Association Between Flexibility and Low Back Pain in Female Adolescent Gymnasts

To determine the relationship between low back pain (LBP), flexibility, and individual demographic characteristics in competitive adolescent female gymnasts.

Cross-sectional observational study.

Gymnastics facilities in Colorado.

Six- to 18-year-old gymnasts who participate in the USA Gymnastics Women's Artistic Junior Olympic Program levels 3 to 10.

Demographic data included height, weight, menstrual status, gymnastics level, and participation hours per week. Flexibility measurements were obtained on the gymnasts. Gymnasts also completed a questionnaire documenting LBP in the past 12 months. Univariable (t test and χ) analyses were used to assess between-group differences; multivariable logistic regression model was used to assess the association between LBP, flexibility, and demographics/injury history.

Low back pain within the past 12 months.

Thirty (45%) of 67 gymnasts reported LBP within the past year. Those who reported LBP were older (11.7 vs 13.7 years, P = 0.005), heavier (37.5 vs 43.4 kg, P = 0.049), and participated in gymnastics more often (19.1 vs 22.4 h/wk, P = 0.017). A greater proportion of gymnasts with LBP had experienced menarche compared with those without LBP (47% vs 16%; P = 0.008). On multivariable analysis, gymnasts with LBP were less likely to have left Iliotibial (IT) band tightness compared with those without LBP [adjusted odds ratio (aOR) = 0.186; 95% confidence interval (CI), 0.04-0.82] and more likely to have experienced menarche (aOR = 8.0; 95% CI, 1.2-50.9).

Low back pain is more common in gymnasts who experienced menarche, whereas limited joint flexibility does not seem to be associated with LBP in this population.