Multidirectional instability of the shoulder in elite female gymnasts

Multidirectional instability (MDI) of the shoulder is symptomatic laxity in 2 or more directions, 1 of which is inferior. MDI is well described in overhead athletes (eg, baseball players, tennis players, swimmers) but not in gymnasts. We conducted this study to estimate the incidence of any type of shoulder pathology in elite gymnasts, to estimate MDI incidence in this population, and to determine which if any circumstances place these gymnasts at higher risk for developing MDI. An 18-question multiple-choice questionnaire was administered to 70 female US collegiate gymnastics teams. Potential risk factors were cross-matched against those gymnasts with traumatic shoulder injuries and again against those gymnasts who met MDI study inclusion criteria. Of the 1115 questionnaires distributed, 457 (34 teams) were returned. Twenty-two percent of gymnasts suffered from a traumatic shoulder injury, and 11% met study inclusion criteria. There was a statistically significant (P =.02) relationship between generalized ligamentous laxity and traumatic shoulder instability but not MDI. Incidence of atraumatic or traumatic shoulder injuries in gymnasts is higher than previously recognized. Although this study did not reveal any potential risk factors, it does provide several avenues for more specific research.