Article Text

Download PDFPDF
Injuries and illnesses among competitive Norwegian rhythmic gymnasts during preseason: a prospective cohort study of prevalence, incidence and risk factors
  1. Marte Charlotte Dobbertin Gram1,
  2. Benjamin Clarsen2,3,
  3. Kari Bø1,4
  1. 1 Department of Sports Medicine, Ullevål Stadion, Norwegian School of Sport Sciences, Oslo, Norway
  2. 2 Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo Sports Trauma Research Center, Oslo, Norway
  3. 3 Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
  4. 4 Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
  1. Correspondence to Marte Charlotte Dobbertin Gram, Department of Sports Medicine PB 4014, Ullevål Stadion, Norwegian School of Sport Sciences, Oslo 0806, Norway; martecdg{at}


Objectives Rhythmic gymnastics is an Olympic sport that demands high training volume from early age. We investigated the extent of, and risk factors for, injuries among competitive Norwegian rhythmic gymnasts.

Methods One hundred and seven of 133 (80.5%) female rhythmic gymnasts (mean age: 14.5 years (SD 1.6), mean body mass index: 18.9 (SD 2.2)) participated. All gymnasts completed a baseline questionnaire and the ‘Triad-Specific Self-Report Questionnaire’. Injuries, illnesses and training hours were recorded prospectively for 15 weeks during preseason using the ‘Oslo Sports Trauma Research Center Questionnaire on Health Problems’ (OSTRC-H2).

Results Response rate to OSTRC-H2 was 97%. Mean overuse and acute injury prevalence were 37% (95% CI: 36% to 39%) and 5% (95% CI: 4% to 6%), respectively. Incidence was 4.2 overuse injuries (95% CI: 3.6 to 4.9) and 1.0 acute injuries (95% CI: 0.5 to 1.6) per gymnast per year. Overuse injuries in knees, lower back and hip/groin represented the greatest burdens. Previous injury increased the odds of injury (OR 30.38, (95% CI: 5.04 to 183.25)), while increased age (OR 0.61 per year, (95% CI: 0.39 to 0.97)) and presence of menarche (OR: 0.20, (95% CI: 0.06 to 0.71)) reduced the odds of all injuries and substantial injuries, respectively.

Conclusions Overuse injuries were common among Norwegian rhythmic gymnasts. Younger gymnasts had higher all-injury risk. Gymnasts who were not menstruating had higher substantial injury risk. Injury prevention interventions should start at an early age and focus on preventing knee, lower back and hip/groin injuries.

  • gymnastics
  • overuse injury
  • injuries
  • risk factor
  • female athlete triad

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @benclarsen

  • Contributors All authors participated in the study design and development, analyses and interpretation of data and writing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Regional Ethics Committee (2018/1047/REK Sør – Øst B, 09 August 2018) and the Norwegian Centre for Research Data (NSD: 148616, 10 September 2018).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Please contact the authors with requests to access anonymised data.