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Determining Causes of Lower Back Stress Fracture in Female High School Gymnasts

Background: Lower-back stress fractures are a common injury in thirteen to eighteen year old competitive female gymnasts, but the causes of this injury, outside of the mechanical stress of the sport, have not been thoroughly explored. Objective: Assess the nutritional intake, training habits, and menstruation patterns of female, high-school-aged gymnasts with and without lower-back stress fractures. Methods: Validated surveys were used to assess nutritional intake, training habits, and menstruation patterns. Height and weight were also measured. Twenty-five female gymnasts between the ages of thirteen and eighteen, currently training on competitive levels, were recruited for the study. Eleven had a history of a lower-back stress fracture, and fourteen did not. Results were analyzed using Microsoft Excel, Statistical Package for the Social Sciences ® (SPSS). A p<0.05 was considered significant. Results: Gymnasts with lower-back stress fractures consumed significantly more vitamin A and folate on non-training days and significantly less total energy, protein, fat, carbohydrates, and other nutrients on training days than gymnasts without the injury. Both groups experienced similar average number of total injuries, but the lower-back stress fracture group had a higher ratio of bone injuries to total injuries. None of the training elements were significantly different between groups. Gymnasts without lower-back stress fractures were less likely to have experienced menarche. Conclusions: Menstruation patterns, higher intake of vitamin A and folate, and lower intake of energy and macronutrients were correlated with higher risk of lower-back stress