Gesellschaft für Orthopädisch-Traumatologische Sportmedizin

Ringen aus sportmedizinischer Sicht

Sehr geehrte Damen und Herren,

vom 8. bis 14. September 2014 finden in Usbekistan die Weltmeisterschaften im Ringen statt. Die Athleten des Deutschen Ringer-Bundes nutzten die letzten Tage vor dem Wettkampf für Trainingslehrgänge in Ungarn und an der Sportschule Hennef. Wir betrachten die traditionsbehaftete Sportart in diesem Newsletter aus der Sicht der Sportmedizin. Die Veröffentlichung und Weiterverbreitung des Materials ist freigegeben.

Mit freundlichen Grüßen
Frank Wechsel und Dr. Wolfgang Schillings, GOTS-Pressesprecher

Ringen aus sportmedizinischer Sicht

Vom 8. bis 14. September 2014 finden in Taschkent (Usbekistan) die Weltmeisterschaften im Ringen statt. Die Athleten des Deutschen Ringer-Bundes nutzten die letzten Tage vor dem Wettkampf für Trainingslehrgänge in Ungarn und an der Sportschule Hennef. Dort floss noch einmal ordentlich Schweiß, bevor es noch einige Tage nach Hause – und schließlich ins ferne Taschkent geht. Die gesamte deutsche Spitze wurde in Hennef noch einmal zusammengezogen, um sich von Bundestrainer Sven Thiele den letzten Schliff geben zu lassen.

Ringen ist ein bereits seit der Antike bekannter Kraft- und Kampfsport, in dem es in einem harten und dynamischen Wettkampf Ziel ist, den Gegner auf beide Schultern zu zwingen oder ihn nach Punkten zu besiegen. Gekämpft wird beim Ringen in zwei Stilarten: Im griechisch-römischen Ringkampf ist es verboten, den Gegner unterhalb der Hüfte zu fassen, ihm das Bein zu stellen, seine Beine zu greifen oder die Beine aktiv zur Ausführung eines Griffs zu benutzen. Im Freistil-Ringen ist dies alles erlaubt, insbesondere dürfen die Beine aktiv zur Durchführung von Aktionen eingesetzt werden. Es kommen hierbei Techniken wie Würfe, Schleudern und Hebel zum Einsatz. Schläge, Tritte, Stöße und Würgen sind verboten. Die Herren kämpfen griechisch-römisch und Freistil, während bei den Damen nur im Freistilringen gekämpft wird.

Allgemeine Aspekte und Reglement: Wettkampfmodus

Der Wettkampf findet auf einer von der FILA (internationaler Amateur-Ringer-Verband) zugelassenen Matte statt, die einen Durchmesser von 9 Metern sowie eine Umrandung von 1,5 Metern mit der gleichen Stärke wie die Matte hat. Bei den Schülern und Kadetten werden zwei Kampfrunden à 2 Minuten mit 30-sekündiger Pause absolviert. Junioren und Senioren kämpfen zwei Runden à 3 Minuten mit 30-sekündiger Pause. Der Kampf kann entweder durch einen Schultersieg, durch Aufgabe, Verletzung, durch die Disqualifikation eines Ringers oder nach Ablauf der regelgerechten Zeit beendet werden. Der Gewinner wird dann durch die Addition der Punkte beider Runden ermittelt. Ein Kampf endet ebenfalls vorzeitig bei technischer Überlegenheit, sobald eine Punktedifferenz von zehn Punkten im Freistil und acht Punkten im griechisch-römischen Stil erreicht werden. Es wird in unterschiedlichen Gewichts- und Altersklassen gekämpft (siehe auch offizielles Fila-Reglement).

Allgemeine Aspekte und Reglement: Ausrüstung und Bekleidung

Das Tragen von leichten Knieschützern oder Bandagen ohne Metallteile ist gestattet. Zum Schutz der Ohren oder bei langen Haaren können von der FILA zugelassene Ohrenschützer verwendet werden, was in der Praxis jedoch nur wenig Anwendung findet. Die Athleten müssen knöchelbedeckende Ringerschuhe tragen.

Es ist verboten:

Verletzungshäufigkeiten

Ein höheres Lebensalter, eine hohe Anzahl der Ringerjahre, bereits stattgehabte Frakturen und/oder Luxationen sowie ein niedriges Alter, in dem mit dem Ringersport begonnen wurde, sind Risikofaktoren für das Erleiden einer Fraktur oder einer Luxation. Die in der Literatur verfügbaren Verletzungsstatistiken beziehen sich häufig auf sehr unterschiedlich definierte Athletenkollektive (z.B. Highschool, College, Breiten-/Vereinssport, Kaderathleten). Hierdurch ergeben sich sehr variable Angaben zur Verletzungsinzidenz, weshalb eine genauere Betrachtung und Aufschlüsselung sehr hilfreich ist, da beispielsweise Alter und Sporterfahrung relevante Risikofaktoren sind. Für Ringer auf Highschool- und College-Niveau werden Verletzungsraten von 2,33 bis 7,25 pro 1.000 Stunden angegeben.

Von Verletzungen betroffene Körperregionen beim Ringen
(mod. nach Pasque 2000)

Schulter 24 %
Knie 17 %
Rücken/Nacken 11 %
Fuß/Sprunggelenk 11 %
Hand/Handgelenk 11 %
Kopf 8 %
Rumpf 8 %
Ellenbogen 7 %
Oberschenkel 3 %

Verletzungen treten häufiger im Wettkampf als im Training auf. Bei etwa 50 Prozent der Verletzungen handelt es sich typischerweise um Zerrungen, Prellungen und Verstauchungen. Die Rate der Luxationen/Subluxationen wird mit knapp unter zehn Prozent angegeben. Schultergelenk (24 Prozent) und Kniegelenk (17 Prozent) sind die am häufigsten verletzten Körperregionen (siehe Tabelle). Die Inzidenz für größere Verletzungen beim Ringen beträgt 2,7 bis 4,2 pro 10.000 Stunden für Frakturen und 1,6 bis 7,2 pro 10.000 Stunden für Luxationen.

Anforderungs- und Belastungsprofil

Der Athlet benötigt für das Ringen eine extrem gute Flexibilität und Kraft nahezu des gesamten Körpers. Die untere Lendenwirbelsäule, die Hüftgelenke (hier insbesondere Hüftbeuger und -strecker) sowie die Halswirbelsäule sind dabei besonders hervorzuheben. Es konnte nachgewiesen werden, dass Ringer mit einer guten Schultergürtelflexibilität weniger Schulterverletzungen erleiden. Das harte Zu-Fall-Bringen und das Sparring sind die typischen Situationen, die zu Verletzungen führen. Unkontrollierte Stürze sind die häufigste Ursache für AC-Gelenksverletzungen und Schulterluxationen. Bezüglich der Verletzungsstatistik findet sich eine deutliche Dominanz der akuten Verletzungen, Überlastungsschäden spielen im Ringersport dagegen eine untergeordnete Rolle. Neben dem Sturz auf den ausgestreckten oder überstreckten Arm führen das Überschreiten des physiologischen Bewegungsausmaßes sowie regelwidrige Aktionen wie beispielsweise das Ansetzen eines langen Hebels (Fassen am Unterarm) zu Verletzungen der oberen Extremität. Jedoch kann auch der regelkonforme Griff mit kurzem Hebel, beispielsweise bei aktivem Widerstand gegen einen Angriff, zu einer entsprechenden Verletzung führen.

Kenntnisse über sportartspezifische Verletzungen und Belastungen sind nicht nur für den Sportmediziner in der Athletenbetreuung von großer Bedeutung. Häufig sind Trainer und Physiotherapeuten die eigentlichen Erstversorger in der Halle und haben auch über die Art und den Inhalt des Trainings direkten Einfluss auf das Verletzungsrisiko und mögliche Präventionsmaßnahmen.

Allgemeine und spezielle Präventionsmaßnahmen für Ringer

Über den Autor:
Dr. Casper Grim, Facharzt für Orthopädie und Unfallchirurgie, Oberarzt in der Klinik für Orthopädie, Unfall- und Handchirurgie im Klinikum Osnabrück, Verbandsarzt Deutscher Ringer Bund (DRB), Mannschaftsarzt bei den Jugend Olympischen Spielen 2010 und 2014, Mannschaftsarzt bei den World Games 2009 und 2013, GOTS-Mitglied seit 2007

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