USING SCREENING RESULTS

Areas of weakness identified by screening can aid construction of an appropriate S&C plan1

IMPROVING MOBILITY

ANKLE MOBILITY

Evidence suggests restricted ankle dorsiflexion (DF) range of movement (ROM) in non-injured athletes alters gait and landing mechanics2, predisposing to injuries2-4.  There is no clear consensus on what defines restricted DF ROM5 thus results must be interpreted using experience. Several methods of improving ankle DF have been described in non-injured individuals.  Static, PNF stretching5, stretching immediately after calf raises5, and dynamic stretches6,7 effectively increase short term DF ROM  Dynamic stretching is preferred prior to training due to static stretching resulting in short- term decreases in force production8 & gymnastic performance9,10.  Ballistic stretching is ineffective11.  Self-myofascial release (SMR) also provides short term improvements in DF ROM possibly ≈30 minutes, although the exact duration is unclear12,13,15.  Good evidence demonstrates eccentric single leg calf lowers improve both short and long-term ankle DF ROM14,15. Currently insufficient evidence exists to recommend soleus trigger point therapy and ankle joint mobilisation techniques5.

 

Considering only eccentric training has clear long term effects14,15, gymnasts with restricted ankle DF ROM should utilise eccentric calf lowers, combined with stretching, using appropriately timed static stretching along with SMR and dynamic stretching immediately prior to training.

 

 

 

 

 

 

 

 

 

 

 

 

Logic suggests a lack of extensibility in forearm muscles limits wrist extension thus, forearm SMR may be beneficial13 in gymnasts with inadequate wrist extension. Because of the positive short-term effects of dynamic stretching on ROM16, SMR prior to weight bearing dynamic exercises has been advocated with anecdotal success17.  Although commonly performed, there is insufficient evidence in peripheral joints that joint mobilisation techniques and manual therapy are beneficial5,18 Evidence evaluating evaulating specific wrist ROM is lacking, and no research is in gymnasts thus more research is required.

WRIST MOBILITY

SHOULDER MOBILITY

Sub-optimal motor control of the shoulder is a reported risk factor for injury in overhead athletes19-23 and is likely to influence handstand technical ability24.  Scapular dyskinesis such as increased anterior scapular tilt and reduced scapular upwards rotation has been linked to decreased serratus anterior and lower trapezius activity and increased in upper and mid trapezius muscle activity21,22,24,25.  Thus, these muscle imbalances have been addressed with serratus anterior and lower trapezius muscle exercises in rehabilitation settings26.  Additionally, reduced extensibility of the pectoralis minor25 will inhibit scapular movement and a lack of extensibility of latissumuss dorsi and pectoralis major restricts GH joint function27,28 causing compensatory lumbar extension27 suggesting SMR and dynamic stretches of these muscles will provide short term benefit.  Much of the research is in rehabilitation, examining links between injury and abnormal movement rather than interventions to improves these alterations.  The significance of dyskenesis in gymnasts and athletic populations is unclear thus more research is required examining intervention efficacy and relevance in gymnastics.  Meanwhile a focus on areas neglected by their usual gymnastics training combined with improving general strength and motor control to consciously control scapulae may be beneficial29.  Appropriate coaching is important and using visual feedback may be required.

HIP MOBILITY

Due to considerable research advocating dynamic stretching for increasing joint ROM, without detrimental effects on force production16 or gymnastic performance9, coaches advocate SMR followed by dynamic stretches for increasing hip mobility, especially pre-performance.  In footballers, dynamic stretching produced greater increases in hip ROM30 than static stretching.    Furthermore, improving trunk motor control and endurance may also improve hip mobility31 although niether studies used gymnasts who are likely to have greater hip ROM than other populations.  Ballistic stretching is not recommended due to non beneficial effects on performance, combined with the potential for injury32,33.  Static stretching is likely to be beneficial34, providing timing is considered8-10.  Vibration techniques combined with stretching have shown promise for increasing hip ROM in gymnasts in the forward splits34-37, although the equipment utilised varied and is not readily available.

IMPROVING NEUROMUSCULAR CONTROL

Hypermobility is common in gymnasts, especially females38-40.  Hypermobile populations demonstrate decreased proprioception41,42,, with hypermobile elite young athletes displaying decreased postural stability compared to non-hypermobile peers43.  Whilst hypermobility has advantages, improving proprioception along with body awareness and motor control is likely to be important44.  This may be achieved by improving balance, muscular coordination, strength and endurance45.   Appropriate coaching is critical, with the use of mirrors or video feedback to aid proprioception in addition to appropriate verbal feedback and cues45,46.  It is suggested to improve motor control, joints should first be trained in inner to middle range before progressing to end range where stability is decreased and consideration should be given to proximal joint stability44-48.   In non-gymnasts, closed chain exercises have been suggested initially to enhance proprioceptive feedback and control before progressing to open chain multi-directional exercises47,48.  One study utilized eccentric training to improve elbow hypermobility49.  Despite not specifically testing for hypermobility the Y- balance test and FMS may indicate extreme ROM41-43 thus training to improve proprioception and NM control may be useful and further healthcare advice required.

IMPROVING LANDING MECHANICS

Two metanalyses examining the effect of short term neuromuscular training programs designed to improve nervous system function and muscular co-ordination suggest the combination of leg and possibly trunk strength training, jump landing tasks and plyometrics with appropriate coaching and balance training are effective at improving altered landing mechanics such as valgus50,51 when performed at least once a week for a minimum of 6 weeks51. Balance or strength training alone is unlikely to be effective51, crucially, the gymnast must learn how to use their strength when landing through appropriate coaching and visual feedback.  Identifying the specific landing alterations allows individualisation, which may be more effective51,52, however generic neuromuscular plans are effective50,51, so may be used when more than one alteration is present51 or when training a large group with multiple altered abnormalities. In young gymnasts, emphasis should be on quality of motor skills rather than performance51. Others factors such as restricted ankle ROM may also influence landings2, furthermore, although evidence is good that knee valgus can be improved, other knee and hip biomechanical variables associated with knee injury may not improve with training50, additonally, evidence in gymnasts is lacking with literature specifically aimed at decreasing risk of non-contact ACL injury.

IMPROVING LEG STRENGTH

Resistance training improves muscular strength in youths53,54, although maturation stage and gender play a part in efficacy54,55.  Unilateral resistance exercises are often utilised due to specificity and the bilateral deficit effect where it is possible to produce greater force in the two sides combined compared with a bilateral movement56.   Evidence suggests however, that strength and sprint speed improvements are equal between unilateral and bilateral exercises55-57.  There may however be differences in muscle activation in females with the rear elevated split squat (RESS) demonstrating greatest hamstring muscle activity, greatest gluteus medius muscle activation in the single leg squat (SLS) and greatest quadriceps muscle activity in the bilateral squat58,59.  Although studies in males demonstrated no difference60,61, differences may also be due to level of experience62.  Only the SLS is truly unilateral with the rear foot supporting around 15% in RFESS58 and there is no evidence examining squat variations in young gymnasts, however both are likely to be beneficial for leg strength as part of a varied plan.  Intensity and volume for strength depends on the training age, for youths performing multi joint exercises, once the technique can be performed correctly with light load, it is suggested that 2-4 sets, 6- 12 repetitions are used62. One repetition maximum (1RM) testing is not always feasible and research suggests prescribing load based on 1RM may be inaccurate in novices63.  Rating of percieved exertion (RPE)64 may be a useful alternative65 as it allows for some of the limitations of 1RM66-70. Youths recover quicker than adults thus rest periods of 1 minute between sets maybe adequate in younger gymnasts71.   

HAMSTRING STRENGTH

Training with accentuated eccentric muscle action (AEMA) utilises both eccentric and concentric muscle actions with emphasis on the eccentric72 portion, and is used to increase hamstring strength72,73.  Benefits in strength and power have been demonstrated in adult athletes73 as well as enhancing flexibility14 and reducing injury risk74, although studies mainly use male football players.  Considering gymnasts require strength at extreme ranges of motion, it seems sensible to utilise as AEMA training, considering implications of the resultant muscle soreness.   However more studies are required in gymnasts examining different exercises protocols and their effect on performance & injury.

CALF COMPLEX STRENGTH & ENDURANCE

Calf complex strength and endurance is important to minimise risk of injury and for strength and power during tumbling75,76.  Plyometric training and resistance training have been shown to increase calf strength77 however because gymnasts already perform a high volume during technical training it seems prudent to manage load carefully and consider other modalities.  Eccentric unilateral calf training is useful as it increases tendon cross sectional area and stiffness as well as muscle function, increasing stretch shortening cycle function and therefore power as well as strength73 & flexibility14.  No research involved gymnasts.

IMPROVING TRUNK STRENGTH & ENDURANCE

In elite junior female gymnasts, a progressive 8-week training intervention progressing from static stable exercises to dynamic unstable exercises consisting of 3 sessions a week improved trunk endurance78.  A study in college gymnasts suggests a 10-week trunk training program of just 2 x weekly, 15 min trunk muscle training targeting mainly trunk extensors and lateral flexors also improved trunk endurance79. The authors also suggest the incidence of back pain decreased.   Another study80 in female college gymnasts suggested a 3-week trunk training intervention resulted in improved handstand performance, however methodological flaws in all three studies makes validity questionable.  In dancers dynamic balance, co-ordination and vertical jump performance81 improved following a high volume progressive plan, involving trunk stability exercises on stable and unstable surfaces, in addition to proprioception and balance tasks, progressing to dance specific exercises.   It is suggested that for sports performance, strength, endurance and muscular co-ordination should be considered82, including resisting movement (extension, lateral flexion and rotational forces) as the purpose of the trunk is for force transfer and movement resistance83 and as well as creation of sppropriate flexion, rotation and extension in certain movements .  These should be progressive81 and can be periodised around the competetive season.

IMPROVING LEG POWER

Several techniques are commonly used to improve lower limb power in youths and young athletes including plyometrics, weightlifting and kettlebell exercises, with most research in youth athletes84,85,86 and gymnasts87,88,89 utilising plyometrics.  In youths, jump performance improvements occurred following plyometric training84,85. Sessions of > 2 sessions/ week, longer sessions > 30 minutes, and programs of > 8 weeks are likely to be more beneficial, with rest periods of 60 seconds more beneficial than 30 seconds84.  In gymnasts, plyometric training improved jump parameters87,88,with no increased injury risk88. Furthermore, possible improvements in vault kinematics occurred, although vault performance was not evaluated87.   Gymnasts have a high plyometric ability90, performing 3000-4000 contacts/week from a young age89, demonstrating superior jumping ability compared to other athletes89, implying more advanced plyometrics such as drop jumps may be useful providing load is monitored. A study found drop heights of 40-60cm were optimal for well-trained female and male gymnasts respectively89,  Less experienced gymnasts required 20-40cm with elite, world champions requiring 80cm89.   Excessive heights should be avoided as they increase contact time and compromise technique. Maturation status affects motor control and training efficacy84,85,91

 

There is evidence that weightlifting improves power production, rate of force development, sprint speed and jump height in adults92-97 & children98,99.  Furthermore, research suggests that when appropriately taught and supervised, weightlifting in youths is safe100, however there is no research examining their effect on gymnastic performance.  There is some suggestion that weightlifting pulling derivatives are of equal, or even greater benefit to athletes101,,102.  Furthermore, they likely require less time teaching and involve less loading of the wrists and elbows103.  The small amount of research examining power output for these suggests that that relatively light loads of 30-45% hang power clean 1RM are optimal101,,102 with the intention to move as explosively as possible important104,105.  The majority of weightlifting studies used progressive loading with twice weekly sessions. 

 

Kettlebell swings increase lower limb strength and power  in adults106,107 as effectively as weightlfting107, however greater strength improvements occurred with weightlifting107.  Increased strength and power also occurred after a kettlebell intervention with progressively increasing training intensity and exercise complexity, although the study used recreationally active adults not young athletes108.  Another study utilizing kettlebell swings alone did not improve sprint performance109, suggesting kettlebell swings alone are inadequate, although the duration was shorter. More effective kettlebell plans utilized larger volumes, less rest and heavier loads110.  There is limited evidence using kettlebell training and none in gymnasts, however, extrapolating from other populations, kettlebell training may be a useful variation.  Additionally, there are early indications that kettlebell training may improve lower back pain111 improving postural reactions to sudden perturbations112 although further research is required.

IMPROVING LEG ASYMMETRIES

Short term interventions involving combinations of unilateral and bilateral strength, plyometric training and balance training have all seemingly improved limb asymmetries of greater than 10-25%113-118, however, limitations in study design, notably, the lack of comparison of the reduction in asymmetry compared to test variability of error119, makes interpretation difficult.  Furthermore, a metanalysis demonstrated equivocal evidence relating improvement to sports performance, suggesting improvements were probably sports specific, therefore the lack of research in gymnasts means directly applying evidence from other sports may be inappropriate.  Moreover, asymmetries may be desirable as gymnasts demonstrating a high degree of limb dominance during beam routines120 and many gymnastic elements involve asymmetrical limb loading121.  A coach should also consider the impact on motor control of improving strength and power in the non-dominant leg with a transient drop in performance common, thus intervention timing should be considered122.

SUMMARY

The results of screening and assessment can help formulate an individualised strength and conditioning program for gymnasts, however other factors such as training age, goals, maturation stage, and phase of the season should be considered.  Except in trunk training and plyometrics, research is lacking in gymnasts, thus much of the evidence is extrapolated from other sports which may not always be transferrable. The athlete should be reassessed relatively regularly to assess the efficacy of the training plan.  There are other things to consider such as upper body power and strength which will be discussed in another post.

REFERENCES

  1. Myer, G. D., Ford, K. R., Brent, J. L., & Hewett, T. E. (2007). Differential neuromuscular training effects on ACL injury risk factors in" high-risk" versus" low-risk" athletes. BMC Musculoskeletal Disorders, 8(1), 39.

  2. Mason-Mackay, A. R., Whatman, C., & Reid, D. (2017). The effect of reduced ankle dorsiflexion on lower extremity mechanics during landing: A systematic review. Journal of Science and Medicine in Sport, 20(5), 451-458.

  3. Malliaras, P., Cook, J. L., & Kent, P. (2006). Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. Journal of Science and Medicine in Sport, 9(4), 304-309.

  4. Backman, L. J., & Danielson, P. (2011). Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study. American Journal of Sports Medicine, 39(12), 2626-2633.

  5. Young, R., Nix, S., Wholohan, A., Bradhurst, R., & Reed, L. (2013). Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of Foot and Ankle Research, 6(1), 46.

  6. Samukawa, M., Hattori, M., Sugama, N., & Takeda, N. (2011). The effects of dynamic stretching on plantar flexor muscle-tendon tissue properties. Manual Therapy, 16(6), 618-622.

  7. Pamboris, G. M., Noorkoiv, M., Baltzopoulos, V., Gokalp, H., Marzilger, R., & Mohagheghi, A. A. (2018). Effects of an acute bout of dynamic stretching on biomechanical properties of the gastrocnemius muscle determined by shear wave elastography. PloS one, 13(5), e0196724.

  8. Simic, L., Sarabon, N., & Markovic, G. (2013). Does pre‐exercise static stretching inhibit maximal muscular performance? A meta‐analytical review. Scandinavian Journal of Medicine & Science in Sports, 23(2), 131-148.

  9. Siatras, T., Papadopoulos, G., Mameletzi, D., Gerodimos, V., & Kellis, S. (2003). Static and dynamic acute stretching effect on gymnasts’ speed in vaulting. Pediatric Exercise Science, 15(4), 383-391.

  10. Di Cagno, A., Baldari, C., Battaglia, C., Gallotta, M. C., Videira, M., Piazza, M., & Guidetti, L. (2010). Preexercise static stretching effect on leaping performance in elite rhythmic gymnasts. Journal of Strength & Conditioning Research, 24(8), 1995-2000.

  11. Medeiros, D. M., & Martini, T. F. (2017). Chronic effect of different types of stretching on ankle dorsiflexion range of motion: Systematic review and meta-analysis. The Foot. 34, 28-35.

  12. de Souza, A., Sanchotene, C. G., da Silva Lopes, C. M., Beck, J. A., da Silva, A. C. K., Pereira, S. M., & Ruschel, C. (2017). Acute effect of two self-myofascial release protocols on hip and ankle range of motion. Journal of Sport Rehabilitation, 1-21.

  13. Beardsley, C., & Škarabot, J. (2015). Effects of self-myofascial release: a systematic review. Journal of Bodywork and Movement Therapies, 19(4), 747-758.

  14. O'Sullivan, K., McAuliffe, S., & DeBurca, N. (2012). The effects of eccentric training on lower limb flexibility: a systematic review. British Journal of Sports Medicine, 46, 838-845.

  15. Aune, A. A., Bishop, C., Turner, A. N., Papadopoulos, K., Budd, S., Richardson, M., & Maloney, S. J. (2018). Acute and chronic effects of foam rolling vs eccentric exercise on ROM and force output of the plantar flexors. Journal of Sports Sciences, 1-8.

  16. Opplert, J., & Babault, N. (2018). Acute effects of dynamic stretching on muscle flexibility and performance: An analysis of the current literature. Sports Medicine, 48(2), 299-325.

  17. Shift Movement Science. Wrist extension mobility series for handstands. https://www.youtube.com/watch?v=DWJVN-9fTpc

  18. Westad, K., Tjoestolvsen, F., & Hebron, C. (2018). The effectiveness of Mulligan's mobilisation with movement (MWM) on peripheral joints in musculoskeletal (MSK) conditions: A systematic review. Musculoskeletal Science and Practice.

  19. Kibler WB, McMullen J. (2003) Scapular dyskinesis and its relation to shoulder pain. Journal of American Academy of Orthopaedic Surgery. ;11(2):142–151.

  20. Lin, J. J., Hanten, W. P., Olson, S. L., Roddey, T. S., Soto-quijano, D. A., Lim, H. K., & Sherwood, A. M. (2005). Functional activity characteristics of individuals with shoulder dysfunctions. Journal of Electromyography and Kinesiology, 15(6), 576-586.

  21. Cools AM, Witvrouw EE, Mahieu NN, Danneels LA (2005). Isokinetic scapular muscle performance in overhead athletes with and without impingement symptoms. Journal of Athletic Training, 40(2):104–110.

  22. Ludewig, P. M., & Cook, T. M. (2000). Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical Therapy, 80(3), 276-291.

  23. Howe, L. P., & Blagrove, R. C. (2015). Shoulder function during overhead lifting tasks: Implications for screening athletes. Strength & Conditioning Journal, 37(5), 84-96.

  24. Kamkar A, Irrgang J, Whitney SL. (1993). Nonoperative management of secondary shoulder impingement syndrome. Journal of Orthopaedic Sports Physical Therapy, 17(5):212–224.

  25. Borstad, J. D., & Ludewig, P. M. (2005). The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. Journal of Orthopaedic & Sports Physical Therapy, 35(4), 227-238.

  26. Bdaiwi, A. H., Mackenzie, T. A., Herrington, L., Horsley, I., & Cools, A. M. (2015). Acromiohumeral distance during Neuromuscular Electrical Stimulation of the lower trapezius and serratus anterior muscles in healthy participants. Journal of Athletic Training, 50(7), 713-718.

  27. Herrington, L., & Horsley, I. (2014). Effects of latissimus dorsi length on shoulder flexion in canoeists, swimmers, rugby players, and controls. Journal of Sport and Health Science, 3(1), 60-63.

  28. Sahrmann, S., Azevedo, D. C., & Van Dillen, L. (2017). Diagnosis and treatment of movement system impairment syndromes. Brazilian Journal of Physical Therapy.

  29. McQuade, K. J., Borstad, J., & De Oliveira, A. S. (2016). Critical and theoretical perspective on scapular stabilization: What does it really mean, and are we on the right track? Physical Therapy, 96(8), 1162-1169.

  30. Amiri-Khorasani M., Abu Osman NA., Yusof A. (2011). Acute effect of static and dynamic stretching on hip dynamic range of motion during instep kicking in professional soccer players. Journal of Strength and Conditioning Research. 25,1647–52.

  31. Moreside, J. M., & McGill, S. M. (2012). Hip joint range of motion improvements using three different interventions. Journal of Strength & Conditioning Research, 26(5), 1265-1273.

  32. Konrad A, Stafilidis S, Tilp M. Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties. Scandinavian Journal of Medicine and Science in Sports, 27,1070–80.

  33. Medicine ACoS (2006). ACSM’s guidelines for exercise testing and prescription. 7th ed. Baltimore: Lippincot Williams Wilkins

  34. Sands, W. A., McNeal, J. R., Stone, M. H., Russell, E. M., & Jemni, M. (2006). Flexibility enhancement with vibration: Acute and long-term. Medicine & Science in Sports & Exercise, 38(4), 720-725.

  35. Sands, W. A., Murray, M. B., Murray, S. R., McNeal, J. R., Mizuguchi, S., Sato, K., & Stone, M. H. (2014). Peristaltic pulse dynamic compression of the lower extremity enhances flexibility. Journal of Strength & Conditioning Research, 28(4), 1058-1064.

  36. Sands, W. A., McNeal, J. R., Stone, M. H., Kimmel, W. L., Gregory Haff, G., & Jemni, M. (2008). The effect of vibration on active and passive range of motion in elite female synchronized swimmers. European Journal of Sport Science, 8(4), 217-223.

  37. Kinser, A. M., Ramsey, M. W., O'bryant, H. S., Ayres, C. A., Sands, W. A., & Stone, M. H. (2008). Vibration and stretching effects on flexibility and explosive strength in young gymnasts. Medicine & Science in Sports & Exercise, 40(1), 133-140.

  38. Gannon, L. M., & Bird, H. A. (1999). The quantification of joint laxity in dancers and gymnasts. Journal of Sports Sciences, 17(9), 743-750.

  39. Larsson, L. G., Baum, J., & Mudholkar, G. S. (1987). Hypermobility: features and differential incidence between the sexes. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 30(12), 1426-1430.

  40. Larsson, L. G., Baum, J., Mudholkar, G. S., & Srivastava, D. K. (1993). Hypermobility: prevalence and features in a Swedish population. Rheumatology, 32(2), 116-119.

  41. Pacey, V., Adams, R. D., Tofts, L., Munns, C. F., & Nicholson, L. L. (2014). Proprioceptive acuity into knee hypermobile range in children with joint hypermobility syndrome. Pediatric Rheumatology, 12(1), 40.

  42. Pacey, V., Nicholson, L. L., Adams, R. D., Munn, J., & Munns, C. F. (2010). Generalized joint hypermobility and risk of lower limb joint injury during sport: a systematic review with meta-analysis. American Journal of Sports Medicine, 38(7), 1487-1497.

  43. Soper, K., Simmonds, J. V., Kaz, H. K., & Ninis, N. (2015). The influence of joint hypermobility on functional movement control in an elite netball population: A preliminary cohort study. Physical Therapy in Sport, 16(2), 127-134.

  44. Rombaut, L., De Paepe, A., Malfait, F., Cools, A., & Calders, P. (2010). Joint position sense and vibratory perception sense in patients with Ehlers–Danlos syndrome type III (hypermobility type). Clinical Rheumatology, 29(3), 289-295.

  45. Fatoye, F., Palmer, S., Macmillan, F., Rowe, P., & van der Linden, M. (2008). Proprioception and muscle torque deficits in children with hypermobility syndrome. Rheumatology, 48(2), 152-157.

  46. Ferrell, W. R., Tennant, N., Sturrock, R. D., Ashton, L., Creed, G., Brydson, G., & Rafferty, D. (2004). Amelioration of symptoms by enhancement of proprioception in patients with joint hypermobility syndrome. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 50(10), 3323-3328.

  47. Simmonds, J. V., & Keer, R. J. (2007). Hypermobility and the hypermobility syndrome. Manual Therapy, 12(4), 298-309.

  48. Simmonds, J. V., & Keer, R. J. (2008). Hypermobility and the hypermobility syndrome, part 2: assessment and management of hypermobility syndrome: illustrated via case studies. Manual Therapy, 13(2), e1-e11.

  49. Kaux, J. F., Forthomme, B., Foidart-Dessalle, M., Delvaux, F., & Debray, F. G. (2013). Eccentric training for elbow hypermobility. Journal of Novel Physiotherapies,3(180), 4.

  50. Lopes, T. J. A., Simic, M., Myer, G. D., Ford, K. R., Hewett, T. E., & Pappas, E. (2018). The effects of injury prevention programs on the biomechanics of landing tasks: a systematic review with meta-analysis. American Journal of Sports Medicine, 46(6), 1492-1499.

  51. Hewett, T. E., Ford, K. R., & Myer, G. D. (2006). Anterior cruciate ligament injuries in female athletes: Part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. American Journal of Sports Medicine, 34(3), 490-498.

  52. Myer, G. D., Ford, K. R., Brent, J. L., & Hewett, T. E. (2007). Differential neuromuscular training effects on ACL injury risk factors in" high-risk" versus" low-risk" athletes. British Medical Council Musculoskeletal Disorders, 8(1), 39.

  53. Behringer, M., vom Heede, A., Yue, Z., & Mester, J. (2010). Effects of resistance training in children and adolescents: a meta-analysis. Pediatrics, 126(5), e1199-e1210.

  54. Moran, J. J., Sandercock, G. R., Ramírez-Campillo, R., Meylan, C. M., Collison, J. A., & Parry, D. A. (2017). Age-related variation in male youth athletes' countermovement jump after plyometric training: a meta-analysis of controlled trials. Journal of Strength & Conditioning Research, 31(2), 552-565.

  55. Botton, C. E., Radaelli, R., Wilhelm, E. N., Rech, A., Brown, L. E., & Pinto, R. S. (2016). Neuromuscular adaptations to unilateral vs. bilateral strength training in women. Journal of Strength and Conditioning Research, 30(7), 1924-1932.

  56. McCurdy, K. W., Langford, G. A., Doscher, M. W., Wiley, L. P., & Mallard, K. G. (2005). The effects of short-term unilateral and bilateral lower-body resistance training on measures of strength and power. Journal of Strength & Conditioning Research, 19(1), 9-15.

  57. Speirs, D. E., Bennett, M. A., Finn, C. V., & Turner, A. P. (2016). Unilateral vs. bilateral squat training for strength, sprints, and agility in academy rugby players. Journal of Strength & Conditioning Research, 30(2), 386-392.

  58. McCurdy, K., O’Kelley, E., Kutz, M., Langford, G., Ernest, J., & Torres, M. (2010). Comparison of lower extremity EMG between the 2-leg squat and modified single-leg squat in female athletes. Journal of Sport Rehabilitation, 19(1), 57-70.

  59. Mausehund, L., Skard, A. E., & Krosshaug, T. R. O. N. (2018). Muscle Activation in Unilateral Barbell Exercises: Implications for Strength Training and Rehabilitation. Journal of Strength and Conditioning Research, 4.

  60. DeForest, B. A., Cantrell, G. S., & Schilling, B. K. (2014). Muscle activity in single-vs. double-leg squats. International Journal of Exercise Science, 7(4), 302.

  61. Jones, M. T., Ambegaonkar, J. P., Nindl, B. C., Smith, J. A., & Headley, S. A. (2012). Effects of unilateral and bilateral lower-body heavy resistance exercise on muscle activity and testosterone responses. Journal of Strength & Conditioning Research, 26(4), 1094-1100.

  62. Lloyd, R. S., Faigenbaum, A. D., Stone, M. H., Oliver, J. L., Jeffreys, I., Moody, J. A., ... & Herrington, L. (2014). Position statement on youth resistance training: the 2014 International Consensus. British Journal of Sports Medicine, 48(7), 498-505.

  63. Bocalini, D. S., Portes, L. A., Ribeiro, K. J., Tonicelo, R., Rica, R. L., Pontes Junior, F. L., & Serra, A. J. (2013). Insight for learning and stability of one repetition maximum test in subjects with or without experience on resistance training. Gazzetta Medica Italiana, 172(11), 845-851.

  64. Noble, B. J., Borg, G. A., Jacobs, I. R. A., Ceci, R., & Kaiser, P. (1983). A category-ratio perceived exertion scale: relationship to blood and muscle lactates and heart rate. Medicine and Science in Sports and Exercise, 15(6), 523-528.

  65. Lagally, K. M., Robertson, R. J., Gallagher, K. I., Goss, F. L., Jakicic, J. M., Lephart, S. M., ... & Goodpaster, B. (2002). Perceived exertion, electromyography, and blood lactate during acute bouts of resistance exercise. Medicine and Science in Sports & Exercise, 34(3), 552-559.

  66. Richens, B., & Cleather, D. J. (2014). The relationship between the number of repetitions performed at given intensities is different in endurance and strength trained athletes. Biology of Sport, 31(2), 157.

  67. Bulbulian, R., Heaney, J. H., Leake, C. N., Sucec, A. A., & Sjoholm, N. T. (1996). The effect of sleep deprivation and exercise load on isokinetic leg strength and endurance. European Journal of Applied Physiology and Occupational Physiology, 73(3), 273-277.

  68. Bartholomew, J. B., Stults-Kolehmainen, M. A., Elrod, C. C., & Todd, J. S. (2008). Strength gains after resistance training: the effect of stressful, negative life events. Journal of Strength & Conditioning Research, 22(4), 1215-1221.

  69. Helms, E. R., Zinn, C., Rowlands, D. S., Naidoo, R., & Cronin, J. (2015). High-protein, low-fat, short-term diet results in less stress and fatigue than moderate-protein, moderate-fat diet during weight loss in male weightlifters: A pilot study. International Journal of Sport Nutrition and Exercise Metabolism, 25(2), 163-170.

  70. Thomas, A. C., Lepley, L. K., Wojtys, E. M., McLean, S. G., & Palmieri-Smith, R. M. (2015). Effects of neuromuscular fatigue on quadriceps strength and activation and knee biomechanics in individuals post–anterior cruciate ligament reconstruction and healthy adults. Journal of Orthopaedic and Sports Physical Therapy, 45(12), 1042-1050.

  71. Faigenbaum, A. D., Kraemer, W. J., Blimkie, C. J., Jeffreys, I., Micheli, L. J., Nitka, M., & Rowland, T. W. (2009). Youth resistance training: updated position statement paper from the national strength and conditioning association. Journal of Strength & Conditioning Research, 23, S60-S79.

  72. Chaabene, H., Prieske, O., Negra, Y., & Granacher, U. (2018). Change of direction speed: toward a strength training approach with accentuated eccentric muscle actions. Sports Medicine, 1-7.

  73. Douglas, J., Pearson, S., Ross, A., & McGuigan, M. (2017). Chronic adaptations to eccentric training: a systematic review. Sports Medicine, 47(5), 917-941

  74. Goode, A. P., Reiman, M. P., Harris, L., DeLisa, L., Kauffman, A., Beltramo, D., ... & Taylor, A. B. (2015). Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis. British Journal of Sports Medicine, 49(6), 349-356.

  75. Madeley, L. T., Munteanu, S. E., & Bonanno, D. R. (2007). Endurance of the ankle joint plantar flexor muscles in athletes with medial tibial stress syndrome: a case-control study. Journal of Science and Medicine in Sport, 10(6), 356-362.

  76. Brueggemann, G. P., & Hume, P. A., (2013). Biomechanics related to injury. In D. J., Caine, K., Russell, & L., Lim (Eds.), Handbook of Sports Medicine and Science, Gymnastics (pp.63-74). New Jersey:John Wiley Blackwell.

  77. MacDonald, C. J., Lamont, H. S., & Garner, J. C. (2012). A comparison of the effects of 6 weeks of traditional resistance training, plyometric training, and complex training on measures of strength and anthropometrics. Journal of Strength & Conditioning Research, 26(2), 422-431.

  78. Bassett, S. H., & Leach, L. L. (2011). The effect of an eight-week training programme on core stability in junior female elite gymnasts, African Journal for Physical, Health Education, Recreation and Dance, 17(supplement) 9-19: erratum. African Journal for Physical Health Education, Recreation and Dance, 17(3), 567.

  79. Riches, F. (2014). The effect of a 3-week core stability training programme on trunk stability during a static handstand position in female university level gymnasts (Doctoral dissertation, Cardiff Metropolitan University).

  80. Durall, C. J., Udermann, B. E., Johansen, D. R., Gibson, B., Reineke, D. M., & Reuteman, P. (2009). The effects of preseason trunk muscle training on low-back pain occurrence in women collegiate gymnasts. Journal of Strength & Conditioning Research, 23(1), 86-92.

  81. Kalaycioglu, T., Apostolopoulos, N. C., Goldere, S., Duger, T., & Baltaci, G. (2018). Effect of a Core Stabilization Training Program on Performance of Ballet and Modern Dancers. Journal of Strength & Conditioning Research.

  82. Willardson (2007). Core Stability Training for Healthy Athletes: A Different Paradigm for fitness professionals. Strength and Conditioning Journal, 29(6), 42-49.

  83. Kibler, W. B., Press, J., Sciascia, A. (2006). The role of core stability in athletic function. Sports Medicine, 36, 189-198.

  84. Moran, J., Clark, C. C., Ramirez-Campillo, R., Davies, M. J., & Drury, B. (2018). A Meta-Analysis of Plyometric Training in Female Youth: Its Efficacy and Shortcomings in the Literature. Journal of strength and conditioning research.

  85. Moran, J. J., Sandercock, G. R., Ramírez-Campillo, R., Meylan, C. M., Collison, J. A., & Parry, D. A. (2017). Age-related variation in male youth athletes' countermovement jump after plyometric training: a meta-analysis of controlled trials. Journal of Strength & Conditioning Research, 31(2), 552-565.

  86. Bedoya, A. A., Miltenberger, M. R., & Lopez, R. M. (2015). Plyometric training effects on athletic performance in youth soccer athletes: a systematic review. The Journal of Strength & Conditioning Research, 29(8), 2351-2360.

  87. Hall, E., Bishop, D. C., & Gee, T. I. (2016). Effect of plyometric training on handspring vault performance and functional power in youth female gymnasts. PLOS One, 11(2).

  88. Marina, M., & Jemni, M. (2014). Plyometric training performance in elite-oriented prepubertal female gymnasts. The Journal of Strength & Conditioning Research, 28(4), 1015-1025.

  89. Bencke, J., Damsgaard, R., Sækmose, A., Jørgensen, P., Jørgensen, K., & Klausen, K. (2002). Anaerobic power and muscle strength Characteristics of 11 years old elite and on‐elite boys and girls from gymnastics, team handball, tennis and swimming. Scandinavian Journal of Medicine & Science in Sports, 12(3), 171-178.

  90. Marina, M., Jemni, M., Rodríguez, F. A., & Jimenez, A. (2012). Plyometric jumping performances of male and female gymnasts from different heights. Journal of Strength & Conditioning Research, 26(7), 1879-1886.

  91. Lloyd, R. S., Radnor, J. M., Croix, M. B. D. S., Cronin, J. B., & Oliver, J. L. (2016). Changes in sprint and jump performances after traditional, plyometric, and combined resistance training in male youth pre-and post-peak height velocity. The Journal of Strength & Conditioning Research, 30(5), 1239-1247.

  92. Arabatzi, F., Kellis, E., & Saèz-Saez De Villarreal, E. (2010). Vertical jump biomechanics after plyometric, weight lifting, and combined (weight lifting+ plyometric) training. Journal of Strength and Conditioning Research, 24(9), 2440-2448.

  93. Hoffman, J. R., Cooper, J., Wendell, M., & Kang, J. (2004). Comparison of Olympic vs. traditional power lifting training programs in football players. Journal of Strength and Conditioning Research, 18(1), 129-135.

  94. Hori, N., Newton, R. U., Andrews, W. A., Kawamori, N., McGuigan, M. R., & Nosaka, K. (2008). Does performance of hang power clean differentiate performance of jumping, sprinting, and changing of direction? Journal of Strength and Conditioning Research, 22(2), 412-418.

  95. Kawamori, N., & Haff, G. G. (2004). The optimal training load for the development of muscular power. Journal of Strength and Conditioning Research, 18(3), 675-684.

  96. Moir, G., Sanders, R., Button, C., & Glaister, M. (2007). The effect of periodized resistance training on accelerative sprint performance. Sports Biomechanics, 6(3), 285-300.

  97. Tricoli, V., Lamas, L., Carnevale, R., & Ugrinowitsch, C. (2005). Short-term effects on lower-body functional power development: weightlifting vs. vertical jump training programs. Journal of Strength and Conditioning Research, 19(2), 433-437.

  98. Channell, B. T., & Barfield, J. P. (2008). Effect of Olympic and traditional resistance training on vertical jump improvement in high school boys. Journal of Strength & Conditioning Research, 22(5), 1522-1527.

  99. Chaouachi, A., Hammami, R., Kaabi, S., Chamari, K., Drinkwater, E. J., & Behm, D. G. (2014). Olympic weightlifting and plyometric training with children provides similar or greater performance improvements than traditional resistance training. Journal of Strength and Conditioning Research, 28(6), 1483-1496.

  100. Myer, G. D., Quatman, C. E., Khoury, J., Wall, E. J., & Hewett, T. E. (2009). Youth versus adult “weightlifting” injuries presenting to United States emergency rooms: accidental versus nonaccidental injury mechanisms. Journal of Strength and Conditioning Research, 23(7), 2054.

  101. Suchomel, T. J., Comfort, P., & Stone, M. H. (2015). Weightlifting pulling derivatives: Rationale for implementation and application. Sports Medicine, 45(6), 823-839.

  102. Suchomel, T. J., & Sole, C. J. (2017b). Power-time curve comparison between weightlifting derivatives. Journal of Sports Science & Medicine, 16(3), 407.

  103. Suchomel, T. J., Wright, G. A., Kernozek, T. W., & Kline, D. E. (2014). Kinetic comparison of the power development between power clean variations. Journal of Strength and Conditioning Research, 28(2), 350-360.

  104. Fielding, R. A., LeBrasseur, N. K., Cuoco, A., Bean, J., Mizer, K., & Singh, M. A. F. (2002). High‐velocity resistance training increases skeletal muscle peak power in older women. Journal of the American Geriatrics Society, 50(4), 655-662.

  105. Young, W. B., & Bilby, G. E. (1993). The effect of voluntary effort to influence speed of contraction on strength, muscular power, and hypertrophy development. Journal of Strength and Conditioning Research, 7(3), 172-178.

  106. Lake, J. P., & Lauder, M. A. (2012). Kettlebell swing training improves maximal and explosive strength. Journal of Strength & Conditioning Research, 26(8), 2228-2233.

  107. Otto III, W. H., Coburn, J. W., Brown, L. E., & Spiering, B. A. (2012). Effects of weightlifting vs. kettlebell training on vertical jump, strength, and body composition. Journal of Strength & Conditioning Research, 26(5), 1199-1202.

  108. Manocchia, P., Spierer, D. K., Lufkin, A. K., Minichiello, J., & Castro, J. (2013). Transference of kettlebell training to strength, power, and endurance. Journal of Strength & Conditioning Research, 27(2), 477-484.

  109. Holmstrop, M. E., Jensun, B. T., Evans, W. S., & Marshall, E. C. (2016). Eight weeks of kettlebell swing training does not improve sprint performance in recreationally active females. International Journal of Exercise Science, 9(4), 437.

  110. Jonen, W., & Netterville III, J. T. (2014). Kettlebell safety: a periodized program using the clean and jerk and the snatch. Strength & Conditioning Journal, 36(2), 1-10.

  111. Jay, K., Frisch, D., Hansen, K., Zebis, M. K., Andersen, C. H., Mortensen, O. S., & Andersen, L. L. (2011). Kettlebell training for musculoskeletal and cardiovascular health: a randomized controlled trial. Scandinavian Journal of Work, Environment & Health, 196-203.

  112. Jay, K., Jakobsen, M. D., Sundstrup, E., Skotte, J. H., Jørgensen, M. B., Andersen, C. H., ... & Andersen, L. L. (2013). Effects of kettlebell training on postural coordination and jump performance: a randomized controlled trial. Journal of Strength & Conditioning Research, 27(5), 1202-1209.

  113. Bazyler, C. D., Bailey, C. A., Chiang, C. Y., Sato, K., & Stone, M. H. (2014). The effects of strength training on isometric force production symmetry in recreationally trained males. Journal of Trainology, 3(1), 6-10.

  114. Brown, S. R., Feldman, E. R., Cross, M. R., Helms, E. R., Marrier, B., Samozino, P., & Morin, J. B. (2017). The Potential for a Targeted Strength-Training Program to Decrease Asymmetry and Increase Performance: A Proof of Concept in Sprinting. International Journal of Sports Physiology and Performance, 12(10), 1392-1395.

  115. Golik-Peric D, Drapsin M, Obradovic B,and Drid P. (2011) Short-term isokinetic training versus isotonic training: Effects on asymmetry in strength of thigh muscles. Journal of Human Kinetics 30, 29-35.

  116. Gonzalo-Skok, O., Tous-Fajardo, J., Suarez-Arrones, L., Arjol-Serrano, J. L., Casajús, J. A., & Mendez-Villanueva, A. (2017). Single-leg power output and between-limbs imbalances in team-sport players: unilateral versus bilateral combined resistance training. International Journal of Sports Physiology and Performance, 12(1), 106-114.

  117. Sannicandro, I., Cofano, G., Rosa, R. A., & Piccinno, A. (2014). Balance training exercises decrease lower-limb strength asymmetry in young tennis players. Journal of Sports Science & Medicine, 13(2), 397.

  118. Lacono, A., Padulo, J., & Ayalon, M. (2016). Core stability training on lower limb balance strength. Journal of Sports Sciences, 34(7), 671-678.

  119. Bishop, C., Turner, A., & Read, P. (2018). Effects of inter-limb asymmetries on physical and sports performance: a systematic review. Journal of Sports Sciences, 36(10), 1135-1144.

  120. Pajek, M. B. (2015). The possible impact and significance of asymmetries in artistic gymnastics. Science of Gymnastics Journal, 7(3), 129.

  121. Čuk, I., & Marinšek, M. (2013). Landing quality in artistic gymnastics is related to landing symmetry. Biology of Sport, 30(1), 29.

  122. Faigenbaum, A. D., Kraemer, W. J., Blimkie, C. J., Jeffreys, I., Micheli, L. J., Nitka, M., & Rowland, T. W. (2009). Youth resistance training: updated position statement paper from the national strength and conditioning association. Journal of Strength & Conditioning Research, 23, S60-S79.

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