Americans are keenly watching gymnastics superstar Simone Biles this year, especially after her withdrawal from the 2021 Olympics. At the start of the 2024 Paris Olympic Games gymnastics competition, she experienced a calf injury and millions of viewers watched as she wrapped her calf yet continued to perform.

Injuries are just part of the experience for the almost 600 different athletes competing for the U.S. in the 2024 Olympics. Many of these athletes have been practicing their sport since they were young children.

Given their intense training and competition schedules, Olympic athletes are prone to various injuries so must continually take precautions to protect their bodies. Most have an entire team of physical therapists, doctors, coaches, athletic trainers, nutritionists, and sports psychologists behind them to help them stay injury-free.

Statistically, boxing generates the highest number of injuries among all Olympic sports followed by BMX and skateboarding. These sports involve a high level of risk of traumatic injury, not related to overuse or wear and tear.

Following are some of the most common orthopedic injuries faced by Olympic athletes and some insights and tips from Midwest Orthopaedics at Rush physicians (team doctors for the Chicago Bulls, Chicago White Sox, Chicago Dogs, Chicago Red Stars, and Joffrey Ballet) on to prevent them.

Foot & ankle injuries

Gymnastics is one of the few impact sports where athletes are completely barefoot. Although gymnasts land on mats, they are still generating a tremendous amount of force when they land. This is considerably worse for women on the balance beam on which they perform jumps and landings on a hard surface only four inches wide.

According to Dr. Simon Lee, a foot and ankle surgeon at Midwest Orthopaedics at Rush, it’s simple physics. “It comes down to Force = Mass x Acceleration,” he says. “Just calculate how much a gymnast weighs and how high they are falling from, then factor in gravity. To put it simply, if you placed a scale underneath a gymnast as they landed it would show seven to eight times their body weight.” This can certainly explain why the foot and ankle have such a high incidence of tendon ruptures (Achilles), ankle and foot sprains, and stress fractures (navicular and metatarsals)

“For every single routine you see on television, a gymnast has probably practiced that hundreds of times this year and several dozen in the last few weeks,” explains Dr. Ed Hur, foot and ankle surgeon, Midwest Orthopaedics at Rush. “That's a lot of wear and tear on their legs and arms.”

Shoulder injuries

Swimming requires a lot of repetition during training. A swimmer’s shoulder is particularly prone to injury given the intense demands of pulling one’s body through the water at Olympic speeds. “Swimming really showcases some of the unique things the shoulder can do — it has more range of motion than any other major joint — and swimming really highlights that combination of both strength and flexibility,” explains Dr. Grant Garrigues, a sports medicine/shoulder surgeon at Midwest Orthopaedics at Rush.

Unfortunately, that amount of strength and an impressive amount of motion, coupled with swimming thousands and thousands of yards per day can lead to injuries, particularly from overuse. “Swimming has a relatively low rate of injury during the actual competition, but injuries during the grueling training are quite common as the repetitive motion can cause frequent contact within the shoulder that can lead to a host of issues,” Dr. Garrigues says.

These injuries can include bursitis or “impingement syndrome” where the bony roof of the shoulder blade rubs against the tendons in the shoulder as the arm is raised, causing pain. Similarly, overuse can cause biceps tendonitis and labral tears.

“The best preventive measures for shoulder conditions are dedicated strengthening activities outside the pool,” explains Dr. Nikhil Verma, sports medicine surgeon, at Midwest Orthopaedics at Rush. “Maintaining range of motion and working on strength and stability to focus on the rotator cuff and scapular musculature is key."

Sprains and Strains

When ligaments or muscles are overstretched or torn, this is considered a sprain or strain.

Olympic athletes competing in movement and cardio-heavy sports such as track and field, gymnastics, and team sports may encounter these injuries due to their increased movement and risk of an awkward landing or collision.

For both Olympic athletes and everyday athletes, it is important to properly warm up and stretch. This helps prepare muscles and ligaments for more strenuous activity while playing sports or exercising.

Stress Fractures

Think of ‘sticking a landing’. Stress fractures commonly occur when muscles become fatigued and can no longer absorb added shock, transferring the stress to the bones instead. They are small cracks in a bone caused by repetitive force or overuse, often resulting from high-intensity training.

Olympic athletes most prone to stress fractures include long-distance runners, marathoners, and sprinters, due to the constant impact on their lower limbs. Gymnasts and dancers are also at high risk because the repetitive jumping and landing can put significant strain on their bones.

To prevent stress fractures, it is important for athletes to not “overdo it” while training. Any increases in load should be done gradually to avoid rapid wear and tear of the bones. Cross-training or doing different exercises for different muscle groups is critical. Equally as important is proper footwear.

ACL Injuries

An ACL (anterior cruciate ligament) injury in the knee often occurs from sudden stops or changes. Olympic athletes competing in sports like soccer, volleyball, gymnastics, basketball, or track that require quick pivots or lateral movements, have a higher risk of an ACL injury.

"ACL injuries are more common when fatigue sets in and, similar to overuse leading to shoulder pain, athletes are at a higher risk during the competition for ACL injury due to fatigue-related factors,” explains Dr. Brian Cole, sports medicine surgeon, at Midwest Orthopaedics at Rush.

Both Olympic or recreational athletes can lower their risk of an ACL injury by incorporating strength training for the muscles around the knees and hips, focusing on proper technique. Performing agility drills and balance exercises can improve knee stability and further reduce injury risk. A thorough warm-up before workouts and adequate recovery time also helps to avoid overuse.