ACSM Olympic Games Expert Commentary

The Young Gymnast

At these games there have been concerns raised that some of the female Chinese gymnasts do not appear to meet the minimum age requirement of 16 years old. This raises the question - is competitive gymnastics safe for girls under 16 years of age? Historically there have been two areas of concern: growth and development in young gymnasts and risk of injuries. Many people have looked at these issues to determine if indeed young gymnasts are at risk.

It is clear that over time gymnasts are getting smaller but it is not clear whether this is a result of selection or participation in gymnastics. Researchers have found that elite level gymnasts may experience diminished growth during their years of training and competition and then catch-up growth during time off or after stopping the sport. No one is sure whether the catch-up is complete however.

The second concern has to do with young gymnasts and risk of injury. Advanced levels of training and competition do appear to correlate with increased risk of injury. These can be acute injuries like ankle sprain or overuse injuries like wrist pain. Studies also show that elite gymnasts have a high re-injury rate after injury, suggesting rapid return to activity with inadequate rehabilitation.

You may have noticed a lot of the young gymnasts wearing wrist braces. There is a specific injury unique to gymnasts that is an injury to the growth plate of the forearm bone called the radius. As they spend a lot of time walking, jumping and landing on their arms, the growth plate can be injured and actually stop growing. Not only does this cause the arm to be short but also results in long term wrist pain and inability to do gymnastics. The growth plate normally closes around age 14 in girls so is not a problem for older gymnasts.

Andrew JM Gregory, MD, FAAP, FACSM
Pediatric Sports Medicine Specialist
Vanderbilt University; Nashville, TN

Ankle Sprains in Gymnastics

Each year, more than 86,000 gymnastics-related injuries are treated in hospitals, doctors' offices and hospital emergency rooms. Gymnasts run, jump and tumble on soft surfaces and compete on narrow equipment, which makes them prone to ankle sprains. Considered a ligament injury, 75 percent of sprains are classified as lateral ankle sprains.

Here are a few things gymnasts should consider:

There are three grades of ankle sprains. A grade one means that the ligament is not completely torn it’s just injured but stable. Grade two and three lateral ankle sprain involve a complete tear of one or two ligaments.

The problem with a lateral ankle sprain in sports is typically the pain and instability.  Long term, most ankle sprains respond well to resting, icing, and compression to get the swelling down and a period of immobilization. If the ankle is stable, taping it can help support it during a competition – this form of treatment is commonly used during major competitions like the Olympics.

For those athletes with a more severe ligament tear, taping the ankle typically will not provide the kind of support needed to compete at a more advanced level. Definitive treatment will require some form of support, bracing or immobilization. If a gymnast with a lateral ankle sprain decides to compete they may be forced to make small adjustments to their routine due to pain or fear of re-injury. Ultimately this will significantly affect their performance.

If a gymnast is faced with a severe ankle injury, rest and medical attention is always the best course of action.

David A. Porter, MD, PhD, FACSM

Methodist Sports Medicine Center

Clarian Human Motion, Indianapolis

Ice Vest Precooling

The idea that some mild degree of pre-cooling (a slight reduction in body core temperature of 0.5-1.0 °C prior to exercise) might reduce thermal stress during exercise in the heat has been around for over 20 years. Many studies have demonstrated that pre-cooling results in less thermal strain during exercise, i.e. a lower body core temperature during exercise of similar intensity.  While pre-cooling has been shown to modify (improve) the thermoregulatory responses to exercise not all studies have demonstrated a clear improvement in performance. Lately, using an ice vest has been shown to provide adequate pre-cooling to lower body core temperature prior to exercise and appears almost as effective as more sophisticated pre-cooling procedures (i.e. water immersion, whole body cooling garments) in lowering body temperature.  Use of such ice-vests has allowed researchers to get out of the laboratory and evaluate pre-cooling in the field.  Recent fieldwork has verified that pre-cooling with an ice-vest can reduce body temperature and reduce thermoregulatory strain during most, but not all real or simulated athletic competitions. Overall, endurance athletic events seem to respond best to ice-vest pre-cooling.  Fieldwork has verified the ability to reduce the rise in core temperature under actual 4-5 km race conditions.  In addition, pre-cooling with an ice vest prior to an interval workout (8 x 1000 m) is able to keep body core temperature lower during the first 5-6 repeats. In addition, peak power output during a high intensity cycling exercise (Wingate test) is higher in athletes who undergo ice vest pre-cooling. In contrast, no real advantage has been ascribed to pre-cooling individuals performing high intensity-intermittent exercise (simulated soccer match).  Laboratory tests have provided good evidence that pre-cooling with an ice vest can reduce thermal strain and improved performance.  However, improved athletic performance from ice vest pre-cooling in competitive events has not been verified. Overall, ice vest pre-cooling does not impair performance but does reduce thermal strain in competitive athletes. Regardless of its impact on performance ice-vest pre-cooling should be beneficial to the health and safety of endurance athletes.

Gary W. Mack, PhD, FACSM

Department of Exercise Sciences, Brigham Young University

Ready, set, go! Getting primed for prime time

After Michael Phelps tied Mark Spitz's record of seven gold medals in one Olympics, Phelps stated that his hard work, imagination, confidence, and coach, in addition to his competitors' comments, get him fired up to compete.

Observers of the Olympics are often amazed at how some athletes are able to handle the pressures of their sport while performing on a world stage. Successful athletes, such as Michael Phelps, often have an uncanny ability to manage their thoughts and emotions, even when all eyes are upon them. This ability to be focused and in control of their emotions under pressure is a result of the many training hours and competitive experiences they have endured.

Training involves learning, not only the physical and technical skills of their sport, but also the mental skills and strategies associated with their sport. The mental skills that are frequently associated with success are resiliency, motivation, arousal and emotional management, confidence, and attentional focus control. Coaches of successful athletes often incorporate mental training into daily practices. Through mental training, athletes often identify their present needs, beliefs, worries, behaviors, and emotional responses to their performances. They also learn to examine the consequences of certain feelings and thoughts and learn how to generate alternative causal explanation to negative events.

Mental skills such as positive self-talk and positive imagery can help them challenge and modify their negative responses to poor performances. Practice and rehearsal of these mental skills serve to make thought processing more efficient and emotionally beneficial. Regular use of these skills can help develop mental toughness or calmness under pressure, which will greatly improve the odds that they will be successful in the future.

Scott B. Martin, Ph.D., ACSM Member

Department of Kinesiology, Health Promotion, and Recreation

University of North Texas, Denton

More from ACSM's Staff Roving Reporter...

Sold Out...But Plenty of Empty Seats

So far, we've been to three of our four events. We saw men's gymnastics (including Team USA), women's gymnastics (France, Brazil and some mixed groups), and two men's basketball games (Iran/Russia and Germany/Angola). It's my understanding that everything is sold out; however, there have been plenty of seats where we've been. It's kind of sad that there are so many people who want tickets and so many empty seats, but no way to get them. I'm sure a fair number of them are reserved for athletes, sponsors, media, family, etc. – but there are still plenty more. I wasn't sure what to expect as far as ticket scalpers. I've seen a few folks with signs that say "I need tickets," usually in multiple languages, but none with signs to sell tickets. There were a couple of people on our Great Wall tour the other day who came here with no tickets, expecting they would be available. We are definitely glad we planned ahead and got ours!

We've got spirit, yes we do...

One of my favorite parts about being at the Olympics was seeing people get excited and cheer for their country. The Brazilians seemed to be especially good at this. One of the beach volleyball matches we saw was Brazil against Georgia. The Brazilian men's team won the gold at the last Olympics, and this was Georgia's first time at the Olympics for beach volleyball. The Brazilian fans were loud and crazy - and having a great time. But there were plenty of people cheering for the underdogs, too. Though Georgia was playing a tough team, they held their own. I think everyone NOT from Brazil was cheering for Georgia. The same principle rang true at the basketball games we saw. Though Russia and Germany were no match for Iran and Angola, respectively, all the teams seemed to have plenty of fans and people to cheer for them. I guess that's part of the Olympic spirit.

Stephanie Garwood
ACSM Staff