Gymnastics and Trampoline Injuries: Wrists, Ankles, Knees and Backs

Every gymnastics, trampoline and cheer injury, by body part

Start from where it hurts. Rows with a link go to the page that covers that injury in full. Rows marked doctor first need a doctor before they need us.

The common ones, in more depth

Gymnast’s wrist, and the growing wrist

Gymnast’s wrist is pain at the back of the wrist from repeated weight-bearing with the wrist bent fully back: handsprings, round-offs, vaults and handstands. In a child or teenager, the stress often falls on the growth plate at the end of the radius, the forearm bone on the thumb side. That is why a young gymnast with wrist pain that does not settle within a few days, or that comes back with every handstand, needs a doctor and an X-ray before anything else. The doctor decides how long the wrist stays off load. In an adult, the same loading more often irritates the back of the wrist or the cartilage on the little-finger side. Once a doctor has cleared it, we measure grip strength and wrist range against the other hand, and rebuild weight-bearing in steps: hands on a bench, then on the floor, then a handstand against the wall.

The fall onto the hand: wrist, scaphoid and the child’s elbow

Falls from the bars, the beam, a stunt or off a trampoline usually land on an outstretched hand. In a teenager or adult, that is how the wrist and the scaphoid break. The scaphoid is a small bone at the base of the thumb, and its fracture can be missed on the first X-ray, so pain in the hollow at the base of the thumb after a fall needs a doctor even if the wrist looks normal. In a younger child, the same fall often breaks the bone just above the elbow, or the wrist near the growth plate. A child with a painful, swollen elbow or wrist after a fall, or who will not use the arm, needs a doctor and an X-ray the same day. After the fracture is managed, our hand therapists make or adjust the splint, then work on the stiffness and the grip.

Ankles on landing

A short landing off the vault, a foot on the join between two mats, or a jump that lands on a trampoline’s frame or pad edge turns the ankle in. Most are sprains of the ligaments on the outside of the ankle. Some are fractures, and the two can look alike at first. A doctor and an X-ray come first if you cannot take four steps on it, or if the bone at the back or tip of either ankle knob is tender. In a child, pain and swelling over the bone near the growth plate counts as a possible fracture until an X-ray says otherwise. We train the ankle back with balance, hop and landing tests, measured against the other side.

The knee on landing

The ACL usually goes on a landing with the knee collapsing inward or twisting, often with a pop and swelling within a few hours. That needs a doctor the same day. The slower knee is pain just below the kneecap from repeated take-offs and landings, which builds over weeks of tumbling or vault and is worst on the first jumps of the day. We watch the landing as well as test it: whether the knee stays over the foot, and whether both legs take the same share.

The arching back

Repeated arching, in back walkovers, bridges and flyer positions, can cause a stress fracture in a small part of the spine called the pars. It is called spondylolysis, and it is a well-known cause of back pain in young gymnasts. It hurts arching back and is often fine bending forward. Low back pain in a young gymnast or cheer flyer that is worse on arching and lasts more than two weeks needs a doctor, who decides whether imaging is needed. We see it most in teenagers in a heavy training block, and rebuild the back with trunk strength first and arching last.

Head and neck: doctor first

Flips and somersaults on a trampoline, two or more jumpers at once, and falls from a stunt are how head and neck injuries happen. In one study, the trampoline park injuries serious enough for admission included spinal cord injuries.¹ Anyone who lands on their head or neck and has neck pain with numbness, tingling or weakness in the arms or legs needs 995, and should not be moved. Any suspected concussion stops activity for the day and sees a doctor, and the return follows the doctor’s plan. Physiotherapy for neck pain or stiffness comes after a doctor has ruled out a serious injury.

Return on tests, not dates

Pain going away is the first sign, not the last. After a fracture, a growth plate injury or a concussion, a doctor clears the return first. These are the checks we use before full training:

• Wrist and elbow: grip strength close to the other hand, then weight through the hands without pain, on a bench, then on the floor, then in a handstand.
• Ankle and knee: single-leg balance, hop and landing tests compared with the other leg, with the knee staying over the foot on landing.
• Lower back: trunk holds, then arching without pain, including the next morning.
• Shoulder: rotation strength against the other side, then hanging and handstand holds without pain the next morning.

Then volume comes back in steps: basic skills first, then one apparatus or one stunt, then full routines.

Is this normal?

Some muscle soreness a day or two after a new skill or a long training, in an adult or a child, is usual. Stiff wrists after a weekend of handstands that ease by the next morning are common. Pain in a bone, pain that makes a child limp or avoid using a hand, wrist pain that comes back with every handstand, or back pain on arching that lasts more than two weeks is not part of training. It needs a doctor’s look first.

When to see a doctor first

• Call 995 if someone lands on their head or neck and has neck pain with numbness, tingling or weakness in the arms or legs, or cannot move them. Do not move them, and keep them still until help arrives. Also call 995 for anyone who is unconscious, has a seizure, or has severe breathlessness.
• Emergency department now after a head injury with any loss of consciousness, vomiting more than once, a headache that keeps getting worse, confusion or unusual drowsiness; a wrist, elbow, ankle or leg that is visibly out of shape, or with bone through the skin; or a hand or foot that is cold, white or numb after an injury.
• Doctor the same day for any child with a painful, swollen wrist or elbow after a fall, or who will not use the arm; a young child who limps or will not walk after trampolining; any suspected concussion; an ankle you cannot take four steps on; or a knee that popped and swelled within a few hours.
• Doctor soon if a child’s or teenager’s wrist hurts on weight-bearing for more than a few days, or the pain returns with every handstand; a young gymnast’s back pain is worse on arching and lasts more than two weeks; a wrist stays painful at the base of the thumb after a fall, even if it looked normal; or back pain comes with pain, numbness or weakness down the leg.

Numbness around the groin or saddle area, or a change in bladder or bowel control, is an emergency department today.

Questions people ask

What are the most common trampoline park injuries?

Sprains and fractures are the most common trampoline park injuries, and they involve the legs more often than injuries on home trampolines. Most come from falls, collisions with other jumpers and flips. Head and neck injuries are less common but more serious. A child with a possible fracture needs a doctor and an X-ray first.

Is wrist pain normal in young gymnasts?

Wrist pain is common in young gymnasts, because handsprings, vaults and handstands put body weight through a wrist bent fully back. Mild stiffness that eases within a day is usual. Wrist pain that lasts more than a few days, or returns with every handstand, needs a doctor and an X-ray, because the growth plate can be involved.

Should my child see a doctor after a fall at gymnastics or a trampoline park?

Yes, if the wrist, elbow, ankle or leg is swollen, out of shape or too painful to use, or if your child limps or will not use the arm. In children, a fall that would sprain an adult’s ligament can break a bone or injure a growth plate, so a doctor and an X-ray come first.

When can a gymnast go back to training after an injury?

Return depends on tests rather than a date. Grip strength, weight through the hands without pain, hop and landing tests, and arching without pain are compared with the uninjured side. After a fracture, a growth plate injury or a concussion, a doctor clears the return first. Training then comes back in steps.