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The sport and injuries

The following article was written by Jonathan Betser when he was Osteopath and Lead Therapist of the British Trampolining Federation.

Most of us can relate to sporting contests in football, rugby, swimming, athletics and cricket easily because we took part in them at school. Amongst the “minor sports” trampolining has what is arguably a unique position in that most of us have also, as a child, been on a trampoline at some stage or other – whether at school, on a beach or even in the back garden.

Treating elite level trampolinists is, however, a somewhat different experience.

As with any sport the only way to really start to appreciate its complexity and demands is by watching it. Certainly in the case of the gymnastics’ disciplines (of which trampoline is one) this is profoundly true.

A routine consists of a series of “in-bounces” (simple bouncing up and down in order to progressively gain (lots of!) height) followed by ten moves of varying complexity. To appreciate the physical demands of an individual’s personal routine one naturally has to find out the level at which they’re competing (for simplicity, please refer to Table I). The more advanced the individual, the more complex and demanding the routine inevitably becomes. A competition requires a ‘set routine’ (a routine which is based on set guidelines) followed by voluntary (or ‘free’ routine). The second of these is then repeated in a ‘final’.

When assessing the individual physically, remember they only twist in one direction and although they can’t always remember which way they twist themselves (honestly!), it’s naturally of great significance from a biomechanical perspective. Somersaults are either “tucked” (knees held close to chest so the body is in a “ball”) or “piked” (hands behind knees with both legs straight and hips flexed) – anyone with a hamstring problem/positive SLR is obviously going to struggle with throwing themselves into a series of repeated “piked” moves.

The more advanced trampolinists generally have “spotters” next to the trampoline. These are individuals (usually one at each corner if it’s a competition) who stand in preparation of someone falling off. This helps minimise serious injury but it has been known for a spotter to save a competitor and get injured himself/herself in the process! At the more basic level, a spotter generally is much less necessary (and, if inexperienced, will often concern the trampolinist more with nervous reactions than reassure them!).

However some of the basic moves can cause problems. A seat drop (landing in a seated position) or back drop (onto your back) are quite hard to induce injury but it’s not that uncommon for inexperienced trampolinists to land badly in a “front drop” (forcing their spine into hyperextension) or when trying their first somersault.

As with any sport, learning from a qualified coach (especially one who has a “bungy rig” to practice new moves in) is always the best way to avoid injury. I would certainly recommend anyone who treats trampolinists to go and watch them in action. The coach will be more than happy and your ability to understand, advise and treat will be much improved.

I’ve been fortunate to have been invited to provide and organise cover at numerous competitions and squads over the years and I can honestly say that, when managed correctly, it really is one of the safer “performance” sports. Many of the injuries one sees relate to the sort of over-use injuries (eg. Achilles or patellar tendonitis), joint problems (e.g. lumbar spine facet joint compaction injury due to hyper extension) and “acute on chronic” injuries (e.g. lumbar disc complaint) that one could sensibly anticipate would happen in the sport. However, most of the problems we treat are relatively minor acute injuries resulting from a poorly executed move or landing badly.  The one fear of most trampolinists is the almost unmentionable “lost move syndrome” (also known as suffering with “head problems”!). This describes a situation when a trampolinist becomes prone to losing their positional awareness in the middle of performing (i.e. not knowing where you are “in the air” in relation to the trampoline). This is, understandably, a serious problem and is best addressed (early on!) between the trampolinist’s coach and a good psychologist.

The “medical team” for trampolining’s national squad structure is a good mix of osteopaths and physiotherapists. This enables us to provide across-the-board musculo-skeletal skills to complement the British Gymnastics’ Doctors and Exercise Physiologists. It also means that in those circumstances where there is more than one therapist (such as at a World Championships), we can provide both an Osteopath and a Physiotherapist – I’m pleased to say that this has been enthusiastically endorsed by all those concerned. We work well as a team and with the advent of the internet there’s an easy facility to ensure continuity of care. We’re working closely with the coaches and technical committee to continue developing this support and to ensure that testing regimes, a core stability programme and preventative treatment all complement the acute care provision that our trampolinists deserve.

It’s been wonderful to see trampolining, a sport we’ve always been good at in the U.K., reach a stage where it’s developing a significant profile; especially when we have performers who can expect to be in a good position to be winning medals at the Olympics! So watch out for some.
I’ve enormously enjoyed working with trampolinists over the years and have been grateful for the opportunities given to me by the national coaches and admin staff.

Level   What it means   What it will probably entail
School/beginners club level   Interest only - non-competitive   Simple jumping up and down, with basic moves (front drop, seat drop, back drop and single somersaults) - not in a specific routine
Junior competitive   Local level and inter-school competitions   As above, but combined in a continuous routine
National competition level Grade 1s and 2s   Regular competitions at sub- elite level - generally aiming to step-up to the next stage   Routines that involve several somersaults (including 'doubles' for the older trampolinists) and with most of the 10 moves involving a 'skill' rather than being a simple jump
National/International with voluntary tariff of over 10   Difficult routines and regular competitions throughout the year (likely to be aged in mid/late 'teens unless very good)   A combination of demanding moves including a lot of twisting and somersaults (a tariff of high 14s and above is senior men at a top level and will involve several triple somersaults

Table I: a simple guide to complexity of voluntary routines (Nb. boys / men generally compete at a slightly higher tariff than girls / ladies).

© Jonathan Betser