title: Survey of injuries in Seattle area levels 4 to 10 female club gymnasts.
abstract: OBJECTIVE
  To evaluate incidence, distribution, and contributing factors of injury in club gymnastics.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Five randomly selected gymnastics clubs near Seattle, WA.
  
  
  METHODS
  Ninety-six club gymnasts from competitive levels 4 to 10.
  
  
  METHODS
  The participants completed a questionnaire regarding demographics, injuries and contributing factors, and exposure time in the last competitive season.
  
  
  METHODS
  Acute and overuse injury incidence rates stratified by practice and competition, age categories, and level using relative risks and 95% confidence intervals (CIs). Chi-square testing was used to compare demographic-specific and gymnastic-specific variables between injured and uninjured. Multivariate regression modeling was used to assess independent risk factors for risk of acute and overuse injuries.
  
  
  RESULTS
  Acute injury rate was 1.3 per 1000 hours and in univariate, but not multivariate analysis, it was 3.6-fold greater (95% CI, 1.6-9.1) among 10 to 12 year olds and 3.1-fold greater (95% CI, 1.3-8.0) among 13 to 17 year olds compared with 7 to 9 year olds. The most common acutely injured body parts were foot (21.0%), ankle (19.3%), knee (14.0%), and wrist (8.8%). The majority of injuries occurred in practice, but the meet injury rate was higher. Most injuries occurred on floor exercise (32.1%), beam (20.7%), and bars (17.0). Injury was most common during landing. The overuse injury rate was 1.8 per 1000 hours. During their gymnastics careers, concussions occurred in 30.2% and stress fractures affecting mostly low back and foot occurred in 16.7% of the gymnasts.
  
  
  CONCLUSIONS
  Gymnasts are at similar risk of acute and overuse injuries, and acute injury rates were greater among older gymnasts. However, this predictor did not remain significant in multivariate analysis. Concussions and stress fractures are common. Gymnastics injury prevention studies should focus on older gymnasts, concussion education, and landing after a skill.
authors.affiliation: Department of Orthopaedics and Sports Medicine, University of Washington Sports Medicine Clinic, Seattle, Washington 98195, USA. jokane@u.washington.edu
authors.forename: John W
authors.initials: JW
authors.lastname: O'Kane
authors.forename: Marni R
authors.initials: MR
authors.lastname: Levy
authors.forename: Kristin E
authors.initials: KE
authors.lastname: Pietila
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Caine
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Schiff
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D016512:Ankle Injuries / Q000453:epidemiology; D019567:Back Injuries / Q000453:epidemiology; D001924:Brain Concussion / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000453:epidemiology; D005260:Female; D018409:Foot Injuries / Q000453:epidemiology; D015775:Fractures, Stress / Q000453:epidemiology; D006173:Gymnastics / Q000293:injuries* / Q000706:statistics & numerical data; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology; D014954:Wrist Injuries / Q000453:epidemiology