A three-year epidemiological study of injuries affecting young female gymnasts

Objectives. The purpose of this study was to determine the rate and distribution of injuries affecting beginning- and advanced-level competitive female gymnasts over a three-year period. Of particular interest, was the comparison of risk and severity of injury among these groups during training and competition. Design. Prospective cohort. Setting. Regional university and community-based gymnastics club in the Pacific Northwest. Participants. Seventy nine female artistic gymnasts, ages 7-18 years, representing USA Gymnastics competitive levels 4-10. Main outcome measures. Injury incidence. A log-linear model was used to estimate the relative risk (RR) of injury in competition versus training and among beginning versus advanced level gymnasts. Chi square analysis using Fisher's exact test was used to compare the distribution of injuries by event, anatomical location, type and time loss. Results. During the study, 60 of 79 gymnasts sustained 192 injuries while 19 gymnasts remained injury-free. The overall injury rate was 2.5 injuries/1000 h. The RR of injury during competition relative to practice was 2.69 (95% CI: 1.53, 4.75; p less than or equal to 0.001). This was mostly driven by the advanced group; when stratified by competition level and compared to all practice injuries, the RR of injury during competition was 0.47 (95% CI: 0.07, 3.42) for the beginning group, and 4.34 (95% CI: 2.39, 7.88; p = 0.035) for the advanced group. Chi square analyses showed a variant injury distribution for injury location, event, and time loss depending on competitive group and whether injury occurred during practice or competition. Notably, a greater proportion of severe injuries, as measured by time loss, affected advanced- than beginning-level gymnasts (Fisher's exact p-value = 0.003) and occurred in competition relative to practice (Fisher's exact p-value = 0.007). Conclusions. The findings of this study suggest that advanced-level competitive female gymnasts experience a higher risk and severity of injury compared to their beginning-level counterparts, especially during competition. (C) 2003 Elsevier Science Ltd. All rights reserved.