Preseason lower extremity range of motion, flexibility, and strength in relation to in-season injuries in NCAA division I gymnasts

ABSTRACT

Objectives

To determine if preseason lower extremity ROM, flexibility, and strength differ in collegiate gymnasts (NCAA Division 1) who do or do not sustain an injury during the competitive season.

Methods

Over four seasons, a total of 15 female gymnasts (age = 20.5 ± 1.0 years) underwent preseason screening (30 gymnast-season). We tested joint ROM (hip: flexion, internal and external rotation; ankle: weightbearing dorsiflexion), muscle flexibility (passive straight leg raise, Thomas,’ Ober’s, Ely’s tests) and strength (hip extensors, abductors, and flexors isometric strength via a handheld dynamometer; knee: quadriceps and hamstring isokinetic strength at 60°/sec). The team athletic trainer tracked overuse lower extremity injuries (restricted gymnasts from full participation, occurred as from participation in organized practice or competition, and required medical attention) during each season. For athletes that tested multiple seasons, each encounter was considered independent, and each preseason assessment was linked to overuse injuries sustained during the same competitive season. Gymnasts were dichotomized into injured and non-injured groups. An independent t-test was used to measure differences in preseason outcomes between injured and non-injured groups.

Results

During four years, we recorded 23 overuse lower extremity injuries. Gymnasts that sustained an in-season overuse injury demonstrated significantly lower hip flexion ROM (mean difference: −10.6°; 95% confidence interval: −16.5, −4.6; p < 0.01) and lower hip abduction strength (mean difference: −4.7% of body weight; 95% confidence interval: −9.2, −0.3; p = 0.04).

Conclusion

Gymnasts who sustain an in-season overuse lower extremity injury have significant preseason deficit of hip flexion ROM and weakness in the hip abductors. These findings indicate potential impairments in the kinematic & kinetic chains responsible for skill performance and energy absorption during landing.

KEYWORDS:

• Gymnastics
• hip joint
• overuse injury
• female athlete
• college

Acknowledgements

The authors thank the University of Florida Athletic Association for the opportunity to work with its athletes. They also thank Stacey Higgins, ATC, Janet Wilson, ATC, and Kelly Flemming for tracking injuries; Susan Tillman PT, SCS for assisting with data collection; and UF Health Sports Residency program.

Disclosure statement

This work was supported in part by the Academy of Orthopaedic Physical Therapy; under a Career Development Award; the National Institute of Health; under the Rehabilitation Research Career Development Program [number K12 HD055929] and a research grant [number R21 AR077231].

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.