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Gymnast wrist: an epidemiologic survey of ulnar variance and stress changes of the radial physis in elite female gymnasts.

The ulnar variance in female gymnasts attending the World Championship Artistic Gymnastics Rotterdam 1987 was measured. There was a marked increase in the ulnar length in adult as well as immature gymnast compared with nonathletes. The changes in relative ulnar length were correlated to weight, height, and skeletal age of the athletes. In 10% of the gymnasts' wrists we noted so-called "stress-related changes" of the distal physis of the radius. Repetitive injury and compression of the wrist leads to a premature closure of the distal radial growth plate resulting in secondary ulnar overgrowth.

Adolescent↗
PubMed1992

[The spine--a problem area in high performance artistic gymnastics. A retrospective analysis of 24 former artistic gymnasts of the German A team].

24 former female artistic gymnasts of the German national team were examined for spinal deformities after the end of their athletic career. In 3 cases we found osseous lesions of the spine without neurological complications. However, emphasis was on spinal changes due to stress. During their athletic career 15 gymnasts complained of low back pain which persisted in 7 of them after finishing their athletic activities. The lumbar radiographs revealed bilateral spondylolysis at L5 in 6, unilateral spondylolysis in 1, spondylolisthesis at L5/S1 in 3, degenerative changes of the intervertebral joints in 5, retrolisthesis at L5/S1 in 2, and scoliosis in 6 cases.

Adult↗
PubMed1998

Morphological and performance characteristics as drop-out indicators in female gymnasts.

BACKGROUND: Aim of this study was to investigate if morphological and performance characteristics are significant indicators to predict drop-out in female gymnasts. METHODS EXPERIMENTAL DESIGN: comparative investigation between two groups of female gymnasts at the start of a 3-year follow-up period. SETTING: participants of the study came from two gymnastic clubs from the Antwerp region in Flanders, Belgium. PARTICIPANTS: in total, 81 female competitive gymnasts (mean age: 10.5 + 2.6 years) were investigated, of which 46 were continuing gymnasts, while 35 dropped-out from the sport during the following 3 years. MEASURES: included were a large battery of a anthropometric characteristics, skeletal maturation, physical fitness tests, and gymnastic-specific strength and flexibility tests. Differences between the two groups were analysed by means of the t-test and analysis of co-variance with chronological age as the co-variate. RESULTS: Compared to the gymnasts, the drop-outs were significant (p < 0.01) older (11.3 and 9.7 years respectively), more mature (skeletal ages are 10.6 and 9.4 years respectively), taller (143.5 cm and 135.2 cm respectively), and heavier (36.0 kg and 29.4 kg respectively). Also for almost all other anthropometric dimensions, gymnasts were significantly (p < 0.01) smaller than the drop-outs, except for the biceps, triceps, medial calf, and thigh skinfolds. Concerning the fitness and gymnastic-specific test characteristics, the drop-outs performed also significantly (p < 0.01) better than the continuing gymnasts. The ANCOVA-analysis, however, revealed that it was mainly the age factor that distinguished both groups. After controlling for chronological age, no differences between both groups could be demonstrated for almost all anthropometric and performance characteristics with the exception for upperarm circumference flexed, calf circumference, and biceps skinfold. For these variables, drop-outs showed still significant (p < 0.05) higher values compared to the gymnast's group. CONCLUSIONS: Based on these findings, it is concluded that factors related to the physical make-up and performance capacities of our gymnasts under study are minor indicators for the withdrawal from competitive gymnastics, and it is hypothesized that the social and psychological factors associated with the older age of the drop-out girls are presumably more important.

Adolescent↗
PubMed1995

Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea.

Female athletes exhibit a higher prevalence of exercise-associated amenorrhea and oligomenorrhea compared with nonathletic women, and both conditions are related to reduced bone mineral density (BMD), particularly at the spine. This study investigated bone mass and oligomenorrhea and amenorrhea in two groups of competitive female athletes with different skeletal loading patterns: gymnasts and runners. Bone mineral density (g/cm2) of the femoral neck, lumbar spine (L2-4), and whole body was assessed by dual energy X-ray absorptiometry (QDR-1000/W, Hologic Inc., Waltham, MA) in collegiate gymnasts (n = 21) and runners (n = 20), and nonathletic college women (n = 19). The runners and gymnasts had similar values for percent body fat (14.7 +/- 2.2% and 15.6 +/- 2.9%, respectively), which were lower (p < 0.001) than controls (22.3 +/- 3.0%). Lean body mass (LBM) did not differ among the groups, but when adjusted for body surface area, gymnasts had a higher LBM/height2 (p = 0.0001) compared with runners and controls. Muscle strength was significantly greater (p < 0.05) in gymnasts for quadriceps, biceps, and hip adductor force, compared with runners and controls. Gymnasts had a significantly later menarche age (16.2 +/- 1.7 years) compared with runners (14.4 +/- 1.7 years) and controls (13.0 +/- 1.2 years). The prevalence of oligo- and amenorrhea was 47% for gymnasts (6 amenorrheic, 4 oligomenorrheic), 30% for runners (3 amenorrheic, 3 oligomenorrheic), and 0% for controls. Furthermore, athletic groups had similar menstrual histories given the higher proportion of gymnasts who had experienced primary amenorrhea. When evaluated since menarche, however, runners had somewhat longer histories due to an earlier age at menarche and slightly older ages. Dietary calcium intake did not differ among groups, although mean values were below the RDA of 1200 mg/day. By athletic group, BMD at any site did not differ among women with amenorrhea versus oligomenorrhea versus eumenorrhea, although there was a trend for the regularly menstruating athletes in both groups to have slightly higher values. Lumbar spine BMD was lower (p = 0.0001) in runners (0.98 +/- 0.11 g/cm2) compared with both gymnasts and controls (1.17 +/- 0.13 and 1.11 +/- 0.11 g/cm2, respectively). Femoral neck BMD differed among all groups (p = 0.0001): gymnasts = 1.09 +/- 0.12 g/cm2 > controls = 0.97 +/- 0.10 g/cm2 > runners = 0.88 +/- 0.11 g/cm2. Whole body BMD was lower (p < 0.01) in runners (1.04 +/- 0.06 g/cm2) compared with gymnasts and controls (1.11 +/- 0.08 and 1.09 +/- 0.06 g/cm2, respectively).(ABSTRACT TRUNCATED AT 400 WORDS)

Absorptiometry, Photon↗
PubMed1998

[Effect of high performance sports on puberty development of female and male gymnasts].

High impact training may influence the pubertal development of athletes. The effects of high intensity training on pubertal development of female and male elite gymnasts are presented. 22 female and 18 male elite gymnasts were enlisted in this study. Prepubertal and pubertal stages were determined and hormonal levels regarding the hypophyseal, gonadal and adrenal axes were measured. The LH/FSH ratio necessary for the advancement of full pubertal maturation was assessed at 13.9 amd 13.0 years in female and male gymnasts, respectively. Female gymnasts demonstrated, on average, a delayed bone age of 1.7 years compared to their chronological age, whereas both bone and chronological age were identical in male gymnasts. There were no significant pubertal increase of estrogen levels in female gymnasts during their peripubertal development indicating a low amount of fat mass in female elite gymnasts. Intensive physical training of elite female gymnasts combined with inadequate nutritional intake markedly affect pubertal development. These peripubertal effects are not observable in male gymnasts due to different training regimes in male and female elite gymnast. Regular monitoring of female gymnast during their vulnerable growth phase is necessary to minimize life-long physiological and psychological side effects of high impact training.

Adolescent↗
PubMed1998

Cardiovascular stress and lactate formation during gymnastic routines.

BACKGROUND: Carried out to investigate cardiovascular and metabolic response during various gymnastic routines [Pommel Horse (PH), Roman Ring (RR), Parallel Bar (PB), Horizontal Bar (HB) and Floor Exercise (FE)]. METHODS EXPERIMENTAL DESIGN: comparative and randomized. SETTING: General purpose, applicable on gymnastics training. Participants. Five male volunteers drawn from students attending sports coaching course in gymnastics at NIB, Patiala. A mixed population from all over India who had competitive experience of 6 to 10 years. INTERVENTIONS: no interventions. MEASURES: presence of heart rate overshooting, high lactate levels and individual characteristics of the gymnastics routines. RESULTS: In all the routines peak HR was much lower than maximum heart rate (HRmax) of the gymnasts. Mean HR was lowest in first set and highest in the final (3rd set) on all the apparatuses. Highest mean HR was recorded in HB followed by FE, RR, PB and PH respectively. After both first and third sets blood lactic acid (La) was highest in FE followed by RR, PB, HB and PH. La levels following the first set were 7.11, 6.77, 6.23, 5.97 and 5.18 mM/l, respectively. Third set values were 10.54, 10.16, 8.95, 8.74 and 8.04 mM/l. CONCLUSIONS: (a) Cardiovascular load in various gymnastic routines is considerably less than maximal running; (b) HR overshoot is common at the end of all the men's gymnastic routines; training evaluation or performance evaluation in gymnastics through heart rate should consider this fact to avoid any misinterpretation; (c) PH is physiologically least demanding among the five while FE and RR are most stressful; (d) repetition of gymnastic exercise routines with short rest pause may lead the gymnast to reach nearer to his lactate tolerance; (e) gymnastics activity is dominated by anaerobic metabolism.

Adult↗
PubMed1997

Does repetitive physical loading inhibit radial growth in female gymnasts?

OBJECTIVE: Stress-related injuries to the distal radius have been noted in female gymnasts with potential for resultant premature closure and abnormal growth at this site. The purpose of this study was comprehensively to review and critically to appraise the available literature to examine the evidence related to this question: does repetitive physical loading inhibit growth of the radius in female gymnasts? DATA SOURCES: MEDLINE and SPORT Discuss were searched from 1975 to the present by using "gymnast" in combination with injury, growth plate, epiphyseal, and ulnar variance. Additional references were retrieved from the bibliographies of the retrieved articles. STUDY SELECTION: All descriptive and analytic studies that included data related to stress-related injuries affecting the distal radius of competitive female gymnasts were included. Conclusions regarding the effects of gymnastics training on radial growth of female gymnasts were limited to data from case reports, clinical series, cross-sectional studies, and descriptive cohort studies. Data from relevant experimental animal studies also were included. DATA EXTRACTION AND SYNTHESIS: In reviewing the literature, particular attention was paid to the relative strengths of the different study designs. From these data, information associated with growth inhibition at the distal radius was examined. MAIN RESULTS: The descriptive research reviewed included clinical, cross-sectional, and cohort studies that establish the existence of stress-related injuries affecting one or more constituent parts of the epiphyseal-physeal-metaphyseal (EPM) complex of the distal radius, symptomatic ulna-radial-length difference (URLD), and distal radius physeal arrest among female gymnasts. Five cross-sectional studies showed radiographic abnormalities consistent with distal radius physeal-stress reaction in 10-85% of gymnasts studied. Two cross-sectional studies indicated "abnormal" positive URLD in 8-20% of wrists radiographed. Four cross-sectional studies showed significant correlations between training intensity and URLD, suggesting a dose-response relation. Three cross-sectional studies indicate greater URLD in gymnasts compared with nongymnasts. Radiographic evidence of distal radius physeal arrest involving physically immature female gymnasts is presented in four studies (two clinical series, one cross-sectional, and one descriptive cohort). In animal studies, prolonged physical training has also been shown to inhibit or stop growth in weight-bearing long bones. However, there were no rigorous studies (i.e., randomized control trials or analytic cohorts) examining the question. CONCLUSION: The results of this critical review of the scientific literature support the plausibility of stress-related distal radius physeal arrest with secondary URLD. However, the strength of evidence is inadequate to be conclusive.

Adolescent↗
PubMed1999

Water-gymnastics reduced the intensity of back/low back pain in pregnant women.

OBJECTIVE: To investigate if water-gymnastics during pregnancy may reduce the intensity of back/low back pain and the number of days on sick-leave. METHODS: A prospective, randomized study. One hundred and twenty-nine women were randomized to participate in water-gymnastics once a week during the second half of pregnancy and 129 were randomized to a control group. The women in both groups filled in questionnaires in gestational weeks 18, 34 and within the first postpartum week. Every day from week 18 to labor they assessed the intensity of back/low back pain. RESULTS: Back pain intensity increased during pregnancy. No excess risk for the pregnancy associated with water-gymnastics was observed. The women participating in water-gymnastics recorded a lower intensity of back/low back pain. The total number of days on sick-leave because of back/low back pain was 982 in the water-gymnastics group (124 women) compared with 1484 in the control group (120 women). After weeks 32 33, seven women in the water-gymnastics group compared with 17 in the control group were on sickleave because of back/ low back pain (p=0.031). CONCLUSIONS: Intensity of back/low back pain increased with advancing pregnancy. There was no excess risk for urinary or vaginal infections associated with water-gymnastics. Water-gymnastics during the second half of pregnancy significantly reduced the intensity of back/ low back pain. Water-gymnastics decreased the number of women on sick-leave because of back/low back pain. Water-gymnastics during pregnancy can be recommended as a method to relieve back pain and may reduce the need for sick-leave.

Absenteeism↗
PubMed1996

Physique as a risk factor for ulnar variance in elite female gymnasts.

The aims of this study were: 1) to determine ulnar variance variability of elite, female gymnasts; 2) to evaluate the relationship between ulnar variance and physique, maturity status, and training characteristics of these gymnasts. All 156 skeletally immature female gymnasts were participants at the World Championships Artistic Gymnastics, Rotterdam, The Netherlands, in 1987. Chronological ages varied between 13.1 and 20.6 yr (mean = 15.9 +/- 1.3 yr). A large set of anthropometric dimensions was taken and somatotype was determined by the Heath-Carter technique. Skeletal age was assessed by the Tanner-Whitehouse II method. Menarcheal status and training data were collected by questionnaire. Ulnar variance was determined according to Hafner et al. Gymnasts differ significantly from reference girls with respect to physique and maturational status: gymnasts were smaller and delayed in skeletal maturity with about 1.5 yr. For those who had attained menarche, mean age at menarche was 15.1 +/- 1.3 yr. Ulnar variance shows a normal distribution in the gymnasts, ranging from -10.5 mm to +5.9 mm, which is somewhat more positive, i.e., an ulnar overgrowth, than reference wrists. The relationship between ulnar variance and somatic and maturational features suggests that female gymnasts who are more mature and have a physique characterized as relatively tall with a high lean body mass are at greater risk for developing a positive ulnar variance. No relationship between ulnar variance and training characteristics was evident. It is concluded that the observed positive ulnar variance in this sample of elite female gymnasts is less pronounced than originally stated in most "case reports."

Adolescent↗
PubMed1994

The effects of gymnastics training on bone mineral density.

The purpose of this study was to examine the effect of 27 wk of gymnastics training on bone mineral density (BMD), body composition, insulin-like growth factor I (IGF-I), and osteocalcin. Subjects were 11 female intercollegiate gymnasts and 11 controls. Dual energy x-ray absorptiometry (Lunar DPX) was used to determine BMD (L2-L4 and femur) and to assess body composition. The gymnasts were significantly lower in weight (53.9 and 60.8 kg) and % body fat (22.6 and 30.6) compared with controls. After training, body weights of gymnasts remained the same but there was a significant increase in lean tissue mass of 2.9 kg (6.7%, P < 0.05). No changes in body composition were observed in the controls. The gymnasts had significantly higher mean lumbar (1.321 vs 1.225), and femoral neck (1.163 vs 1.079) BMD (g.cm-2) than the controls. Lumbar BMD increased significantly (1.3%) in gymnasts following training but femoral neck BMD did not increase. No BMD changes occurred in the control group. Regarding serum IGF-I, no differences were seen between the groups or across time. Serum osteocalcin values were significantly higher in the gymnasts than the controls, but no differences were found across time. In conclusion, gymnasts had significantly higher BMDs than controls, and a significant increase in lumbar BMD was seen in the gymnasts following 27 wk of training.

Absorptiometry, Photon↗
PubMed1996

Eating disorder symptoms in former female college gymnasts: relations with body composition.

The purpose of this investigation was to describe eating disorder symptoms in 36.6 +/- 3.8-y-old former college gymnasts as well as relations between body dissatisfaction and body composition. Former college gymnasts (n = 22) and age-(mean +/- SE difference: 0.05 +/- 0.26 y), height-(0.47 +/- 0.75 cm), and weight-matched (2.20 +/- 0.30 kg) control subjects (n = 22) participated. Current and past symptoms were assessed by using the Eating Disorders Inventory-2 (EDI-2) and visual analog scales. EDI-2 body-dissatisfaction scores were correlated with assessments of body composition by dual-energy X-ray absorptiometry. Weight preoccupation was stable across the life span for control subjects but was lower before former gymnasts had begun gymnastics training and higher for former gymnasts when they were participating in college gymnastics (P = 0.03). Current levels of body dissatisfaction were more strongly related to actual minus ideal body-weight discrepancy scores (r = 0.77) than to percentage fat (r = 0.50) for the former gymnasts whereas the opposite was true for the control subjects (r = 0.51 and 0.77, respectively). These results suggest that symptoms of eating disorders abate after retirement from gymnastics and that concerns about achieving an ideal body may be a more important determinant of body dissatisfaction than percentage body fat for gymnasts.

Absorptiometry, Photon↗
PubMed1984

Are young female gymnasts malnourished? An anthropometric, electrophysiological, and histological study.

Competitive rhythmic sportive gymnastics have been accused of promoting an unphysiologic weight reduction which may progress to manifest anorexia nervosa. In this study, eight young female gymnasts who represented Norway in the European Championships in Rhythmic Sportive Gymnastics 1982 were examined for evidence of malnutrition. Ten girls, matched for age and height, served as controls. The examination included registration of anthropometric data (height, weight, and body-mass index), motor and sensory neurography and biopsies of the vastus lateralis muscle with exact measurements of muscle fibre areas on sections stained for myofibrillar ATPase activity. The mean body weight of the gymnasts did not differ from that of the control group or of a large series of age matched Norwegian females. This finding excludes the possibility of general malnutrition among the examined gymnasts. Muscle fibres of both types 1 and 2 were found to be smaller in the gymnasts than in the controls, with values of 3,404 microns2 vs 3,811 microns2 for type-1 fibres and 2,985 microns2 vs 3,942 microns2 for type-2 fibres respectively. Although contradictory to most previous reports, this finding suggests that the reduction in fibre size among the gymnasts might be an effect of physical training. There were some differences in neurographic parameters between the groups, but the mean values were all within normal ranges. The motor nerve conduction velocity in the proximal segments of the median and ulnar nerves was significantly slower in the gymnasts and, as a possible consequence of smaller muscle fibres, the motor responses were generally less in this group.

Adolescent↗
PubMed1992

Gymnastic injuries.

In the past 15 to 20 years gymnastics has become very popular. The increased participation exposes a greater number of athletes to potential injury. The risk of gymnastic injuries seems to be proportional to the level of the athletes; the higher the level of gymnastics, the more hours are spent in practice, with a greater exposure time. With the increased risk in gymnastics, the incidence of acute injuries will also increase, and as the skill level increases, the load during the workout will also increase, providing more opportunity for chronic injuries. As in many sports, the ankle is the most injured body part. Some injuries, however, seem to be specific to gymnastics. In gymnastics the upper extremities are used as weightbearing limbs, so high impact loads are distributed through the elbow and wrist joint. Back problems appear to result not only from single episodes of macrotrauma, but also from repeated microtrauma caused by specific impact loads during vaults and hyperextension. Early detection is the key to treating elbow, wrist and back pain in the gymnast. Reinjury following an acute injury may be reduced by allowing for complete rehabilitation before returning to full practice. Some studies indicate that maturation rate could play a potential role in injury predisposition. The combination of periods of rapid growth and intense training could provide for conditions where the gymnast is more injury prone.

Athletic Injuries↗
PubMed1992

Growth and menarcheal status of elite female gymnasts.

The growth and maturity status of 201 elite female gymnasts was considered. The subjects were participants at the 24 World Championship Artistic Gymnastics in 1987. In addition to age at menarche, weight, stature, biacromial, and bicristal breadths, the sitting height/stature ratio, and the Health-Carter anthropometric somatotype of gymnasts 13-20 yr of age were compared with reference data for a nationally representative sample of Flemish girls. Median age at menarche (probit analysis) in gymnasts is 15.6 +/- 2.1 yr compared with 13.2 +/- 1.2 yr in Flemish girls. Anthropometric dimensions increase with age until about 16 yr and then tend to plateau. In contrast to body size, there is little variation in somatotype with age. Compared with adolescent girls, elite gymnasts are considerably shorter and lighter with narrower shoulders and hips, but the differences are more apparent after 17 yr. Elite gymnasts do not differ from nonathletes in relative leg length, but they have proportionally broader shoulders relative to hips. Differences in somatotype occur primarily in endomorphy (especially lower in gymnasts) and to a lesser extent in mesomorphy (higher in gymnasts).

Adolescent↗