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Impact of detraining on bone loss in former collegiate female gymnasts.

Undesirable changes in health-related parameters are thought to occur in retiring female athletes, but this has not been examined in longitudinal studies. The purpose of this study was to examine longitudinal changes in bone mineral density (BMD), body composition, and dietary intake in gymnasts and controls. Nonathletic, college-age women (: n = 9) were selected as a control group for comparison to the gymnasts (n = 10). Initial BMDs for the gymnasts were determined by using dual energy X-ray absorptiometry (Lunar, DPX) at the beginning of their final competitive year. Initial BMDs for the controls were measured during a similar time-frame. Follow-up measurements were made at least 1-year after the initial measurement. Gymnasts had significantly greater BMD of the femoral neck (1.262 versus 1.058 g/cm2, respectively), Ward's triangle (1.230 versus 1.008 g/cm2), greater trochanter (1002 versus 0.822 g/cm2), and total body (1.232 versus 1.145 g/cm2) than controls while still competing (P < .05). Following retirement from competition, (mean years of retirement, 4 years), BMD of the gymnasts remained significantly greater than controls at total body, femoral neck, trochanter, and Ward's triangle (P < .05). Significant declines in femoral neck, Ward's triangle, and greater trochanter BMD were found in both gymnasts and controls (0.72% to 1.9% per year), but only gymnasts had a significant decline at the lumbar spine (0.87% per year). In conclusion, BMD changes in former gymnasts appear to be site-specific, and gymnasts continue to have greater proximal femur BMD than controls, despite their decreased exercise, which may help postpone or prevent osteoporosis later in life.

Absorptiometry, Photon↗

Peripubertal perturbations in elite gymnasts caused by sport specific training regimes and inadequate nutritional intake.

Low body fat masses of elite female gymnasts are favoured for the current aesthetic appeal required for complex movements performed by the gymnasts. Optimal nutritional intake relative to physical training regimes is essential for pubertal development. Here we evaluate how high intensity training in combination with nutritional intake affects pubertal development. Twenty-two female (13.6 +/- 1.0 years) and 18 male (12.4 +/- 1.6 years) elite gymnasts from national cadres were enlisted in this study. Skeletal maturation and hormonal levels of the hypophyseal, gonadal, and adrenal axes were estimated. Prepubertal and pubertal stages were determined, and body composition was measured using two indirect methods. Whereas female gymnasts showed bone retardation (1.7 years), reduced height potential, minimal fat mass (4.3 +/- 1.3 kg), no significant increase in pubertal oestradiol levels (17.6 +/- 4.2 pg/ml vs. 23.9 +/- 13.4 pg/ml), and delayed menarche (2.3 years), male gymnasts displayed virtually unaltered pubertal development due to different training regimes. Nutritional intake was insufficient in all gymnasts although to a lesser extent for male gymnasts. Intensive physical training of elite female gymnasts combined with inadequate nutritional intake can alter the normal pattern of pubertal development. In female gymnasts the onset of menarche can be influenced by keeping the amount of fat mass low. There is a peripubertal change favouring fat mass over muscle mass in females while there is a net gain of muscle mass during pubertal development in males.

Body Composition↗

Physique as a risk factor for ulnar variance in elite female gymnasts.

The aims of this study were: 1) to determine ulnar variance variability of elite, female gymnasts; 2) to evaluate the relationship between ulnar variance and physique, maturity status, and training characteristics of these gymnasts. All 156 skeletally immature female gymnasts were participants at the World Championships Artistic Gymnastics, Rotterdam, The Netherlands, in 1987. Chronological ages varied between 13.1 and 20.6 yr (mean = 15.9 +/- 1.3 yr). A large set of anthropometric dimensions was taken and somatotype was determined by the Heath-Carter technique. Skeletal age was assessed by the Tanner-Whitehouse II method. Menarcheal status and training data were collected by questionnaire. Ulnar variance was determined according to Hafner et al. Gymnasts differ significantly from reference girls with respect to physique and maturational status: gymnasts were smaller and delayed in skeletal maturity with about 1.5 yr. For those who had attained menarche, mean age at menarche was 15.1 +/- 1.3 yr. Ulnar variance shows a normal distribution in the gymnasts, ranging from -10.5 mm to +5.9 mm, which is somewhat more positive, i.e., an ulnar overgrowth, than reference wrists. The relationship between ulnar variance and somatic and maturational features suggests that female gymnasts who are more mature and have a physique characterized as relatively tall with a high lean body mass are at greater risk for developing a positive ulnar variance. No relationship between ulnar variance and training characteristics was evident. It is concluded that the observed positive ulnar variance in this sample of elite female gymnasts is less pronounced than originally stated in most "case reports."

Adolescent↗

Relationship between energy deficits and body composition in elite female gymnasts and runners.

PURPOSE: The purpose of this study was to evaluate energy balance and body composition in 42 gymnasts (mean age = 15.5 yr) and 20 runners (mean age = 26.6 yr), all of whom were on national teams or were nationally ranked. METHODS: Athletes were assessed for body composition using DEXA and skinfolds, and energy balance was determined with a Computerized Time-Line Energy Analysis (CTLEA) procedure. RESULTS: Results from the CTLEA were assessed as the number of within-day energy deficits (largest and frequency) and within-day energy surpluses (largest and frequency). There was a significant difference (P = 0.000) in the mean number of hourly energy deficits > 300 kcal experienced by gymnasts (9.45 +/- 6.00) and runners (3.70 +/- 5.34). There was also a significant difference (P = 0.001) in the mean number of hourly energy surpluses > 300 kcal experienced by gymnasts (1.40 +/- 3.04) and runners (6.20 +/- 5.50). The mean largest daily energy deficit was 743 (+/- 392) kcal for gymnasts and 435 (+/- 340) kcal for runners. The mean largest daily energy surplus was 239 (+/- 219) kcal for gymnasts, and 536 (+/- 340) kcal for runners. There was a significant relationship between the number of daily energy deficits > 300 kcal and DEXA-derived body fat percent for gymnasts (r = 0.508; P = 0.001) and for runners (r = 0.461; P = 0.041). There was also a negative relationship between the largest daily energy surplus and DEXA-derived body fat percentage for gymnasts (r = -0.418; P = 0.003). Using the energy balance variables, age, and athlete type (artistic gymnast, rhythmic gymnast, middle-distance runner, long-distance runner) as independent variables in a forward stepwise regression analysis, a small but significant amount of variance was explained in DEXA-derived (P = 0.000; R2 = 0.309) and skinfold-derived (P = 0.000; R2 = 0.298) body fat percent by the number of energy deficits > 300 kcal and age. CONCLUSIONS: These data suggest that within-day energy deficits (measured by frequency and/or magnitude of deficit) are associated with higher body fat percentage in both anaerobic and aerobic elite athletes, possibly from an adaptive reduction in the REE. These data should discourage athletes from following restrained or delayed eating patterns to achieve a desired body composition.

Adolescent↗

Scoliosis in rhythmic gymnasts.

STUDY DESIGN: An anamnestic, clinical, radiographic study of 100 girls actively engaged in rhythmic gymnastics was performed in an attempt to explain the higher incidence and the specific features of scoliosis in rhythmic gymnastic trainees. OBJECTIVES: To analyze the anthropometry, the regimen of motion and dieting, the specificity of training in rhythmic gymnastics, and the growth and maturing of the trainees, and to outline the characteristics of the scoliotic curves observed. An etiologic hypothesis for this specific subgroup of scoliosis is proposed. SUMMARY OF BACKGROUND DATA: The etiology of scoliosis remains unknown in most cases despite extensive research. In the current classifications, no separate type of sports-associated scoliosis is suggested. METHODS: The examinations included anamnesis, weight and height measurements, growth and maturing data, eating regimen, general and back status, duration, intensity, and specific elements of rhythmic gymnastic training. Radiographs were taken in all the patients with suspected scoliosis. The results obtained were compared with the parameters of normal girls not involved in sports. RESULTS: A 10-fold higher incidence of scoliosis was found in rhythmic gymnastic trainees (12%) than in their normal coevals (1.1%). Delay in menarche and generalized joint laxity are common in rhythmic gymnastic trainees. The authors observed a significant physical loading with the persistently repeated asymmetric stress on the growing spine associated with the nature of rhythmic gymnastics. Some specific features of scoliosis related to rhythmic gymnastics were found also. CONCLUSIONS: This study identified a separate scoliotic entity associated with rhythmic gymnastics. The results strongly suggest the important etiologic role of a "dangerous triad": generalized joint laxity, delayed maturity, and asymmetric spinal loading.

Adolescent↗

Why do idiopathic scoliosis patients participate more in gymnastics?

The influence of physical and sporting activities (PSA) on idiopathic scoliosis (IS) is still obscure. The aim of this study was to investigate whether such an influence exists and if so, to determine its characteristics. Two hundred and one teenagers with IS and a control group of 192 adolescents completed an epidemiological questionnaire. Those practising gymnastics were more numerous in the IS group than in the control group. Moreover, the practice of gymnastics was chosen before IS was diagnosed. As gymnastic activities are considered neither as a therapy nor as a precursor of IS, the distribution observed could be linked to a common factor that both increases the likelihood of IS and favors the practice of gymnastics. Joint laxity (JL) may be such a common factor, and was therefore tested (wrist and middle finger) on 42 girls with IS and 21 girls of a control group. IS patients, practising gymnastics or not, showed a higher JL than the control group practising gymnastics or not. Furthermore, the groups practising gymnastic activities did not show higher JL levels than the other groups. Children with a high JL could be drawn toward gymnastics because of their ability to adapt to the constraints of this sport. Girls with a high JL may therefore be prone to developing IS. The fact that most teenagers with IS practise gymnastics could be related to a higher JL.

Adolescent↗

Balancing the risk of injury to gymnasts: how effective are the counter measures?

BACKGROUND: To minimise injury risk and maximise gymnastics performance, coaches, parents, and health professionals working with young gymnasts need to understand and practise safe gymnastics. AIMS: To (a) identify the various injury counter measures specific to gymnastics, (b) critically review the literature describing each injury prevention measure, and (c) assess, using available risk factor and injury data, the weight of evidence to support each of these counter measures. Specific recommendations for further research and implementation strategies to prevent injury and improve safety are also given. METHODS: The relevant literature was identified through the use of Medline (1966 to May 1998) and SPORT Discus (1975 to May 1998) searches, hand searching of journals and reference lists, and discussions with key Australian gymnastics organisations. RESULTS: The key gymnastics injury counter measures identified in this review include coaching (physical preparation, education, spotting, and performance technique), equipment, and the health support system (medical screening, treatment, and rehabilitation). Categorisation of the type of evidence for the effectiveness of each of these counter measures in preventing injury showed that most of it is based on informal opinion/anecdotal evidence, uncontrolled data based studies, and several prospective epidemiological studies. There is no evidence from formally controlled trials or specific evaluation studies of counter measures for gymnastics. CONCLUSIONS: Although gymnastics is a sport associated with young participants and frequent high volume, high impact training, there is a paucity of information on injury risk factors and the effectiveness of injury practices. Further controlled trials are needed to examine the extent to which injury prevention counter measures can prevent or reduce the occurrence of injury and re-injury. Particular attention should be devoted to improving training facilities, the design and testing of apparatus and personal equipment used by gymnasts, and coaching and the role of spotting in preventing injury.

Athletic Injuries↗

Longitudinal bone mineral density changes in female child artistic gymnasts.

Changes in bone mineral density (BMD), and related factors, in female child artistic gymnasts (n = 9) and their age- (+/-0.3 years), height- (+/-2.8 cm), and weight- (+/-1.7 kg) matched controls (n = 9) were prospectively examined. It was hypothesized that gymnasts would possess higher BMD at baseline, 6, and 12 months later and have greater gains in BMD over 1 year compared with controls. BMD (g/cm2) of the total proximal femur (TPF), Ward's triangle (WT), trochanter (Troch), femoral neck (FN), lumbar spine (LS, L1-L4), and total body (TB) were measured by dual-energy X-ray absorptiometry. Physical activity was measured by a 7-day recall; daily dietary intakes of energy and nutrients were estimated from 3-day records. Serum osteocalcin and urinary pyridinium cross-links were measured by radioimmunoassay and high performance liquid chromatography, respectively. Gymnasts versus controls possessed significantly higher BMD at all sites measured. Although not significantly different (p > 0.05), gymnasts compared with controls had moderately larger percentage changes in Troch (% Delta = 8.6 +/- 3.0 vs. 3.8 +/- 5.1%, d = 0.41), FN (% Delta = 6.1 +/- 1.2 vs. 3.9 +/- 1.6%, d = 0.55), LS (% Delta = 7.8 +/- 1.1 vs. 6.8 +/- 1.6%, d = 0.26), and TB BMD (% Delta = 5.6 +/- 0.8 vs. 3.4 +/- 0.7%, d = 0.98) as evidenced by the magnitude of the effect sizes (d). Gymnasts versus controls possessed a lower percentage body fat (p < 0.01) and engaged in more hours of very hard activity (p < 0.0001). Calcium, as a percentage of adequate intake, decreased over 12 months (p < 0.01), and urinary cross-links significantly decreased over 6 months in both groups. Female child gymnasts possess higher BMD at the TPF and related sites, LS, and TB compared with nongymnast controls, and 1 year of gymnastics training moderately increases Troch, FN, LS, and TB BMD for gymnasts compared with controls. These findings lend support to the idea that gymnastics training in childhood helps maximize peak BMD.

Adipose Tissue↗

Effects of high-impact exercise on ultrasonic and biochemical indices of skeletal status: A prospective study in young male gymnasts.

Physical activity has been proposed as one strategy to enhance bone mineral acquisition during growth. The aim of this study was to determine whether frequent impact loading associated with gymnastics training confers a skeletal benefit on pre- and peripubertal male gymnasts. We measured broadband ultrasonic attenuation (BUA, dB/MHz) at the calcaneus (CBUA); ultrasound velocity (m/s) at the calcaneus (CVOS), distal radius (RVOS) and phalanx (PVOS); serum osteocalcin (OC); total alkaline phosphatase (ALP) and insulin-like growth factor-I (IGF-I) every 3-4 months over an 18-month period in elite male gymnasts and matched normoactive controls (pubertal stage </=2). Ground reaction forces of common gymnastics maneuvers were determined using a force platform and loading histories of the upper and lower extremities approximated from video recordings. Ultrasound results were expressed as a standardized score (Z score) adjusted for age, height, and weight. At baseline, no differences were detected between the gymnasts (n = 31) and controls (n = 50) for CBUA, although ultrasound velocity at each site was higher in the gymnasts (0.6-1.5 SD) than the predicted mean in controls (p </= 0. 001). Over 18 months, CBUA Z scores increased significantly in the gymnasts from baseline (0.3 vs. 1.0, p < 0.05, n = 18). In contrast, ultrasound velocity did not increase in either group, although CVOS and RVOS remained significantly higher in gymnasts compared with controls (range p < 0.01 and < 0.001). No differences between groups were found for OC, ALP, or IGF-I at any time. Gymnastics training was associated with on average 102 and 217 impacts per session on the upper and lower extremities, respectively, with peak magnitudes of 3.6 and 10.4 times body weight. These results suggest that frequent high-impact, weight-bearing exercise during the pre and peripubertal period may enhance the mechanical competence of the skeleton, perhaps offering an important strategy for osteoporosis prevention if the benefits are maintained.

Body Constitution↗

Changes in bone density and bone markers in rhythmic gymnasts and ballet dancers: implications for puberty and leptin levels.

OBJECTIVE: Our aim was to compare physical activity and biochemical markers with bone mineral acquisition in rhythmic gymnasts and ballet dancers. METHODS: Weight, height, body mass index, nutritional intake, bone age and menstrual histories were analyzed in nine rhythmic gymnasts, twelve ballet dancers and fourteen controls. Bone mineral density (BMD) was assessed by X-ray absorptiometry at the lumbar spine, hip and radius. Bone alkaline phosphatase (bAP) and amino-terminal propeptide of procollagen I (PNIP) in serum and urinary alpha-isomer of the carboxy-terminal telopeptide of collagen I (alpha-CTX) were measured. RESULTS: Bone age was delayed 2 years and mean age at menarche was 15+/-0.9 years in rhythmic gymnasts and 13.7+/-1 years in ballet dancers, compared with 12.5+/-1 years in controls. Trocanteric and femoral neck BMD was significantly higher in rhythmic gymnasts compared with ballet dancers and controls. Right forearm (non-loaded zone) BMD was significantly decreased in rhythmic gymnasts and ballet dancers compared with controls. All subjects had normal bAP and PNIP levels, but the alpha-CTX/creatinine (Cr) ratio was increased in rhythmic gymnasts (P<0.001) with an inverse correlation between right forearm BMD and the alpha-CTX/Cr ratio (r=-0.74, P<0.001). Serum leptin levels were decreased in rhythmic gymnasts and ballet dancers. Rhythmic gymnasts had a positive correlation between right forearm BMD and leptin levels (r=0.85, P<0.001). CONCLUSIONS: Decreased bone mass in rhythmic gymnasts could be partially explained by an increase in bone resorption. Serum leptin levels could be implicated in the pubertal delay and be a good marker of bone mass in these subjects.

Adolescent↗

Growth of highly versus moderately trained competitive female artistic gymnasts.

PURPOSE: To investigate whether growth was adversely affected in 137 young competitive female artistic gymnasts involved in different training volumes. METHODS: This was a 2-yr prospective cohort study in which height, sitting height, leg length, weight, skinfolds, and pubertal status were measured in competitive advanced (20-27 h x wk(-1)) and intermediate (7.5-22 h x wk(-1)) training level female gymnasts every 6-12 months. Biological parameters of the adolescent growth curve were estimated using the Preece-Baines growth model. Growth rates were estimated for both groups from the mixed-longitudinal data. RESULTS: Estimated ages at peak height velocity (PHV) (13-13.5 yr) and mean PHV (6.2-6.4 cm x yr(-1)) for the advanced- and intermediate-level gymnasts suggest that these gymnasts were later maturing and experienced a blunting of the growth spurt relative to reference values for U.S. youth. Comparison of growth velocities by pubertal status revealed that height velocity was lower in the advanced- versus the intermediate-level peripubertal gymnasts, which was due to a significant reduction in sitting height velocity (2.3 vs 3.1 cm x yr(-1), P. < 0.05). No marked acceleration in height or sitting height velocity was detected in the advanced-level gymnasts from pre- to peripuberty. Inspection of individual growth rates revealed that over 35% of the pre- and peripubertal gymnasts experienced growth faltering (height velocity less than 4.5 cm x yr(-1)) during follow-up. CONCLUSION: Advanced-and intermediate-training level competitive female gymnasts tend to exhibit an adolescent growth spurt that is similar in timing and tempo to short, normal, slowly maturing girls, but the high frequency of growth faltering suggests that training may alter the tempo of growth and maturation in some, but not all, female gymnasts.

Adolescent↗

The effects of gymnastics training on bone mineral density.

The purpose of this study was to examine the effect of 27 wk of gymnastics training on bone mineral density (BMD), body composition, insulin-like growth factor I (IGF-I), and osteocalcin. Subjects were 11 female intercollegiate gymnasts and 11 controls. Dual energy x-ray absorptiometry (Lunar DPX) was used to determine BMD (L2-L4 and femur) and to assess body composition. The gymnasts were significantly lower in weight (53.9 and 60.8 kg) and % body fat (22.6 and 30.6) compared with controls. After training, body weights of gymnasts remained the same but there was a significant increase in lean tissue mass of 2.9 kg (6.7%, P < 0.05). No changes in body composition were observed in the controls. The gymnasts had significantly higher mean lumbar (1.321 vs 1.225), and femoral neck (1.163 vs 1.079) BMD (g.cm-2) than the controls. Lumbar BMD increased significantly (1.3%) in gymnasts following training but femoral neck BMD did not increase. No BMD changes occurred in the control group. Regarding serum IGF-I, no differences were seen between the groups or across time. Serum osteocalcin values were significantly higher in the gymnasts than the controls, but no differences were found across time. In conclusion, gymnasts had significantly higher BMDs than controls, and a significant increase in lumbar BMD was seen in the gymnasts following 27 wk of training.

Absorptiometry, Photon↗

Eating disorder symptoms in former female college gymnasts: relations with body composition.

The purpose of this investigation was to describe eating disorder symptoms in 36.6 +/- 3.8-y-old former college gymnasts as well as relations between body dissatisfaction and body composition. Former college gymnasts (n = 22) and age-(mean +/- SE difference: 0.05 +/- 0.26 y), height-(0.47 +/- 0.75 cm), and weight-matched (2.20 +/- 0.30 kg) control subjects (n = 22) participated. Current and past symptoms were assessed by using the Eating Disorders Inventory-2 (EDI-2) and visual analog scales. EDI-2 body-dissatisfaction scores were correlated with assessments of body composition by dual-energy X-ray absorptiometry. Weight preoccupation was stable across the life span for control subjects but was lower before former gymnasts had begun gymnastics training and higher for former gymnasts when they were participating in college gymnastics (P = 0.03). Current levels of body dissatisfaction were more strongly related to actual minus ideal body-weight discrepancy scores (r = 0.77) than to percentage fat (r = 0.50) for the former gymnasts whereas the opposite was true for the control subjects (r = 0.51 and 0.77, respectively). These results suggest that symptoms of eating disorders abate after retirement from gymnastics and that concerns about achieving an ideal body may be a more important determinant of body dissatisfaction than percentage body fat for gymnasts.

Absorptiometry, Photon↗

Are young female gymnasts malnourished? An anthropometric, electrophysiological, and histological study.

Competitive rhythmic sportive gymnastics have been accused of promoting an unphysiologic weight reduction which may progress to manifest anorexia nervosa. In this study, eight young female gymnasts who represented Norway in the European Championships in Rhythmic Sportive Gymnastics 1982 were examined for evidence of malnutrition. Ten girls, matched for age and height, served as controls. The examination included registration of anthropometric data (height, weight, and body-mass index), motor and sensory neurography and biopsies of the vastus lateralis muscle with exact measurements of muscle fibre areas on sections stained for myofibrillar ATPase activity. The mean body weight of the gymnasts did not differ from that of the control group or of a large series of age matched Norwegian females. This finding excludes the possibility of general malnutrition among the examined gymnasts. Muscle fibres of both types 1 and 2 were found to be smaller in the gymnasts than in the controls, with values of 3,404 microns2 vs 3,811 microns2 for type-1 fibres and 2,985 microns2 vs 3,942 microns2 for type-2 fibres respectively. Although contradictory to most previous reports, this finding suggests that the reduction in fibre size among the gymnasts might be an effect of physical training. There were some differences in neurographic parameters between the groups, but the mean values were all within normal ranges. The motor nerve conduction velocity in the proximal segments of the median and ulnar nerves was significantly slower in the gymnasts and, as a possible consequence of smaller muscle fibres, the motor responses were generally less in this group.

Adolescent↗

Hypoleptinemia in female and male elite gymnasts.

BACKGROUND: Elite gymnasts favour low body fat mass as the current aesthetic ideal required for complex movements in this sports discipline. Pubertal development and growth are retarded in juvenile gymnasts. Leptin, the protein product of the ob-gene, is secreted by fat cells. Besides its role in regulation of body weight, leptin also stimulates the reproductive axis. We investigated various serum hormones including leptin, body composition and nutrition in cohorts of female and male elite gymnasts to elucidate if there is a relationship between leptin levels and delayed puberty in elite gymnasts. MATERIALS AND METHODS: Twenty-two female and 18 male elite gymnasts were enrolled in this study. Pubertal stage, various hormonal levels and body composition were determined and nutritional intake was assessed. Leptin was analysed using a specific RIA. RESULTS: Pubertal development and growth were delayed in the study group, especially in girls. The percentage of body fat was reduced as compared to a normal age-matched population: 14.4% versus 21.9% in girls and 10.4% versus 15.1% in boys. Serum leptin levels were decreased, especially in pubertal girls, and did not show the normal developmental pattern with a steady increase in girls and a peak in boys of pubertal stage 2. In all gymnasts leptin levels correlated with the amount of fat mass (r = 0.6, P = 0.005 in girls; r = 0.44, P = 0.038 in boys). When leptin levels were transformed into standard deviation scores (SDS) it became obvious that the gymnasts, especially pubertal females, had significantly lower values than normal controls of the same sex, pubertal stage and body mass index (BMI): leptin SDS (BMI) = -1.21 and -3.99 in prepubertal and pubertal girls, - 0.94 and -0.91 in prepubertal and pubertal boys, respectively. When leptin SDS were based on % body fat instead of BMI, mean values were still significantly decreased compared to normal controls: -1.05 in girls (P < 0.001) and -0.60 in boys (P = 0. 025). CONCLUSIONS: Adjustment of serum leptin levels in elite gymnasts for gender, pubertal stage and BMI or % body fat reveals inappropriately low values. The reason for this hypoleptinemia is most probably insufficient caloric intake. The data suggest that hypoleptinemia in turn causes delayed puberty and growth in this particular group of athletes.

Adipose Tissue↗

Target-directed running in gymnastics: a preliminary exploration of vaulting.

Research to date has demonstrated the importance of running speed and an accurate take-off on gymnastics vaulting performance (Krug et al., 1998; Bohne et al., 2000). Current training practice for gymnastics vaulting is to stereotype the 15-25 m run-ups to the board, which assumes that a fast and reliable approach is best controlled predominantly without visual feedback. Incidences where gymnasts make errors during their run-ups, often landing onto the back of the board, occur frequently, even at the international level. The standard deviation method (e.g. Lee et al., 1982) for identifying visual regulation in long jump run-ups was employed in this first exploration of gymnastics vaulting to examine whether visual regulation processes are utilised. Secondly, the question of how a small number of gymnasts can run fast during the approach and perform more difficult vaults was addressed. Five elite female gymnasts aged 13-15 years performed five round-off entry vaults. One panning 50 Hz video camera recorded each trial from an elevated platform to evaluate the approach step, hurdle, and round-off characteristics, whilst two 250 Hz cameras recorded vaulting performance. Two qualified judges viewed each vaulting trial and provided a performance score. A precursor for a fast take-off from the board when vaulting is to utilise vision early to control the approach kinematics (p = 0.02). High take-off velocity was directly related to judge's score (p = 0.03). Coaches need to supplement gymnasts' vault training to include exercises that improve the gymnasts' ability to visually regulate their gait pattern whilst running.

Adolescent↗

Ulnar variance and skeletal maturity of radius and ulna in female gymnasts.

UNLABELLED: It is has been suggested that repetitive loading on the distal end of the radius in elite gymnasts may lead to epiphyseal changes, a premature closure (union) of the radius growth plate, and ulnar overgrowth. PURPOSE: It is hypothesized that ulnar overgrowth in female gymnasts is associated with advanced maturity status and early onset of epiphyseal closure of the radius, and later maturity status and later onset of epiphyseal closure of the ulnar. METHODS: Posterior-anterior radiographs of 201 female gymnasts, participants of the 1987 World Championships Artistic Gymnastics, were used to measure ulnar overgrowth, to determine skeletal maturation of the hand and wrist with the Tanner-Whitehouse technique, and to determine the maturity status of the radius and ulna separately, particularly with regard to the onset of epiphyseal closure. To test the hypothesis, extreme quintiles for ulnar overgrowth were contrasted for skeletal maturation of the hand and wrist and for maturity stages of the radius and ulna as defined by the Tanner-Whitehouse criteria. RESULTS: Female gymnasts who demonstrate ulnar overgrowth are skeletally more advanced in maturity status of the entire hand-wrist compared with gymnasts who did not show ulnar overgrowth. There were, however, no differences between gymnasts in the extreme quintiles of ulnar overgrowth in the maturation of the radius, although gymnasts with ulnar overgrowth show more advanced maturity status of the ulna. CONCLUSIONS: Ulnar overgrowth is thus not apparently associated with advanced maturity of the distal radial epiphysis as defined in protocols for assessing skeletal maturity and does not apparently lead to premature epiphyseal closure of the distal radius.

Adolescent↗

Contralateral spondylolysis and fracture of the lumbar pedicle in an elite female gymnast: a case report.

STUDY DESIGN: The case of an elite female gymnast whose pathology started in her 12th year and whose evolution has been exceptional is reported. OBJECTIVE: To present a fracture of the right lumbar pedicle showing complete spontaneous consolidation despite gymnastic practice 15 hours a week. SUMMARY OF BACKGROUND DATA: Lumbar pain, which has an incidence of approximately 75% among young athletes, often results from diseases of the posterior arch of vertebrae in gymnasts, including spondylolysis. The association between unilateral spondylolysis and fracture of the contralateral lumbar pedicle in young athletes is poorly described. METHODS: An elite young female gymnast underwent clinical examination and lumbar radiographs (as systematically required by the French Federation for high-level gymnasts) from 1994 to 1997 to join a sports program in gymnastics. RESULTS: Clinical examination and lumbar radiographs systematically required of an asymptomatic female gymnast allowed the condensation of the right pedicle to be observed before lysis of the left isthmus of L5 in 1994, unilateral lysis of the left isthmus of L5 in 1995, a right pedicular fracture of L5 in 1996, and healing of the pedicular fracture in 1997. CONCLUSION: Inconsistency between radiographs and clinical observations can be noted, and spontaneous consolidation of pedicular fractures can occur despite the practice of the gymnastics 15 hours a week.

Child↗