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NATA Report: Epidemiology of NCAA Women's Gymnastics Injuries

Source: National Athletic Trainers' Association

Dallas, August 12, 2015 – Collegiate women’s gymnastics programs continue to recruit student athletes who began specialized training at an early age. That specialization, combined with high-impact upper and lower extremity movements, places many athletes at increased risk of overuse injury, especially if they avoid early warning signs. Examining the incidence of injuries will help schools develop targeted injury-prevention programs.

A new study in the August Journal of Athletic Training, the scientific publication of the National Athletic Trainers’ Association, explores the epidemiology of collegiate women’s gymnastics injuries over a five-year period and is the first to examine non-time loss injuries, which limit participation for less than one day, in the sport: http://natajournals.org/doi/pdf/10.4085/1062-6050-50.7.02.

“Our results show that the time loss injury rate for women’s gymnastics was lower than demonstrated in prior surveillance data,” says lead researcher Zachary Kerr, PhD, MPH, Datalys Center for Sports Research and Prevention. “The decrease may suggest that safety initiatives in women’s gymnastics have helped to minimize frequency and severity of injury. We also noted that lower extremity injuries and floor exercises comprised the largest proportion of injury and injury by apparatus, respectively.”

From 2009-2010 through 2013-2014, the NCAA Injury Surveillance Program (NCAA ISP) monitored all injuries occurring in a sample of women’s gymnastics varsity teams. Athletic trainers from participating programs reported 418 college women’s gymnastics injuries across 28 team seasons from 11 programs.

A reportable injury was defined as one that occurred as a result of participation in a practice or competition and required attention from an athletic trainer or physician; multiple injuries from one injury event could be included. A reportable athlete exposure was defined as one student athlete participating in one practice or competition in which she was exposed to potential injury, regardless of the time associated with the activity.

The days that injuries restricted participation were categorized as non-time loss; injuries restricting participation from one to 21 days; and severe injuries resulting in a time loss of more than three weeks.

Study highlights:
When considering time loss injuries only, the rate was 3.62 per 1,000 athlete exposures, which is a 41 percent reduction in the injury rate reported in earlier NCAA ISP surveillance data. Almost two in three injuries (approximately 60 percent) restricted participation for less than one day.
Overall, 12.4 percent of injuries resulted in time loss of more than three weeks; and of those, 46.2 percent of athletes returned to participation, whereas 53.8 percent of athletes prematurely ended their seasons.
Commonly injured body sites were the ankle (17.9 percent); lower leg/Achilles tendon (13.6 percent); trunk (13.4 percent) and foot (12.4 percent).
Common diagnoses were ligament sprains (20.3 percent) and muscle and tendon strain (18.7 percent). Diagnoses with the largest proportions of severe injuries were dislocations (64.3 percent) and fractures (60 percent). Athletes with dislocations had the largest proportion of surgeries and recurrent injuries.
Of the 291 injuries (69.6 percent) reported during an apparatus event, most occurred during floor exercise (41.9 percent) and uneven bars (28.2 percent).
Ten concussions occurred on gymnastics apparatuses: four on uneven parallel bars; an additional four occurred during the floor exercise and two on balance beam.

The rate of injuries during the preseason was higher than that in the regular or postseason. The authors speculate that this may be because athletes are learning new skills during that earlier period, which may lead to an increased number of injuries and that athletes who are not fully recovered may rest minor injuries during the preseason but play through them during the regular and postseason.

“Given that gymnastics is a high-impact upper and lower body activity, we recommend interventions focus on the technical skills specific to each of the apparatuses – balance beam, floor exercise, uneven bars and vault. We also suggest further examination of lower back injuries and concussions caused by falls or landings,” says Kerr.

Although researchers in the past have highlighted higher frequencies of floor exercise-related injuries, it is also possible that such injuries are due to cumulative exposure on a particular apparatus, not the apparatus itself, and from trying more difficult routines that are rewarded with more points during competition, according to the authors. Because an athlete who experiences a non-time loss injury on one apparatus may continue to participate on another apparatus, she may put herself at risk for more severe future injury.

“Continued sport-related injury surveillance can help drive the development of targeted research and injury- prevention programs in women’s gymnastics,” adds Kerr. “We suggest it include better assessment of apparatus-specific injuries and athlete type – whether an all-around gymnast or someone who specializes in one event. Researchers should also monitor and evaluate the use of injury-prevention strategies, including equipment with padding to absorb shock, low-impact cardiovascular routines, limited-impact routines, participation with pain when injured and core stability programs.”

About NATA: National Athletic Trainers’ Association (NATA) – Health Care for Life & Sport
Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports 39,000 members of the athletic training profession. Visit www.nata.org.

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