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Risks in gymnastics “Lots of twists, lots of knee injuries”

A ruptured cruciate ligament paired with a torn meniscus, as was the case for Andreas Toba, is a common injury in gymnastics, as Dr. med. Andreas Sander-Beuermann, specialist in orthopedics and special orthopedic surgery, knows well. From 1985 to 1998, he was the leading physician at the Hanover/Wolfsburg Olympic training center and has been treating Andreas Toba since his childhood. An interview with the physician and the gymnast.

Bauerfeind life: What makes gymnastics so high-risk for the type of injury that Andreas suffered?
Dr. Sander-Beuermann: A lot depends on the associations and judges. What do they want? What do they give the most points for? If lots of twists are desired in the routines, this often leads to distortion of the knee. We see fewer injuries in movements that are more straight-on. I was at the 2007 world championships in Stuttgart , where I saw lots of twists and lots of cruciate ligament injuries.
Andreas Toba: The scoring system is changed every Olympic cycle. We gymnasts have to decide, where is it worth putting in a triple somersault , or a bend? Should I perhaps connect moves with two jumps? This is exactly what I did at the start of my floor exercise in Rio, where I injured myself. The triple somersault scores high points with the judges.

Is the risk of injury the same for all pieces of apparatus?
Dr. Sander-Beuermann: The high pieces of apparatus are the ones that pose the greatest risk. This means the high bar, vault and rings, but also the floor. You always have to think about the landing, wherever it’s being attempted. The risk isn’t as great on the pommel horse and the parallel bars.
Andreas Toba: But there have been some positive developments in the apparatus, such as softer mats. But of course, there are still some athletes who are on the more reckless side, which pushes the risk level up. And of course, there are cool pieces of equipment that can help in the event of an injury.

A relaxed atmosphere: Orthopedic specialist Dr. med. Andreas Sander-Beuermann once treated Andreas Toba’s father and has known the gymnast since he was little.
A relaxed atmosphere: Orthopedic specialist Dr. med. Andreas Sander-Beuermann once treated Andreas Toba’s father and has known the gymnast since he was little.

Do you mean the orthoses and supports that have helped you to return to competitive gymnastics?
Andreas Toba: For me, they sort of acted like an airbag. The fear that I would break something just disappeared. This gave me the courage to do completely different training exercises to what I had been doing before. I initially had concerns when moving from the SecuTec Genu to the SofTec Genu. It didn’t seem as firm. “It’s all been tested,” I was told. “It fits securely. And it’s even better at protecting you in the stadium, because it sits on your knee just a little bit better.” That’s when it clicked for me, and I was happy to practice with it.

What was stronger while you were returning to your gymnastics activities: The fear or the pain?
Andreas Toba: Pain isn’t the problem. As gymnasts, we’re used to that. Once I landed badly and tore the ligaments in both ankle joints – and carried on with my routine. The problem is the mental block – the fear that something will happen. Will the landing be OK? What will happen if you land badly or catch yourself on the apparatus? My physicians and orthotists took this fear away with their medical aids. The knee is stable. I would not have reached this stage so quickly without the orthoses and supports. Now I can stop using them gradually as I build up my strength and coordination. But when I start my floor routines again properly, I can definitely envisage using a support to begin with.
Dr. Sander-Beuermann: The deciding factor is this: The athlete’s head must not be clouded with negative thoughts. He must have absolute faith in his joint before it can function again properly.

Images: Anika Büssemeier