Injuries in Artistic Gymnastics: Etiology, Prevention Strategies, and Multifactorial Perspectives-A Systematic Review.

Artistic gymnastics places enormous repetitive stress on the joints, especially during growth spurts and at elite competitive levels, and researchers have long tried to understand why some gymnasts get injured while others don't. This systematic review pulled together nineteen studies published over the past decade to look beyond the usual biomechanical and training explanations, asking whether molecular and genetic factors also play a role in injury risk. The review found that most injuries clustered in upper and lower limb joints, driven mainly by repetitive loading, technique errors, and inadequate recovery time. It also identified inflammatory markers and specific gene variants that were associated with flexibility, explosive strength, and injury susceptibility.

These molecular and genetic links are interesting because they hint at a more personalized way of thinking about injury prevention, but the underlying evidence comes from a modest, mixed set of studies, so these associations should be read as exploratory rather than established causes of injury.

If you're a gymnast, coach, or parent, you've probably noticed how physically punishing this sport can be on joints, particularly during the teenage growth years and at higher competition levels. This review gathered nineteen studies to explore not just the usual causes of gymnastics injuries, like repetitive strain and technique issues, but also whether biological markers in the blood and certain inherited gene variations might make some athletes more prone to injury than others. The researchers found that joint injuries in the arms and legs were the most common problem, tied to overuse, poor technique, and not enough recovery time between training sessions.

They also found associations between certain inflammation-related molecules and gene variants and things like flexibility, strength, and injury risk. These are early, associative findings rather than proof that testing for these markers would prevent injuries.

The evidence base is still small and the field is young, so these ideas about personalized injury prevention are promising directions for future research rather than settled practice guidance.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This PRISMA-guided systematic review (PROSPERO-registered) synthesized nineteen studies from 2015 to 2025 examining injury etiology in artistic gymnastics, with a specific focus on integrating biomechanical findings with molecular and genetic data, an angle the authors note has been underexplored relative to training and biomechanical factors alone. Injuries were predominantly localized to upper and lower extremity joints, with repetitive loading, technique deficiencies, and insufficient recovery cited as primary mechanisms, particularly during puberty and at higher competitive levels. Notably, the review identified associations between inflammatory biomarkers (interleukin-6, tumor necrosis factor-alpha) and microRNAs (miR-155, miR-146a) with inflammatory injury processes, alongside genetic polymorphisms (ACTN3 R577X, ESR1 rs2234693, CYP19A1 rs936306) linked to flexibility, explosive strength, and injury susceptibility.

These are associative findings drawn from a heterogeneous set of included studies rather than causal or mechanistic proof, and the review does not report pooled effect sizes or formal risk-of-bias grading across the nineteen studies. Clinically, the synthesis suggests that injury prevention frameworks incorporating molecular and genetic profiling alongside biomechanical and clinical assessment could theoretically improve early detection of overuse pathology, but this remains a conceptual integration proposed by the authors rather than a validated intervention tested in this review.