Achilles injuries ended Olympic dreams for two U.S. gymnastics contenders. Can they be prevented?

Kayla DiCello dedicated her life to making the U.S. women's Olympic gymnastics team. After being named an alternate for the 2020 Tokyo Olympics, 2024 seemed destined to be her year. A two-time world medalist, DiCello won the season's first meet, the Winter Cup, and finished third in the all-around at the 2024 U.S. Championships.

However, during the opening routine of the U.S. Olympic Gymnastics Trials on June 27, her aspirations came crashing down. Attempting a double-twisting Yurchenko vault, which she had perfected over thousands of repetitions, DiCello landed awkwardly, collapsing to the mat. In tears, she signaled to her coach that something was terribly wrong.

At just 20 years old, DiCello had ruptured her Achilles tendon, abruptly ending her pursuit of Olympic glory and requiring her to be wheeled off the competition floor.

DiCello's injury marked the third major setback for the U.S. gymnastics team, with hers being the second Achilles injury of the trials. Skye Blakely, who recently placed second to Simone Biles at the U.S. Championships, also suffered a similar fate, rupturing her Achilles tendon during a tumbling pass in training.

Dr. Michael Canales, a foot and ankle surgeon specializing in Achilles injuries in gymnastics, expressed little surprise at the spate of injuries. "Emphasizing difficulty and amplifying training demands creates a recipe for disaster," Canales noted. "When these factors are coupled with the heightened demands of an Olympic year, the outcome is unsurprising."

A 2021 study published in Sports Health revealed that collegiate women’s gymnastics athletes face a risk of Achilles injuries ten times higher than their peers in other sports. The demanding training regimens and repetitive motions inherent in elite gymnastics predispose athletes to overuse injuries.

"The repetitive forces from dismounts, vaults, and tumbling can lead to micro-tears," explained Canales. "These micro-tears cause degeneration of the tendon, loss of elasticity, and eventual rupture."

Adding to the risk, gymnasts often train barefoot or in minimal footwear, which offers little support or cushioning for the Achilles tendons. This increases their vulnerability during high-impact routines.

Achilles tendon ruptures typically occur due to a "forceful eccentric load"—lengthening the tendon while it is under tension. Elite gymnasts' "take-off" skills, such as those in Yurchenko vaults and backward tumbling passes, are common triggers for these injuries, as highlighted in a 2023 Orthopedics study.

Gymnasts begin intensive training at young ages, often spending up to 40 hours a week in the gym. While some, like Biles at 27, break age barriers in the sport, prolonged careers result in more wear and tear on the tendons.

Moreover, the surfaces at major competitions like the Olympic trials typically have less padding compared to the softer mats used in home gyms, contributing to the frequency of injuries during public performances.

Blakely described her injury at the trials as "unavoidable" in an Instagram post. "This is not the way I saw my Olympic trials going or how my season ends," she wrote. "I’m devastated and heartbroken but I believe everything happens for a reason. I was so close to reaching my dream but this injury was unavoidable."

Despite the seemingly inevitable nature of these injuries, Dr. Canales suggested several preventive measures that could mitigate risks. These include regular MRI scans, early interventions for tendon pain, and systematic reviews of training and competition videos to identify athletes at risk.

"Training methods must evolve swiftly to match the escalating demands," Canales urged.

Recovery from an Achilles tendon rupture generally spans six to twelve months, involving immobilization, physical therapy, and a gradual return to high-impact activities. Even after recovery, gymnasts face a heightened risk of rupturing the tendons in their opposite legs.

The ultimate goal, Canales stressed, is to adopt preventive measures that could avert such injuries altogether. He criticized the current protocols as inconsistent and arbitrary, advocating for more standardized guidelines across the sport.

Reflecting on her journey, DiCello shared on Instagram, "While this is not the result I envisioned, there’s so much to be proud of. Years of tireless work and dedication in the gym with the dream of representing my country once more at the Olympic Games. Pushing myself to go after new skills, new dreams."