[The gymnastics shoulder].

BACKGROUND: Adult gymnasts show a high prevalence of various shoulder pathologies. Due to the specific equipment used in gymnastics and the high training schedule with weekly training times up to 32 h, the shoulders of gymnasts are mostly subjected to symmetrical bilateral weight bearing. This is in contrast to overhead throwing, racket and martial arts sport forms in which the load is mainly located on the dominant side. CAUSES OF INJURY: Structural lesions of the shoulder and shoulder girdle in male gymnasts can arise due to high repetitive support and swing forces during exercises on the six specific types of apparatus and particularly the rings. INJURY PATTERNS: These lesions particularly affect the biceps tendon anchor, the long head of the biceps tendon and the tendon of the supraspinatus muscle. Because possible pathologies can increasingly occur even in younger gymnasts, awareness of the treating physician and also the trainer should be increased. THERAPY: Early initiation of intensive conservative treatment and arthroscopic interventions in cases of failure of non-operative management are relevant for satisfying results. Modern arthroscopic reconstructive techniques are available for treating structural lesions.
CONCLUSION: Nevertheless, in almost 30 % of the patients the occurrence of shoulder pain or the necessity for surgical interventions will prevent them from achieving the national or international level of competition. This underlines the necessity for development of prevention programs.