weeks.

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For Leah, the differences between her earlier ankle surgery, as well as the period she lived with pain and instability without a solution, versus her post-InternalBrace procedure ankle are drastic. Even just two months after her surgery, Leah had zero pain or instability.

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“I feel like I have a new ankle!” she says.

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Leah is a real patient who was compensated for the time she took to share her personal experience with the InternalBrace procedure.

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The InternalBrace surgical technique is intended only to support the primary ligament repair/reconstruction and is not intended as a replacement. The InternalBrace surgical technique is intended only for soft tissue-to-bone fixation and is not cleared for bone-to-bone fixation.    

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 References