Prevalence and physical features associated with tendon, bone, and joint pain in young artistic, acrobatic, and rhythmic female gymnasts

Objectives: To evaluate the prevalence of tendon, bone, and joint pain, and to examine the physical features associated with pain, in young artistic, acrobatic, and rhythmic female gymnasts. Design: Cross-sectional. Participants: 274 gymnasts, aged 9–16 years. Main outcome: All gymnasts were clinically assessed for joint, bone, and tendon pain and for training-impact, anthropometric-measures, bone-properties, muscle-strength, and joint range-of-motion (ROM). Results: Pain was identified in 69.7 % of the participants. Artistic gymnasts suffered a higher prevalence of tendon and bone pain compared to rhythmic gymnasts (p = 0.011 and p = 0.005, respectively). Logistic-regression showed that greater BMI% and lower plantar-flexor strength were associated with tendon pain; greater BMI%, increased age, menarche, reduced tibial-strength, and reduced muscle strength with bone pain; and, increased age, reduced muscle strength and increased ROM with joint pain (p < 0.05). A reduced risk of tendon and joint pain was found in rhythmic and acrobatic gymnasts compared to artistic gymnasts, and reduced risk of bone pain when practicing rhythmic gymnastics compared to artistic gymnastics (p < 0.05). Conclusions: Young female gymnasts are at a high risk of developing pain during training. Physical features are specific to pain categories and to gymnastics disciplines. Clinically, young gymnasts should be routinely screened for physical features and for injuries.