The United States women’s gymnastics team keeps winning gold, but at what cost to the athletes?

The U.S. women’s gymnastics team trounced the competition in Tuesday’s world championships in Tokyo, beating the Russians to win the team gold. The Americans’ dominance was surprising considering the team’s recent run of injuries. World vault champion Alicia Sacramone ruptured her Achilles tendon during training and had to withdraw. Another team member, Anna Li, was demoted to alternate due to an abdominal injury. And Aly Raisman competed in Tokyo despite lightly injuring her ankle just a few days before the world championships started.

Are all of these injuries merely freakishly bad luck? Maybe not. If you read the comments on the USA Gymnastics Facebook page immediately after Sacramone’s injury was publicized—many of which have since been removed—you would’ve seen one person take the blame for all this bodily harm: Martha Karolyi.

Martha Karolyi, who has historically been overshadowed by her much louder, mustachioed husband, Bela, has helmed the U.S. women’s gymnastics program since 2001. Together, the Karolyis coached Nadia Comaneci to the first perfect 10 and Mary Lou Retton to the all-around title at the 1984 Olympics. But now it is Martha who is in charge of team selection and who runs the monthly training camps at their Texas ranch.

While her leadership has been credited with the tremendous success of the women’s program after the medal drought of the 1997-2000 quadrennium, she’s also been criticized for the ligament damage she’s left in her wake. The monthly camps, which are designed to foster camaraderie between the athletes and focus on conditioning, have also been the site of numerous injuries to top gymnasts. In 2008, International Gymnast editor Paul Ziert wrote that the selection procedure for the women’s Olympic team “is simply too demanding,” explaining that he’d “heard one coach call them ‘death camps.’ ”

This year’s gantlet included two days of competition at the televised national championships, followed by two additional training camps, which featured even more closed-door all-around competitions. The United States was one of the last countries to announce its traveling squad for worlds. To get on this team, you literally had to be “the last leotard standing,” as one Internet commenter darkly noted. By contrast, the men’s team was named immediately after national championships, thereby allowing them some time to rest and regroup. Its next competition would be in Tokyo, not on a ranch in Texas.

Injuries are ubiquitous in gymnastics, and never more so than today. Since introducing an open-ended scoring system that eliminated the iconic “10” from the sport’s lexicon, gymnasts have been pushed to cram as many tricks as possible into their sets. Still, the United States women seem to have the world’s worst injury track record, especially right before major competitions.

In 2003, Annia Hatch tore her ACL right before the world championships and had to be replaced by Chellsie Memmel, who had a great competition in Anaheim. Unfortunately, Memmel fractured her foot at the Karolyi ranch a few months before the 2004 Olympics. Courtney Kupets showed up at the same Olympics with a hip injury, while Courtney McCool was nursing a wrist problem. This hobbled team, the defending world champions, lost to a Romanian squad that had won just three silvers at the previous championships.

In 2008, Memmel again was felled during training for the Olympics and Samantha Peszek injured her foot during the warm-ups before the games’ first event. And team captain Alicia Sacramone, normally spunky and charismatic, looked exhausted throughout, her body beat by the arduous selection procedure. It is not surprising that she fell twice in team finals. Many accused her of “losing” the gold for the United States, but the title had been lost long before she fell from the beam. It had been forfeited in Texas.

Why do Martha Karolyi and the USA Gymnastics hierarchy insist on selecting teams in such a Darwinian fashion?

Because they can. Since the breakup of the Soviet Union, the United States has been the primary beneficiary of former Eastern bloc coaching talent, which has increased the level of the athletes as well as the number of gymnasts in contention for spots on elite teams. In a way, it’s an embarrassment of riches—the United States simply has too many gymnasts to choose from. Because of this seeming abundance, we treat our athletes the same way we treat our natural resources, as infinite in quantity and therefore expendable.