SPINAL RANGE OF MOTION AND BACK PAIN IN FEMALE ARTISTIC GYMNASTS DURING BACK WALKOVERS AND BACK HANDSPRINGS

Abstract

Background:Back pain is a common complaint among gymnasts. Gymnastics skills require large amounts of spine flexion, extension, rotation and compression. The combination of these movements in a repetitive fashion during gymnastics may contribute to the development of back pain. Gymnasts perform unique skills on various equipment and surfaces, which makes their movements difficult to evaluate using traditional movement analysis approaches.Hypothesis/Purpose:Our purpose was to measure gymnasts’ movement patterns in their native environment using wearable sensors. Specifically, we examined spine range of motion (ROM) during back walkovers (BWO) and back handsprings (BHS) on the floor and balance beam. We hypothesized that female youth gymnasts with a recent history of back pain would have larger spine ROM compared to gymnasts without back pain when performing these skills.Methods:Female artistic gymnasts ages 8 to 18 years in the Junior Olympic USA Gymnastics program participated in the study. We grouped gymnasts into two groups: those having back pain within the past 12 months and those with no reported back pain in the past 12 months. Gymnasts performed 3 repetitions of BWO and BHS on floor and balance beam while wearing APDM Opal V2 wearable sensors. A BWO requires a controlled bridge kickover while a BHS requires the athlete to jump backwards to her hands (Figure 1). Spine kinematics were then processed via Moveo Explorer. Valid spine sagittal plane maximums, minimums, and ROM of each skill repetition were compared between groups via Kruskal Wallis analysis of variance.Results:Seventeen participants (6 with back pain) completed BWOs and BHSs with acceptable sensor data. There were no demographic differences between the two groups for age, height, weight, competition level, or years of experience (p≥0.129, Table 1). During BWO skills, gymnasts with back pain had greater peak extension and greater ROM in the sagittal plane of the spine (p≤0.032, Figure 2). There were no differences between groups in peak extension, peak flexion, or ROM during BHS skills (p≥0.054, Figure 2).Conclusion:Gymnasts with a history of back pain had increased spinal motion when performing BWO skills. To perform a BWO, gymnasts must have higher levels of shoulder, spine, and hip flexibility, which may relate to back pain. This study suggests the need for future studies to evaluate if increased spinal motion during gymnastics is a contributing factor to the development of back pain.Figure 1.Back walkover (left) and back handspring (right) movements performed by a gymnastTable 1.Demographics for gymnasts with and without back pain.Age (yrs)Height (cm)Mass (kg)Gymnastics Competition Level (1-10)Years of Experience Mean SD Mean SD Mean SD Mean SD Mean SD Back Pain (n=6)13.92.6149.318.937.19.58.21.710.53.4No Pain (n=11)13.31.7147.14.737.23.69.41.09.32.6 p value 0.315 0.155 0.547 0.129 0.510 Figure 2.Spine extension, flexion, and total range of motion (ROM) for back walkover (BWO, top) and back handspring (BHS, bottom) skills performed on the floor and balance beam. Black indicates the mean and standard deviation. Red indicates the median, inter-quartile range, and any outliers.