Is Hip and Lumbar-Spine Pain Related to Physiological Characteristics in Young Elite Gymnasts?

Purpose: Gymnastics performances entail complex and extensive movements that require specific body morphology, strength, and flexibility that may lead to hip and lumbar-spine injuries. The present study aimed to evaluate the prevalence of hip and lumbar-spine pain and their associated physiological characteristics in young gymnasts. Methods: Two hundred seventy-four female rhythmic, acrobatic, and artistic gymnasts age 9 to 16 years were physically examined for hip and lumbar-spine pain and reported pain experienced during training on a visual analog scale. In addition, gymnasts were assessed for impact of training, anthropometric parameters, hip muscle strength, and hip and spine joint range of motion (ROM). Results: Fifty gymnasts (18.2%) presented hip pain, 40 (14.6%) presented lumbar-spine pain, 63 (20.3%) presented hip and lumbar-spine pain, and 121 (44.2%) were pain free. Gymnasts with hip and lumbar-spine pain were significantly older and had greater body mass than injury-free gymnasts (P = .028 and .044, respectively). Group effect showed that gymnasts with hip pain and gymnasts with hip and lumbar-spine pain had weaker muscle strength and greater joint ROM than pain-free gymnasts (P < .05). Puberty effects showed that postpubertal gymnasts were significantly stronger and had reduced joint ROM compared with prepubertal gymnasts. Group × puberty interaction for hip-abduction ROM (F_3,243 = 4.2, P = .006) indicated that postpubertal gymnasts with hip and lumbar-spine pain had significantly lower joint ROM than prepubertal gymnasts with pain. Conclusions: Young competitive gymnasts are at high risk of experiencing hip and lumbar-spine pain. Clinically, it is suggested that young gymnasts should be routinely screened for musculoskeletal pain and physiological abilities by an expert from a very young age.