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

Area of Science:

• Sports Medicine
• Exercise Physiology
• Genetics

Background:

• Artistic gymnastics has a high incidence of acute and chronic injuries.
• Previous research has focused on biomechanics and training, neglecting molecular and genetic factors.
• The multifactorial nature of gymnastics injuries necessitates a broader investigation.

Purpose of the Study:

• To systematically review evidence on the causes, mechanisms, and prevention of artistic gymnastics injuries.
• To emphasize biomechanical, molecular, and genetic determinants of injury risk and performance.
• To provide a comprehensive overview of current research for injury prevention strategies.

Main Methods:

• Systematic review following PRISMA 2020 guidelines, registered on PROSPERO.
• Searched PubMed, KoBSON, and Google Scholar (2015-2025) for keywords: gymnastics injuries, overuse injuries, injury prevention, biomechanics, IL-6, TNF-α, miRNA biomarkers.
• Analyzed 19 studies on injury incidence, localization, mechanisms, and molecular/genetic associations.

Main Results:

• Most injuries affect upper and lower extremity joints, especially during puberty and high competition levels.
• Repetitive loading, poor technique, and inadequate recovery are primary etiological factors.
• Biomarkers (IL-6, TNF-α, miRNAs) linked to inflammation; genetic polymorphisms (ACTN3, ESR1, CYP19A1) associated with flexibility, strength, and injury susceptibility.

Conclusions:

• Injury prevention requires a personalized, multidisciplinary approach integrating biomechanical, clinical, molecular, and genetic data.
• Molecular and genetic profiling can improve early detection of overuse injuries.
• Optimizing gymnast health and performance necessitates incorporating advanced profiling into training and rehabilitation.