There are a few issues in gymnastics that I think every coach, athlete, and parent recognizing as a problem. One of the most common is the concept of rib flaring. This refers to a shape that has an over-arched lower back, and usually comes with the ribs sticking out quite a bit.
In my years in gymnastics, I have seen hundreds of gymnasts struggle with this rib flare issue during skills. I have also the same issue related to lower back pain, elbow pain, and wrist pain. When you take a step back and look at the overlapping movement issues, sometimes there are some common denominators that are important to look for. To help readers out, here are the top 5 reasons I see for rib flaring in gymnasts and the relation to some common injuries.
1. Limited Soft Tissue Mobility
I feel like I talk about limited soft tissue mobility in a ton of blogs. But it’s for good reason, as I think not regularly tending to soft tissue on a daily basis is one of the biggest things most gymnasts miss. The lat muscles run from the upper arms, travel down the back, and then end right above the hips. It is a very powerful muscle the pulls the arm forcefully down, and rotates the shoulders inward (think kipping, swinging on bars, pulling into flip shapes).
What many people don’t realize is that when they are excessively stiff, it’s really easy for a gymnast to cheat their way around the limited flexibility. Gymnasts usually over arch their lower back causing the rib flare, buckle their knees early when swinging their arms overhead in tumbling, or impact without their handstand shoulder angle fully open.
The teres major is another muscle that goes from the inner arm to the shoulder blade, and is also mainly responsible for aggressive motions pulling the arm down as well as turning the shoulder joint inward.
The lat and teres major are very easily over worked and stiff in gymnasts due to how much they use this motion. As a result, you often see the same rib flare compensation from above. The other really common compensation you see is the shoulder blades winging out to the side during handstands. The most common place to catch this is in uneven bar handstand holds, especially front giants. You can actually see it pretty well in Simon Bile’s left shoulder in this handstand.
I have no idea if this is the case with Simone, but given it being so common in gymnasts I would think so. She is just beastly strong in her core and can maintain a good line, but you can see the shoulder blade flaring out during her handstand.
With teres major stiffness, this is often a common compensation during overhead skills. In both of lat and teres major stiffness, the rib flare is seen and may appear to be the problem. However, the real issues it the soft tissue being overly stiff. When people address these issues, the positive changes in handstand lines is pretty crazy. First, we have to screen gymnastics specific shoulder positions. Following this I usually have the gymnast start with foam rolling and lacrosse ball work to these two areas, perform some under grip stretches, and then follow it up with some strength or handstand technique work.
2. Strength Imbalances Around The Shoulder
This is another really common issues I find myself talking about a lot. Just as with the point above, it’s really easy for gymnasts to have some areas of the body (lat, teres, pecs) that are naturally stronger, while other areas (upper back, scaps, posterior chain) tend to get neglected. This is partially due to the nature of gymnastics, but also because sometimes as a whole we neglect them in strength.
The best way to correct this is to first address the soft tissue above, and then make sure to add in regularly horizontal pulling exercises during strength. I try to get 1-2 pulls in for every push each week, and this is always a main focus of rehab in gymnastics patients I treat at Champion. Horizontal Rows, Renegade Rows, and some basic dumbells exercises are usually my go to.
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3. Core Control / Strength Issues
I think this is the most intuitive for all gymnastics coaches, gymnasts, and medical providers. Sometimes, gymnasts simply don’t know how to engage and maintain proper core engagement during skills. This often times creates a situation where they buckle during the skill, and have a really poor core and shoulder position.
If the soft tissue problems have been ruled out about, and they are relatively balanced, it may take just breaking down some basic core control aspects. I personally usually like having gymnasts go on their back, and practice basic breathing/bracing. We do 3 rounds of this (takes a total of 60 seconds) in our warm up every day, so that it helps transfer to events.
Once they get the basics, you can then move to the harder strength, technique, and power based applications to prevent the rib flare from creeping in. I try to focus a lot on this during strength, power, and side station drills as most coaches would. Sometimes it just takes a ton of practice applying it to skills and routines.
4. Technical Issues
This one is quite a broad topic, as there are a ton of technical skill issues that could come up. Many times, gymnasts may have the flexibility and strength for certain skills, but it’s just new and they don’t have a ton of experience. This is where it comes down to having a good coaching eye, being able to explain the issue to the athlete, and then applying the right drills or cues to help correct it. Often times 1 step back can lead to 3 steps forward, and some light bulb moments. I also think that slow motion video feedback is a huge learning tool in these situations.
5. Fatigue
This one is most commonly overlooked as an issue, but people don’t realize how much fatigue ca negatively affect proper shaping/movement patterns. If a gymnast is getting really fatigued or doesn’t have the cardio to get through routines/practice, the rib flare and a loss of core control may be the first thing to go. Especially during high intensity cardio situations, rib flaring is usually the first way the body trys to get more oxygen in and carbon dioxide out.
To help, I’m a huge fan of using “pet rock” workouts during cardio. This idea of holding two weights while resting during a cardio circuit forces gymnasts have to maintain proper core engagement, breathing patterns, and also try to slow their heart rate down. I think it’s really great when used appropriately to help control rib flaring under fatigue. You can see it in this example below, where our girls had to do some horizontal rows, jumps, block pushes, and jump cast handstands, and then immeditaley do a kettlebell hold for 60 seconds when fatigued.
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Concluding Thoughts
So, these are just a few of what I find to be the most common reason for rib flaring in gymnastics. There are definitely some more reasons that could go on this list, including some gymnasts that have unique anatomy any larger rib cages /over extended spines that are more pronounced. I typically find this not to be as common as some people think though. These categories are not mutually exclusive, as sometimes it can also be a combination of a few factors. For now, I hope this helps!
via Dave Tilley DPT, SCSCEO/Founder of SHIFT Movement Science and Gymnastics Education
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