Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency Departments: Sex- and Age-Based Injury Patterns

Background: Despite increasing participation rates in youth gymnastics, the majority of epidemiologic literature focuses on older elite athletes or stratifies athletes by level of competition. Hypothesis: The authors hypothesized that sex- and age-based patterns in youth gymnastics–related injuries exist, which are otherwise overlooked in an unstratified population. Study Design: Descriptive epidemiology study. Methods: Publicly available injury data from the National Electronic Injury Surveillance System were collected on pediatric gymnastics injuries presenting to emergency departments in the United States. Participation data from the National Sporting Goods Association were used to calculate national injury incidence rates in 7- to 11-year-olds (childhood) and 12- to 17-year-olds (adolescence) from January 1, 2012, to December 31, 2018. Z tests were conducted for the comparison of injury rates between girls and boys within each age group and for overall injury rate across age groups. Results: Girls participated in gymnastics at a frequency 6.5 times that of boys in childhood and 13.5 times that of boys in adolescence. An estimated 72,542 youth gymnastics–related injuries were reported in US emergency departments each year. A large proportion (61.3%) occurred in childhood, with female predominance in both age groups. Overall, there was no difference in weighted annual injury rate (injuries per 100,000 athlete-days per year) by age group (6.9 [childhood] vs 8.8 [adolescence]; P =.19) or sex (7.4 [girls] vs 8.1 [boys]; P =.65). In adolescence, boys were more likely than girls to experience injury (16.47 vs 8.2; P =.003). Wrist and lower arm fractures were more common in childhood than adolescence (1.07 vs 0.43; P =.002) and specifically in girls (childhood vs adolescence, 1.06 vs 0.37; P =.001). Ankle injuries and concussions were more common in adolescence vs childhood (P =.01 and.0002). Conclusion: Upper extremity injuries predominated among childhood gymnasts, particularly girls. In adolescence, girls and boys experienced increases in concussions and foot and ankle injuries. Although representing a lower overall number of training gymnasts as compared with girls, adolescent boys experience a higher rate of injuries overall.