The unfortunate combination of injuries Mr. Hamm sustained is not common, but would be understandable because of the demands placed on his body by the sport. Both of his arms are weight bearing in almost all of the required activities in gymnastics. The fracture was healing, but he couldn't place normal weight across the hand, so there was a relatively higher load placed on the other arm and shoulder as he loaded the arms.
Also, there usually is compensation in body position, so the higher applied loads might have been placed in a less than optimal position, thereby increasing the stresses on the shoulder. Finally, there might have been some subclinical injury to the shoulder that was not symptomatic until the extra loads and positions were applied. In all, it was a toxic combination, and under the stress of the time constraints, became more than the body could handle in trying to compete at this high level.
W. Ben Kibler, MD, FACSM
Medical Director for Lexington Clinic
Sports Medicine Center, Lexington, KY
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