Survey of injuries in Seattle area levels 4 to 10 female club gymnasts

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John W O’Kane; Marni R Levy; Kristin E Pietila; Dennis J Caine; Melissa A Schiff.



To evaluate incidence, distribution, and contributing factors of injury in club gymnastics.


Cross-sectional survey.


Five randomly selected gymnastics clubs near Seattle, WA.


Ninety-six club gymnasts from competitive levels 4 to 10.


The participants completed a questionnaire regarding demographics, injuries and contributing factors, and exposure time in the last competitive season.

Main outcome measures

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.


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.


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.


O’Kane JW, Levy MR, Pietila KE, Caine DJ, Schiff MA. Survey of injuries in Seattle area levels 4 to 10 female club gymnasts. Clin J Sport Med. 2011;21(6):486-492. doi:10.1097/JSM.0b013e31822e89a8

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