gymnastics and back problems

[gh]

Not to stray too far off subject here, but given how many times the phrase "severe back pain" crops up in these stories, sounds like gymnastics—at least the high-level version—may in and of itself be something people shouldn't be subjecting their kids too. (won't even get into the diet-control implications of the latest Karolyi piece)

[bambam1729]

Not to stray too far off subject here, but given how many times the phrase "severe back pain" crops up in these stories, sounds like gymnastics—at least the high-level version—may in and of itself be something people shouldn't be subjecting their kids too. (won't even get into the diet-control implications of the latest Karolyi piece)

There is a type of back injury that occurs with some frequency in gymnasts, called a spondylolysis, with the more severe version of it called a spondylolisthesis. Its essentially a stress fracture of the posterior elements of the spinal column. Strangely its also been reported to occur occasionally in long jumpers.

[Pego]

There is a type of back injury that occurs with some frequency in gymnasts, called a spondylolysis, with the more severe version of it called a spondylolisthesis. Its essentially a stress fracture of the posterior elements of the spinal column. Strangely its also been reported to occur occasionally in long jumpers.

Since both the spondylolysis and spondylolisthesis are a fairly common incidental, asymptomatic finding, are there any data how often it is actually traumatic and symptomatic?

[El Toro]

Since both the spondylolysis and spondylolisthesis are a fairly common incidental, asymptomatic finding, are there any data how often it is actually traumatic and symptomatic?

Not the answer you wanted but this very small study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799125/ found 5.56% had spondylolysis but wasn't related to reported back pain. However, they acknowledged this was contrary to most literature. Some previous studies showed:

"Spondylolysis affects 11% of female gymnasts, and the most frequent location is the fifth lumbar vertebra."

"Among Olympic athletes, 63% of gymnasts present observable abnormalities in magnetic resonance examinations"

That last quote aligns with a discussion I had with an Australian physiotherapist working with elite female gymnasts. He said that they had started monitoring the gymnasts with CT scans and found almost universal stress reactions in the spine, with over half with some type of stress fracture (all locations and degrees). I think this was over time, not necessarily all at the same time.

The scary thing was that (a) most athletes were asymptomatic and (b) in opposition to expectations, a substantial number of retired athletes (>12 mths) from the program that they used as a comparator still had identifiable bone weaknesses. He was starting to get concerned that the sport was possibly permanently destructive from training with fractures for years that you never felt pain. Probably not an issue in your 20s and 30s but after that?

[Pego]

Not the answer you wanted but this very small study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799125/ found 5.56% had spondylolysis but wasn't related to reported back pain. However, they acknowledged this was contrary to most literature. Some previous studies showed:

"Spondylolysis affects 11% of female gymnasts, and the most frequent location is the fifth lumbar vertebra."

"Among Olympic athletes, 63% of gymnasts present observable abnormalities in magnetic resonance examinations"

That last quote aligns with a discussion I had with an Australian physiotherapist working with elite female gymnasts. He said that they had started monitoring the gymnasts with CT scans and found almost universal stress reactions in the spine, with over half with some type of stress fracture (all locations and degrees). I think this was over time, not necessarily all at the same time.

The scary thing was that (a) most athletes were asymptomatic and (b) in opposition to expectations, a substantial number of retired athletes (>12 mths) from the program that they used as a comparator still had identifiable bone weaknesses. He was starting to get concerned that the sport was possibly permanently destructive from training with fractures for years that you never felt pain. Probably not an issue in your 20s and 30s but after that?

This is quite useful, thanks. Do you know if they CT'd their research subjects before the actual training commenced?

The last paragraph (the scary part) makes me think that those "identifiable bone weaknesses" that I think refers to spondylolysis were incidental, pre-existing and not traumatic at all.

[El Toro]

This is quite useful, thanks. Do you know if they CT'd their research subjects before the actual training commenced?

The last paragraph (the scary part) makes me think that those "identifiable bone weaknesses" that I think refers to spondylolysis were incidental, pre-existing and not traumatic at all.

The discussion was only incidental to my day job, so it wasn't much longer or more detailed than what I typed and it was also just as they had started looking at the issue. I don't know how it ended up because I couldn't find any published paper on it. Not that that means it doesn't exist.

You could be right that it was no big issue but it stuck in my memory because gymnasts are so much younger than athletes when training at the elite level. If the findings were real, you'd have to recommend for children not to do it and probably destroy any possibility of a successful national program. Hmmm, conspiracy of silence anybody? Gymnastics seems good at that...

[Pego]

Gymnastics is clearly brutal to the body, there is no doubt. I simply wonder how often we equate correlation with causation .

[El Toro]

Gymnastics is clearly brutal to the body, there is no doubt. I simply wonder how often we equate correlation with causation .

True, plenty of people walking around with abnormalities of all kinds and doing all sorts of things. Degree and combination of abnormalities can also impact. Can any study really take all the variables into account?

[Pego]

True, plenty of people walking around with abnormalities of all kinds and doing all sorts of things. Degree and combination of abnormalities can also impact. Can any study really take all the variables into account?

Obviously not, but...We have data of incidence of spondylolysis and spondylolisthesis in general population. It could be compared (at least somewhat closely) with the gymnastics numbers.

[gh]

a solid medical discussion doesn't deserve to be in a thread about a scumbag, so those moved over here.