not permitted.

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© 2016 EDIZIONI MINERVA MEDICA The Journal of Sports Medicine and Physical Fitness 2017 May;57(5):703-10
Online version at http://www.minervamedica.it DOI: 10.23736/S0022-4707.16.06228-9

ORIGINAL ARTICLE
PSYCHOLOGY

Athletes’ perception of the causes of injury in gymnastics

Edvard KOLAR  1, Mitija S. PAVLETIČ  2 *, Maja SMRDU  2, Almir ATIKOVIĆ  3

1Faculty of Education, University of Maribor, Maribor, Slovenia; 2Faculty of Mathematics, Natural Sciences and Information
Technologies, University of Primorska, Koper, Slovenia; 3Faculty of Physical Education and Sport, University of Tuzla, Tuzla, Bosnia
and Herzegovina
*Corresponding author: Mitija S. Pavletič, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Titov trg 4,
6000 Koper, Slovenia. E-mail: mitija@gmail.com

A B S T RAC T
BACKGROUND: Gymnastics requires a high level of flexibility, conditioning and complete body recruitment that is infrequently matched by
other sports. Artistic gymnastics has a relatively high incidence of injuries, which are generally of minor or medium severity. With all its com-
plexity, it poses a unique diagnostic and treatment challenge to medical practitioners. The present study examined athletes’ perception of the
causes of injury and of the possible ways to reduce their incidence.
METHODS: The research involved 63 quality athletes, of whom 20 were in men’s artistic gymnastics, 21 in women’s artistic gymnastics, and
22 in rhythmic gymnastics. We used the self-assessment method. Factors inducing injury were grouped into three different categories: training,
the athlete himself, and the environment. We used the χ2 test to test the association between a risk factor and injuries. The association between
injuries and risk factors was also tested using a multivariate logistic regression analysis.
RESULTS: Overall, an incidence of 184 injuries was found, of which 67 (36.4%) were acute and 117 (63.5%) were chronic injuries. According
to binary logistic regression analyses, psychological factors significantly associated with the prevalence of acute and chronic injury in both sexes
for all disciplines were: a poor technique, improper methods of teaching, and an inadequate load. In our study, higher rates of acute and chronic
injury were observed among male gymnasts, who reported their occurrence during training by overload, and among female gymnasts, who
reported a poor technique, improper methods of teaching, and an inadequate load as main causes of their occurrence.
CONCLUSIONS: Improving the communication between athletes and coaches, taking the opinion of an athlete into account, and the athlete’s
active involvement in preparation of the program include the most crucial points for reducing the incidence of injuries.
(Cite this article as: Kolar E, Pavletič MS, Smrdu M, Atiković A. Athletes’ perception of the causes of injury in gymnastics. J Sports Med Phys Fitness
2017;57:703-10. DOI: 10.23736/S0022-4707.16.06228-9)
Key words: Gymnastics - Self-assessment - Athletic injuries.

A rtistic gymnastics (AG) is classified as a polys-

tructural (i.e., involving a large number of differ-
ent movement structures) and conventional (an agreed
model of movements) sport. It is characterized by an
emphasized aesthetic component of the movement 1 of
which main elements are extremely useful for the de-
velopment of basic motor skills. Average training lasts
5 hours a day, 5 to 6 days per week.2-4 Topology of inju-
ries in artistic gymnastics does not differ much in regard
to other sports.5-7 However, the loads in artistic gymnas-
or other proprietary information of the Publisher.
of gymnasts.3, 8 On apparatuses where athletes move by
hanging and support (uneven bars, high bar, rings), the
measured forces on the arms and shoulder girdles are
6.5 to 9.2 times gymnasts’ body weight, forces reflected
in the wrist when performing elements on the pommel
horse are 1.5 to 2 times their body weight.9
With this kind of the volume and training load, the
health status of an athlete has to be carefully consid-
ered. The fear of incurring an injury and a sport injury
itself are problems both beginners and top athletes face.

tics are high, e.g. landings on the mattress is 10-16 g, In addition to raising awareness and creating teams of
the maximum force on the uneven bars is 3.1 to 3.6 experts to work with athletes, gymnasts must be pro-
times gymnasts’ body weight,3 the take offs from and tected from sports injury through a system of preventive
landings on the floor are 5 to 17.5 times the body weight preparation. In order to create a high-quality prevention

Vol. 57 - No. 5 The Journal of Sports Medicine and Physical Fitness 703
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means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use i
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KOLAR ATHLETES’ PERCEPTION OF INJURY CAUSES IN GYMNASTICS
program, it is important to know the biomechanical
characteristics of the elements as well as the incidence
and mechanisms of sport injuries. Below we systemized
research studies on the incidence of sport injuries and
the mechanisms which affect that incidence. The casual
observer will note that gymnastics requires a high level
of flexibility, conditioning and complete body recruit-
ment that is infrequently matched by other sports. As a
result, gymnasts pose a unique diagnostic and treatment
challenge to medical practitioners. Injury rates in gym-
nastics are well documented in multiple epidemiologic
studies and literature reviews.8, 10-14
Different researches report the incidence of acute in-
juries in gymnastics is from 54% to 64% and of chronic
injuries from 36% to 46%.7, 12, 15, 16 A common injury in
gymnastics is of the overuse-type that often remains la-
tent until near the decisive moments of competition when
the injury rises to the level of incapacitation.3, 17, 18 Artis-
tic gymnastics (AG) has a relatively high incidence of
injuries, which are generally minor or medium (75%).
The percentage of serious injuries (absence from training
due to treatment of more than 28 days) is relatively small
at 20%.16, 19 Most attention after an injury is focused on
finding suitable methods and procedures for physical
rehabilitation. Psychological factors, which have a big
effect on an athlete, are often overlooked. If we ignore
the psychological factors, we need to be aware that one
aspect of an athlete is not being treated.20 Interdisciplin-
ary cooperation between a coach and other experts with
the aim of optimally preparing an athlete is necessary in
modern sport. Cooperation with a sports psychologist
has proven extremely useful especially when an athlete’s
physical load is increased,21 as well as with technical and
tactical preparations for sport and rhythmic gymnastics.22
Flint et al.23 have introduced the so-called “integrated re-
habilitation,” which includes not only the physical, but
also the psychological and social aspects of injury.20 It
would be optimal to ensure more global treatment in elite
sport, to treat the person as a whole and not just the in-
jury — in sports psychology, this method is called the
“biopsychosocial approach”.24
The effects of specific psychological techniques are
mainly on strengthening the motivation and rehabilita-
or other proprietary information of the Publisher.
tion, which results in faster recovery time. The process
of rehabilitation, coping with the injury and the loss of
everything an injury can bring (a drop in performance,
absence from competitions and the consequent loss of
704 The Journal of Sports Medicine and Physical Fitness May 2017
external validation and the achievement of success,
fear of recurrence of the injury, etc.) are similar to the
grieving process. Due to its complexity, with every in-
dividual this is slightly different and may entail varying
emphases for different individuals. Consequently, it is
important to learn and understand how an athlete per-
ceives an injury because that contributes to their more
effective rehabilitation.
In this study, we try to determine the athletes’ per-
ception of their injury with the aim to ascertain how
athletes define the cause of the injuries, quantifying the
extent of those problems, identifying the potential risk
factors to some extent and thus contribute to reducing
the incidence of injuries. The first hypothesis was that
gymnasts would report more chronic than acute inju-
ries, however that there would be no statistically signifi-
cant difference between them. Further hypothesis was
that gymnasts would perceive variables related to the
program of their training, specially overload, as a main
risk factors for injuries. The third hypothesis was that
the questionnaire utilized in this study is contextualized
to produce a form that is relevant to competitive gym-
nasts and enables the researcher to gather the necessary
information.
Materials and methods
Elite gymnasts (N.=63) from three different sport
branches participated in this study: 20 athletes from
men’s artistic gymnastics (MAG), 21 athletes from
women’s artistic gymnastics (WAG) and 22 athletes
from rhythmic gymnastics (RG). All of the measured
athletes aged 14 and up were categorized (youth, na-
tional, prospective, international, or world class). All
athletes below 14 years had to rank among the top
three in the cadet category at the National Champion-
ship (NCh) or National Cup (NCc), or rank in the top
three-quarters of contestants at international competi-
tions (which had to include competitors from at least
three countries). Both of these criteria are a prerequisite
for achieving a youth or national class according to the
criteria of the National Olympic Committee (NOC).
The study focused on measuring an athlete’s percep-
tion of the cause of a sports injury. We used a self-as-
sessment method via a questionnaire. Factors of injury
were organized in two categories:25
—— internal factors: factors related to the program
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means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use i
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ATHLETES’ PERCEPTION OF INJURY CAUSES IN GYMNASTICS KOLAR
of an athlete’s preparation, factors related to the coach
(inferior technique, improper methodology, overload,
poor protection when performing sports elements, in-
ferior mobility, poor physical strength, poor stamina,
inadequate load, other), factors related to athletes’ with
a direct impact on them (fatigue, inadequate warm-up,
restlessness, tension, poor concentration, lack of a seri-
ous approach, overestimation, fear, competition fright,
lower motivation, other);
—— external factors: inappropriate temperatures, in-
adequate lighting, inadequate humidity, poor tools,
poorly prepared tools, other.
Participation in the research was voluntary and anon-
ymous. The research was retrospective in character,
conducted by a qualified examiner who led the discus-
sion in the form of an interview. Together with the ath-
lete, they looked for answers to questions by circling the
answer that best described the athlete’s attitude prior to
the injury. The questions were pre-determined and the
questionnaire was divided into three areas: basic infor-
mation about the athlete, about their injury, and about
the athlete’s perception of the cause of the injury itself.
The athlete’s perception of the cause of the injury is a
relevant area for this study and thus the research com-
prised three different groups of questions. The first set
of questions addressed the athlete’s opinion about the
role their coach played in the occurrence of the injury
(9 responses). The second set of questions related to the
views of the athlete about their own role in the cause
of the injury (11 responses). The last set of questions
focused on external factors and their role in the cause
of the injury (6 responses). For each injury, an athlete
could choose up to three answers and a maximum of
one answer from each group.
The survey covered the two calendar years of 2011
and 2012. The University confirmed that the study did
not need the approval of the Ethics Committee. The ath-
letes had to choose between answers which were bro-
ken down into three different groups. They could select
several answers at the same time to arrive at the best
description of the cause of their injury. We obtained the
consent of the athletes included in the survey so that the
information can be used for research purposes in accor-
or other proprietary information of the Publisher.
dance with the law on the protection of personal data.
All athletes were interviewed according to the same
protocol: the interviews were conducted in the morning,
we explained the purpose and objective of the research,
Vol. 57 - No. 5 The Journal of Sports Medicine and Physical Fitness 705
the order of the questions was always the same, and the
interviews lasted about 40 minutes.25-29
Statistical analysis
Quantitative data were grouped into three basic
groups (MAG, WAG, and RG). The values of each an-
swer were defined by its frequency. Comparisons were
made on the basis of the percentage of shares. We used
the χ2 test to investigate the association between a risk
factor (training, gymnasts, and environment) and inju-
ries. Binary logistic regression tests were used sepa-
rately for the female and male respondents, employing
all variables that showed a significant association with
acute and chronic injuries. The significance level was
set at (P<0.05). All data retrieved were analyzed using
SPSS Statistics v.20.0 (IBM Corporation, Chicago, IL,
USA).
Results
Parameters of descriptive statistics for chronologi-
cal age of athletes, their training age and weekly hours
of training are presented in Table I. It can be observed
that men gymnasts (N.=20) in the study were in aver-
age a bit older than women gymnasts (both in artistic
[N.=21] and rhythmic gymnastics [N.=22]) and con-
sequently had some more years of training. However,
this is due to wider range of chronological age of men
gymnasts (SD and maximum age). Women and men in
artistic gymnastics had approximately the same number
of training hours per week. On the other hand, rhythmic
gymnasts have some more hours (per week) of training
than gymnasts in artistic branches. Since differences be-
tween samples are not statistically important, it can be
concluded that possible injury incidence, would not be
caused by these basic characteristics of training and age.
Overall number of injuries, acute vs. chronic injuries,
age categories
Of the total 63 interviewed athletes, we did not
identify a statistically significant difference (χ2=5.228,
P=0.073) in terms of the number of injuries per gym-
nastic branch (Table II). Overall, the number of injuries
in MAG was 50 (27.1%), in WAG 75 (40.7%), and in
RG 59 (32.0%).
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KOLAR ATHLETES’ PERCEPTION OF INJURY CAUSES IN GYMNASTICS

Table I.—Some characteristics of the participants in the study.

Group Mean±SD Minimum Maximum
MAG
Age (years) 21.09±5.90 12.57 35.92
Years in training 13.84±6.03 6.19 28.92
Frequency of training (h/week) 22.63±3.44 18.00 29.00
WAG
Age (years) 15.35±3.70 10.51 22.74
Years in training 8.75±3.85 4.42 16.74
Frequency of training (h/week) 23.80±2.91 18.00 28.50
RG
Age (years) 14.82±2.97 11.01 22.76
Years in training 8.49±3.07 4.01 16.76
Frequency of training (h/week) 28.95±2.25 24.00 32.00
MAG: men’s artistic gymnastics; WAG: women’s artistic gymnastics; RG: rhythmic gymnastics.

Table II.—Number and proportions of acute and chronic injuries in national artistic and rhythmic gymnastics in the period 2011/2012.
Group N. injuries reported Acute injuries* Chronic injuries*
MAG 50 (27.1%) 22 (44.0%) 28 (56.0%)
WAG 75 (40.7%) 27 (36.0%) 48 (64.0%)
RG 59 (32.0%) 18 (30.5%) 41 (69.4%)
Total 184 (100.0%) 67 (36.4%) 117 (63.6%)
MAG: men’s artistic gymnastics; WAG: women’s artistic gymnastics; RG: rhythmic gymnastics.
*Prevalence rates were rounded to the nearest whole number.

The results of our research (Table 2) showed that the
incidence of injury in MAG was: acute injuries (AI)
22 (44.0%), chronic injuries (CI) 28 (56.0%); WAG:
AI 27 (36.0%), CI 48 (64.0%); RG: AI 18 (30.5%), CI
(69.4%). This study established the total (N.=184) inju-
ries, which on average amounts to 2.9 injuries per ath-
lete. According to the results of the χ2 tests, there was
a statistically significant difference in the occurrence of
acute and chronic injuries (χ2=13.587, P=0.000). Gener-
ally, there were (67, 36.4%) acute injuries and a slightly
higher number of chronic injuries (117, 63.5%). How-
ever, no statistically important differences were find be-
tween acute and chronic injuries and their incidence in
different gymnastic disciplines.
Concerning the relationship between acute and
chronic injuries in different gymnastic branches (Ta-
ble III), the chi square shows no statistically significant
differences between the sample MAG-WAG (χ2=0.806,
P=0.369), MAG-RG (χ2=2.121, P=00.145), and WAG-
or other proprietary information of the Publisher.
robust results and differences from larger and more uni-
form samples. It is interesting that the men had a pro-
portionally greater number of acute (22, 44.0%) and
chronic (28, 56.0%) injuries, while the women had a
proportionally lower number of acute (45, 24.4%) and
chronic (89, 48.3%) injuries.
The results showed there is no statistically significant
difference in terms of age categories with the number of
injuries (χ2=1.761, P=0.185). The number of injuries in
the younger categories is 83 (45.1%) and in older cat-
egories 101 (54.9%).
Possible causes of injury
The athletes had to choose one answer from three
available sets of answers: process and program of train-
ing, athletes’ inner factors and external factors. Gym-
nasts mostly considered process and program of train-
ing as a main cause for their injuries (83.7%; N.=154),

RG (χ2=0.446, P=0.504). Although the chi-square test they evaluated their own mistakes as possible cause for
(Table  III) did not reveal any significant differences injuries in 13.6% (N.=25) of answers and the external
(χ2=1.707, P=0.191) between men and women in acute environment in 2.6% (N.=5). Statistically significant dif-
and chronic injuries, it would be possible to obtain more ferences in the number of responses to individual ques-

706 The Journal of Sports Medicine and Physical Fitness May 2017
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ATHLETES’ PERCEPTION OF INJURY CAUSES IN GYMNASTICS KOLAR

Table III.—Pearson’s χ2 tests between disciplines and overall number of injuries (acute and chronic).

Comparison N. valid cases χ² df P value

MAG-WAG 125 0.806 1 0.369
MAG-RG 109 2.121 1 0.145
WAG-RG 134 0.446 1 0.504
Male-female 184 1.707 1 0.191
MAG: men’s artistic gymnastics; WAG: women’s artistic gymnastics; RG: rhythmic gymnastics.

Table IV.—Logistic regression of significant risk factors in the measurement of gymnasts’ perception of the main causes of sports injuries.
95% CI for exp(β)
Group Causes P value Odds ratio for exp(β)
Lower Upper
MAG, WAG, RG Training* 0.040 0.886 0.789 0.994
Inadequate load* 0.020 6.000 1.324 27.191
Improper methods of teaching* 0.021 14.909 1.510 147.247
Poor technique* 0.030 15.000 1.290 174.386
Male Overload* 0.016 26.000 1.838 367.696
Female Improper teaching methodology* 0.002 6.222 2.003 19.325
Poor technique* 0.003 13.000 2.343 72.137
Inadequate load* 0.022 14.000 1.460 134.250
Other* 0.042 4.500 1.054 19.217
MAG: men’s artistic gymnastics; WAG: women’s artistic gymnastics; RG: rhythmic gymnastics.
*Statistically significant (P<0.05).

tions are seen from the questions relating to the athlete,
training, and the environment. In questions concerning
training, the largest number of answers was directed to
overload (52, 28.3%). Accordingly, the number of un-
selected answers in each part is separately different. The
sum of answers without the unselected answers is 184,
which coincides with the total number of injuries.
According to binary logistic regression analysis (Ta-
ble IV; only statistically significant results are present-
ed), the psychological factors significantly associated
with the prevalence of acute and chronic injury in both
sexes for all disciplines were: poor technique (odds ratio
[OR] 15.00; 95% CI: 1.29-174.38), improper methods
of teaching (OR=14.90; 95% CI: 1.51-147.24), and in-
adequate load (OR=6.00; 95% CI: 1.32-27.19). In our
study, higher rates among male gymnasts of acute and
chronic injury were observed among those gymnasts
who reported they were caused in training by overload
(OR=26.00; 95% CI: 1.83-367.69) and among female
or other proprietary information of the Publisher.
1.46-134.25). We found a statistically significant as-
sociation between injury and three training variables
(Table IV).
Discussion
The incidence of injury is the basis for researching
the causes of injuries. To identify what causes injuries,
the problem of the incidence of injury requires a deep-
er analysis and a further breakdown. In this way, the
optimal prevention programs may be defined and the
number of injuries in artistic and rhythmic gymnastics
reduced. The first step in analyzing injuries is to deter-
mine the frequency of the phenomenon.
Acute and chronic injuries
So far published studies included athletes with a va-
riety of weekly loads at different levels of quality. They

gymnasts who reported they were caused in training by reported that athletes who were training up to 8 hours
poor technique (OR=13.00; 95% CI: 2.34-72.13), im- per week were exposed to more acute injuries and that
proper methods of teaching (OR=6.22; 95% CI: 2.00- chronic injury is not a component of their participation in
19.32) and an inadequate load (OR=14.00; 95% CI: sport. In the case of athletes with a weekly load of more

Vol. 57 - No. 5 The Journal of Sports Medicine and Physical Fitness 707
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means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use i
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KOLAR ATHLETES’ PERCEPTION OF INJURY CAUSES IN GYMNASTICS

Table V.—Overview of the proportion of acute and chronic injuries in artistic and rhythmic gymnastics.
Study N. Year Acute injuries (%)* Chronic injuries (%)*
Caine et al.2 50 1989 57 43
Lindner and Caine30 362 1990 22 78
Lanese et al.31 35 1990 63 37
Dixon and Fricker32 162 1993 37 63
Bak et al.33 115 1994 39 61
Kirialanis et al.16 162 2003 62 38
Caine et al.15 50 2003 56 44
DiFiori et al.12 59 2006 54 46
Yang et al.7 43 2012 63 37
Mean value (median) 115.3 – 50.8 49.2
This study (total) 63 2011/12 36.4 63.5
Prevalence rates were rounded to the nearest whole number.

than 20 hours, a different ratio was recorded, along with
more chronic and fewer acute injuries.15, 23 Since gym-
nasts in our study were all elite gymnast and had, on av-
erage, more than 22 hours of weekly training (Table I) we
assumed they would have more chronic than acute inju-
ries (the first hypothesis). Previous studies on gymnastic
injuries have reported considerable differences in rates
of acute and chronic injuries (Table V).2, 7, 12, 15, 16, 30-33
The average value calculated from ten research samples
(N.=176) (Table V) amounted to 54.9% for acute inju-
ries, and 45.1% for chronic injuries. The values for acute
injuries ranged from 22% to 63.4%, while for chronic
injuries from 37% to 63%. Due to such discrepancy of
results in different studies we further assumed that dif-
ference between acute and chronic injuries would not be
statistically important (the first hypothesis).
In this study, we determined the incidence of injuries,
33.70% were acute injuries and 66.3% chronic injuries
(Table II) and difference between them was statistically
important. Only two other studies have arrived at the ra-
tio 1/3 acute injuries to 2/3 chronic injuries.32, 33 There-
fore, we can partially accept our first hypothesis, since
the athletes did have more chronic than acute injuries,
however the difference in their number was also statisti-
cally important. It seems that hours of training could be
the variable that mostly influences the ratio of acute and
chronic injuries and that this ratio should be viewed in
regard to a quality level of athletes.
or other proprietary information of the Publisher.
juries over a period of 16 years (1988-2004) and cap-
turing 16 sports disciplines (3 individual and 13 team
sports).6 Based on a comparison of the incidence of
sports injuries in artistic gymnastics relative to other
sports, the same study found that the injury incidence
of artistic gymnastics is above-average and worri-
some. The incidence of training injuries was 6.1 per
1000 hours of training or competition.6 On a sample of
1.550 women artistic gymnasts, it was (among other
things) found that most injuries in competition (70%)
occur on the floor when landing or during dismounts;
53% of all injuries in competition and 69% of all inju-
ries in training were sustained by the lower limbs. This
results, studies which reported that the loads in artis-
tic gymnastics are high 3, 8, 9 and personal experiences
in various fields of gymnastics lead us to the assump-
tion that overload (as part of a training program and
process) would be perceived as the most common and
important cause for injuries (the second hypothesis).
In our study, in the perception of the causes of inju-
ries in the area of training, the main finding is that in the
athletes’ opinion the vast majority of injuries (83.7%) in
MAG, WAG, and RG were the outcome of an inappro-
priate program of work as put together by the coach and
the professional team. Athletes also rated their own mis-
takes and evaluated that in 13.6% of answers they could
also have an impact by way of reducing the number of
injuries. According to the athletes, the external environ-
ment is the least problematic for sports injuries in gym-

Possible causes for injuries nastics (2.6%), which was expected since the work is
carried out in a gym and the conditions (temperature,
The largest survey on the incidence of sports inju- humidity) can be controlled. Statistically significant dif-
ries was conducted in the United States, monitoring in- ferences were shown in the frequency of responses to

708 The Journal of Sports Medicine and Physical Fitness May 2017
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, log
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use i
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
©
COPYRIGHT 2017 EDIZIONI MINERVA MEDICA
ATHLETES’ PERCEPTION OF INJURY CAUSES IN GYMNASTICS KOLAR
individual questions (in the part of the training process).
As to the cause of injuries, in 28.3% of answers the ath-
letes identified overload, in 14.7% a poor technique
and in 10.3% an incorrect training methodology. Re-
sults partially confirmed our hypothesis, that overload
would be a most reported cause for injuries. However,
we did not expect that some other variables would be
consider an important risk factor, as well. We can de-
tect from the answers in the research a certain degree of
mistrust between the athlete and the coach. According
to the proportion stating that the causes of injuries are
related to the training area, we assume that individual
links between the athlete and the coach are not acting
in concert. The research results show that the athletes
feel pushed away in decision-making and ultimately lay
most of the blame on their coach or professional team.
We conclude that athletes have doubts in the program in
which they are 100% involved due to their unfamiliar-
ity with the program itself. When viewed in a long-term
perspective, an athlete’s doubt in the correctness of their
training program is not good for their career.
In our opinion, the proposed measures identify the
underlying causes of the current negative perception of
athletes in MAG, WAG, and RG, which were included
in the research. The above points would raise an ath-
lete’s confidence in their program, bring them closer to
the goals while, on the other hand, the coach and the
professional team would gain some quality feedback
about the athlete and increase the levels of mutual trust.
Active communication and a quality information ex-
change would enable direct control of the risk factors
and reduce the number of injuries. This would conse-
quently positively impact on the athlete’s motivation,
self-esteem, self-confidence, etc. At the same time, the
coach could strengthen their authority in the profession-
al field, which is a prerequisite for the good leadership
of an athlete to yield superior results.
A questionnaire for the incidence of injuries in gymnastics
Determining the incidence of injury provides the ba-
sis for understanding and then taking action with the
aim of controlling or minimizing this problem. The in-
or other proprietary information of the Publisher.
cidence of injury is a fact most evidenced by research-
ers of sports injuries. We can only draw conclusions
about the seriousness of the problem of the incidence
of injury when we know what its incidence is. Unlike
Vol. 57 - No. 5 The Journal of Sports Medicine and Physical Fitness 709
football (soccer), artistic gymnastics does not have a
standardized questionnaire to research the incidence of
sports injuries.27 Therefore, basing on decades of our
experiences in gymnastics, we created a questionnaire
that can help us record this information. Since many dif-
ferent and important information were obtained by it,
we can confirm its usefulness (therefore confirming the
third hypothesis). However, we also found it has certain
limitations.
Any review of research and publications regarding
the incidence of sports injuries is linked to several lim-
iting factors. A comparison between the chosen studies/
research is a compromise due to the different samples,
varying definitions in research studies about what a
sport injury itself is: rule changes occur every 4 years,
new skills are developed, there are multiple different
events, and the dynamic activity and body positioning
is unique, unlike in any other sport. The data collection
is largely based on the memory of athletes, coaches and
others involved, but is rarely supported by medical doc-
umentation. Therefore, researchers typically address
acute injuries. Chronic injuries are much more vulner-
able to research because the athlete must independently
determine the time of their occurrence.4 Beside that, this
specific questionnaire and study had additional limita-
tions. Certain parts of the questionnaire could be more
detailed and formulated as a Likert type of questions,
perception of causes for injuries could be compared
with coaches’ perception and incidence could be sup-
ported by medical documentation. Also, the sample of
the study is relatively small, however all high-ranked
Slovenian gymnasts participated in the study, therefore
to get a bigger sample the study should be international.
Conclusions
The areas addressed are sensitive and therefore high
priority was given to an athlete’s trust. We took care that
their confidence remained at a high level and, therefore,
the study did not include coaches. The results we ob-
tained indicate the lack of coaches’ social support. Ath-
letes generally respect their coach’s formal authority,
are formally inferior to the coach, and coaches (mostly)
rely on their formal authority and often do not achieve
the authority of the profession. Coaches lead the process
of an athlete’s preparation and value the athlete’s ac-
tivity, behavior, etc. in different ways. The athlete also
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, log
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use i
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
©
COPYRIGHT 2017 EDIZIONI MINERVA MEDICA
KOLAR ATHLETES’ PERCEPTION OF INJURY CAUSES IN GYMNASTICS
goes through this process. Due to the coach’s formal au-
thority, when communicating with the coach the athlete
often apparently agrees but does not necessary trust his/
her coach and has suspicions about the suitability of the
program, which gradually sees the athlete move away
from the set goals. The proposed measures could help
eliminate the causes of such a negative perception of an
athlete and help reduce the number of injuries.
Our findings add to the evidence regarding the im-
portance of well-conceived training in relation to acute
and chronic injury. If confirmed in other studies, these
findings would hold implications for attempts to pre-
vent injuries in the elite population of gymnasts.
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