Apunts Medicina de l'Esport (English Edition) Apunts Medicina de l'Esport (English Edition)
Apunts Med Esport. 2006;41:100-6 - Vol. 41 Num.151

Injuries and training recommendations in elite rhythmic gymnastics

Merrilee N Zetaruk a, Mariona Violan b, David Zurakowski c, William A Mitchell Jr d, Lyle J Micheli e

a Director. Pediatric Sport and Dance Medicine. Children's Hospital. University of Manitoba. Winnipeg, MB. Canada.
b Cap Mèdic. Centre de Talassotèrapia Marítim. Fundació Claror. Barcelona. España.
c Director of Biostatistics. Department of Orthopaedic Surgery. Children's Hospital. Harvard Medical School. Boston, MA. USA
d Clinical Instructor of Orthopaedic Surgery. Harvard Medical School. Boston, MA. USA.
e Director. Division of Sports Medicine. Children's Hospital. Harvard Medical School. Boston, MA. USA.


Objective: To identify risk factors for injury in rhythmic sportive gymnastics and to provide recommendations for reducing the risk of injury. Methods: A one-year retrospective survey of injuries in twenty national-level rhythmic gymnasts (ages 14.8 to 18.8 years; mean age 17.1 years). Hours of rhythmic gymnastics (RG) training per week, minutes of stretching per day, and hours of conditioning per week, were analyzed as potential risk factors for injury. Main outcome measures were injuries that required time off, major injuries (at least 7 days off), injuries to muscle-tendon units, and fractures. Results: Thirteen (65%) of 20 gymnasts sustained time-loss injuries, and 4 gymnasts (20%) reported major injuries. Seventeen (85%) gymnasts reported muscle-tendon unit injuries and 5 (25%) suffered fractures. Sixteen (80%) of the gymnasts reported back pain or stress fractures of the back, 8 of whom required time off training. One gymnast (5%) incurred a concussion. Logistic regression indicated that rhythmic gymnastics training and stretching were associated with muscle-tendon unit injury. On multivariate analysis, stretching was found to be the only independent predictor of muscle-tendon unit injuries with each additional minute lowering the risk by approximately 10% (p ≤ 0.01). Conditioning and stretching were both independent predictors of fractures. The risk of fracture was estimated to increase by over 60% for each additional hour of weekly conditioning (odds ratio = 1.62, p = 0.03) and decrease by almost 20% for each additional minute of daily stretching (odds ratio = 0.81, p = 0.04). None of the variables studied were predictive of back pain or injury. Conclusions: Injuries in rhythmic gymnastics may be reduced by increasing the amount of time spent stretching per day (at least 40 minutes), and limiting conditioning to a maximum of 6 hours per week.