Association Between Flexibility and Low Back Pain in Female Adolescent Gymnasts

Abstract

Objective: To determine the relationship between low back pain (LBP), flexibility, and individual demographic characteristics in competitive adolescent female gymnasts. Design: Cross-sectional observational study. Setting: Gymnastics facilities in Colorado. Participants: Six- to 18-year-old gymnasts who participate in the USA Gymnastics Women's Artistic Junior Olympic Program levels 3 to 10. Independent Variables: Demographic data included height, weight, menstrual status, gymnastics level, and participation hours per week. Flexibility measurements were obtained on the gymnasts. Gymnasts also completed a questionnaire documenting LBP in the past 12 months. Univariable (t test and χ2) analyses were used to assess between-group differences; multivariable logistic regression model was used to assess the association between LBP, flexibility, and demographics/injury history. Main Outcome Measures: Low back pain within the past 12 months. Results: Thirty (45%) of 67 gymnasts reported LBP within the past year. Those who reported LBP were older (11.7 vs 13.7 years, P = 0.005), heavier (37.5 vs 43.4 kg, P = 0.049), and participated in gymnastics more often (19.1 vs 22.4 h/wk, P = 0.017). A greater proportion of gymnasts with LBP had experienced menarche compared with those without LBP (47% vs 16%; P = 0.008). On multivariable analysis, gymnasts with LBP were less likely to have left Iliotibial (IT) band tightness compared with those without LBP [adjusted odds ratio (aOR) = 0.186; 95% confidence interval (CI), 0.04-0.82] and more likely to have experienced menarche (aOR = 8.0; 95% CI, 1.2-50.9). Conclusions: Low back pain is more common in gymnasts who experienced menarche, whereas limited joint flexibility does not seem to be associated with LBP in this population.

Back Pain Related with Age, Anthropometric Variables, Sagittal Spinal Curvatures, Hamstring Extensibility, Physical Activity and Health Related Quality of Life in Male and Female High School Students

“…Another important finding was that the prevalence of SP increased with chronological age, according with hypothesis (b). A similar evolution has been found in previous studies [ 24 , 31 , 46 ]. This finding has important implications for the introduction of SP education programs in secondary education.…”

“…Furthermore, one interesting finding was that the relationship between age and SP was stronger in FS that in MS, although in general no differences were found in the prevalence of pain reported by the adolescents according to sex. A possible explanation for this may be that menarche is the most predictive demographic or medical history factor associated with LBP according to previous data [ 31 ]. FS hormones, particularly estrogens, increase after menarche, inducing changes in the girls’ bodies.…”

“…For example, adolescents prefer to spend their leisure time in sedentary activities with friends as opposed to performing a physical activity (PA) [ 29 ]. As a result, the importance of these factors on SP and their interinfluence can be different depending on sex [ 23 , 24 , 30 ] and age [ 31 ]. As a consequence, it is necessary to analyze the prevalence of SP risk SP depending of these variables from a global point of view and including pain in the different areas of the spine to understand how to focus interventions in high school and what could be the most influencing factors for each age and sex.…”

Screening Tools as a Predictor of Injury in Gymnastics: Systematic Literature Review

“…Two studies included artistic gymnasts [21,22], 2 studies included rhythmic gymnasts [23,24], 11 studies simply used the term "gymnasts" [1,2,4,9,[25][26][27][28][29][30][31]. With regard to the level of gymnasts, 6 studies included gymnasts classified as national team level [9,21,22,[29][30][31], 2 studies involved gymnasts from clubs affiliated with a national federation [1,23], 1 study involved gymnasts from a precompetitive level [25], 3 studies used competitive-level gymnasts [4,26,28], 2 studies used a mixed group of gymnasts [2,27] and 1 study included gymnasts attending a course and the level was unclear [24].…”

“…Within artistic gymnastics the floor apparatus is associated with the greatest injury risk [6][7][8]. Gymnastic movements rely heavily on integration via the kinetic chain with skills such as handsprings and walkovers involving spine and hip extension and shoulder hyperflexion [9]. Injury surveillance of 3 Olympic games has identified that the lower limb (62.8%), trunk (23.1%) and upper limb (14.1%) as the regions most susceptible to injury with the ankle the most prominent location (21.8%) [10].…”