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



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.



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.


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.


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.


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.


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.   


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 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.


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.


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.


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.


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.


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