Non-elite gymnastics participation is associated with greater bone strength, muscle size, and function in pre- and early pubertal girls

Abstract

Summary

Recent reports indicate an increase in forearm fractures in children. Bone geometric properties are an important determinant of bone strength and therefore fracture risk. Participation in non-elite gymnastics appears to contribute to improving young girls’ musculoskeletal health, more specifically in the upper body.

Introduction

The primary aim of this study was to determine the association between non-elite gymnastics participation and upper limb bone mass, geometry, and strength in addition to muscle size and function in young girls.

Methods

Eighty-eight pre- and early pubertal girls (30 high-training gymnasts [HGYM, 6–16 hr/ wk], 29 low-training gymnasts [LGYM, 1–5 h r/wk] and 29 non-gymnasts [NONGYM]), aged 6–11 years were recruited. Upper limb lean mass, BMD and BMC were derived from a whole body DXA scan. Forearm volumetric BMD, bone geometry, estimated strength, and muscle CSA were determined using peripheral QCT. Upper body muscle function was investigated with muscle strength, explosive power, and muscle endurance tasks.

Results

HGYM showed greater forearm bone strength compared with NGYM, as well as greater arm lean mass, BMC, and muscle function (+5% to +103%, p < 0.05). LGYM displayed greater arm lean mass, BMC, muscle power, and endurance than NGYM (+4% to +46%, p < 0.05); however, the difference in bone strength did not reach significance. Estimated fracture risk at the distal radius, which accounted for body weight, was lower in both groups of gymnasts. Compared with NONGYM, HGYM tended to show larger skeletal differences than LGYM; yet, the two groups of gymnasts only differed for arm lean mass and muscle CSA.

Conclusion

Non-elite gymnastics participation was associated with musculoskeletal benefits in upper limb bone geometry, strength and muscle function. Differences between the two gymnastic groups emerged for arm lean mass and muscle CSA, but not for bone strength.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. 1.

    Bass SL, Pearce G, Bradney M, Hendrich E, Delmas PD, Harding A, Seeman E (1998) Exercise before puberty may confer residual benefits in bone density in adulthood: studies in active prepubertal and retired female gymnasts. J Bone Miner Res 13:500–507

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Ward KA, Roberts SA, Adams JE, Mughal MZ (2005) Bone geometry and density in the skeleton of pre-pubertal gymnasts and school children. Bone 36:1012–1018

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Liang MTC, Arnaud SB, Steele CR, Hatch P, Moreno A (2005) Ulnar and tibial bending stiffness as an index of bone strength in synchronized swimmers and gymnasts. Eur J Appl Physiol 94:400–407

    PubMed  Article  Google Scholar 

  4. 4.

    Eser P, Hill B, Ducher G, Bass SL (2009) Skeletal benefits after long-term retirement in former elite female gymnasts. J Bone Miner Res 24:1981–1988

    PubMed  Article  Google Scholar 

  5. 5.

    Pollock NK, Laing EM, Modlesky CM, O’Connor PJ, Lewis RD (2006) Former college artistic gymnasts maintain higher BMD: a nine-year follow-up. Osteoporos Int 17:1691–1697

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    DiFiori JP, Puffer JC, Mandelbaum BR, Dorey F (1997) Distal radial growth plate injury and positive ulnar variance in nonelite gymnasts. Am J Sports Med 25:763–768

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Laing EM, Wilson AR, Modlesky CM, O’Connor PJ, Hall DB, Lewis RD (2005) Initial years of recreational artistic gymnastics training improves lumbar spine bone mineral accrual in 4- to 8-year-old females. J Bone Miner Res 20:509–519

    PubMed  Article  Google Scholar 

  8. 8.

    Scerpella TA, Davenport M, Morganti CM, Kanaley JA, Johnson LM (2003) Dose related association of impact activity and bone mineral density in pre-pubertal girls. Calcif Tissue Int 72:24–31

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Vincent-Rodriguez G, Dorado C, Ara I, Perez-Gomez J, Olmedillas H, Delgado-Guerra S, Calbet JAL (2007) Artistic verses rhythmic gymnastics: effects on bone and muscle mass in young girls. Int J Sports Med 28:386–393

    Article  Google Scholar 

  10. 10.

    Zanker CL, Gannon L, Cooke CB, Gee KL, Oldroyd B, Truscott JG (2003) Differences in bone density, body composition, physical activity, and diet between gymnasts and untrained children 7–8 years of age. J Bone Miner Res 18:1043–1050

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Prentice A, Parsons TJ, Cole T (1994) Uncritical use of bone mineral density in absorptiometry may lead to size-related artifacts in the identification of bone mineral determinants. Am J Clin Nutr 60:837–842

    PubMed  CAS  Google Scholar 

  12. 12.

    Erlandson MC, Kontulainen SA, Baxter-Jones ADG (2011) Precompetitive and recreational gymnasts have greater bone density, mass, and estimated strength at the distal radius in young childhood. Osteoporos Int 22:75–84

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Kalkwarf HJ, Laor T, Bean JA (2011) Fracture risk in children with a forearm injury is associated with volumetric bone density and cortical area (by peripheral QCT) and areal bone density (by DXA). Osteoporos Int 22:607–616

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Khosla S, Melton L III, Dekutoski M, Achenbach S, Oberg A, Riggs B (2003) Incidence of childhood distal forearm fractures over 30 years: a population-based study. J Am Med Assoc 290:1479

    Article  CAS  Google Scholar 

  15. 15.

    Mäyränpää MK, Mäkitie O, Kallio PE (2010) Decreasing incidence and changing pattern of childhood fractures: A population based study. J Bone Miner Res 25:2476–2483

    Article  Google Scholar 

  16. 16.

    Bencke J, Damsgaard R, Saekmose A, Jorgensen P, Klausen K (2002) Anaerobic power and muscle strength characteristics of 11 years old elite and non-elite boys and girls from gymnastics, team handball, tennis and swimming. Scand J Med Sci Sports 12:171–178

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Jürimäe J, Jürimäe T (2005) Bone mineral density in adolescent girls with different physical activity patterns: relationships with body composition and muscle performance parameters. Pap Anthropol 14:126–131

    Google Scholar 

  18. 18.

    Caine DJ, Cochrane B, Caine C, Zemper E (1989) An epidemiologic investigation of injuries affecting young competitive female gymnasts. Am J Sports Med 17:811–820

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Theintz GE, Howald H, Weiss U, Sizonenko PC (1993) Evidence for a reduction of growth potential in adolescent female gymnasts. J Pediatr 122:306–313

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Ducher G, Jaffré C, Arlettaz A, Benhamou C, Courteix D (2005) Effects of long-term tennis playing on the muscle-bone relationship in the dominant and nondominant forearms. Can J Appl Physiol 30:3–17

    PubMed  Article  Google Scholar 

  21. 21.

    Neu CM, Manz F, Rauch F, Merkel A, Schoenau E (2001) Bone densities and bone size at the distal radius in healthy children and adolescents: a study using peripheral quantitative computed tomography. Bone 28:227–232

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Rauch F, Schoenau E (2005) Peripheral quantitative computed tomography of the distal radius in young subjects–new reference data and interpretation of results. J Musculoskelet Neuronal Interact 5:119–126

    PubMed  CAS  Google Scholar 

  23. 23.

    Kontulainen S, Sievänen H, Kannus P, Pasanen M, Vuori I (2003) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 17:2281–2289

    Article  Google Scholar 

  24. 24.

    Rauch F, Neu CM, Manz F, Schoenau E (2001) The development of metaphyseal cortex—implications for distal radius fractures during growth. J Bone Miner Res 16:1547–1555

    PubMed  Article  CAS  Google Scholar 

  25. 25.

    Orjan E, Kristjan O, Bjorn E (2005) Physical performance and body mass index in Swedish children and adolescents. Scand J Nutr 49:172–179

    Article  Google Scholar 

  26. 26.

    Davis KL, Kang M, Boswell BB, Dubose KD, Altman SR, Binkley HM (2008) Validity and reliability of the medicine ball throw for kindergarten children. J Strength Cond Res 22:1958–1963

    PubMed  Article  Google Scholar 

  27. 27.

    Pate RR, Burgess ML, Woods JA, Ross JG, Baumgartner T (1993) Validity of field tests of upper body muscular strength. Res Q Exerc Sport 64:17–24

    PubMed  CAS  Google Scholar 

  28. 28.

    Fricke O, Weidler J, Tutlewski B, Schoenau E (2006) Mechanography-a new device for the assessment of muscle function in pediatrics. Pediatr Res 59:1–4

    Article  Google Scholar 

  29. 29.

    Duke PM, Litt IF, Gross RT (1980) Adolescents’ self-assessment of sexual maturation. Pediatrics 66:918–920

    PubMed  CAS  Google Scholar 

  30. 30.

    Peat JK, Barton B (2005) Medical statistics: A guide to data analysis and critical appraisal. Blackwell, Massachusetts

    Google Scholar 

  31. 31.

    Poynton TA (2007) EZAnalyze (Version 3.0) In Computer software and manual. Retrieved from http://www.ezanalyze.com

  32. 32.

    Dyson K, Blimkie CJR, Davison KS, Webber CE, Adachi JD (1997) Gymnastic training and bone density in pre-adolescent females. Med Sci Sports Exerc 29:443

    PubMed  CAS  Google Scholar 

  33. 33.

    Ducher G, Hill BL, Angeli T, Bass SL, Eser P (2009) Comparison of pQCT parameters between ulna and radius in retired elite gymnasts: the skeletal benefits associated with long-term gymnastics are bone-and site-specific. J Musculoskelet Neuronal Interact 9:247–255

    PubMed  CAS  Google Scholar 

  34. 34.

    Panzer VP, Wood GA, Bates BT, Mason BR (1988) Lower extremity loads in landings of elite gymnasts. In: de Groot G, Hollander P, Huijing P, Van Ingen Schenau GJ (eds) Biomechanics XI-B. Free University Press, Amsterdam, pp 727–735

    Google Scholar 

  35. 35.

    Dowthwaite JN, Flowers PPE, Spadaro JA, Scerpella TA (2007) Bone geometry, density and strength indicies of the distal radius reflect loading via childhood gymnastics activity. J Clin Densitom 10:65–75

    PubMed  Article  Google Scholar 

  36. 36.

    Dowthwaite JN, Kanaley JA, Spadaro JA, Hickman RM, Scerpella TA (2009) Muscle indices do not fully account for enhanced upper extremity bone mass and strength in gymnasts. J Musculoskelet Neuronal Interact 9:2–14

    PubMed  CAS  Google Scholar 

  37. 37.

    Dowthwaite JN, Scerpella TA (2011) Distal radius geometry and skeletal strength indices after peripubertal artistic gymnastics. Osteoporos Int 22:207–216

    PubMed  Article  CAS  Google Scholar 

  38. 38.

    Ma DQ, Jones G (2002) Clinical risk factors but not bone density are associated with prevalent fractures in prepubertal children. J Paediatr Child Health 38:497–500

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    DeGoede KM, Ashton-Miller JA (2002) Fall arrest strategy affects peak hand impact force in a forward fall. J Biomech 35:843–848

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Burt LA, Naughton GA, Higham DG, Landeo R (2010) Quantifying training load in pre-pubertal artistic gymnastics. Sci Gymnastics J 2:5–14

    Google Scholar 

  41. 41.

    Sanchis-Moysi J, Dorado C, Olmedillas H, Serrano-Sanchez JA, Calbet JA (2010) Bone Mass in Prepubertal Tennis Players. Int J Sports Med 31:416–420

    PubMed  Article  CAS  Google Scholar 

  42. 42.

    Daly RM, Saxon L, Turner CH, Robling AG, Bass SL (2004) The relationship between muscle size and bone geometry during growth and in response to exercise. Bone 34:281–287

    PubMed  Article  CAS  Google Scholar 

  43. 43.

    Taaffe DR, Marcus R (2004) The muscle strength and bone density relationship in young women: dependence on exercise status. J Sports Med Phys Fitness 44:98–103

    PubMed  CAS  Google Scholar 

  44. 44.

    Hangartner TN, Gilsanz V (1996) Evaluation of cortical bone by computed tomography. J Bone Miner Res 11:1518–1525

    PubMed  Article  CAS  Google Scholar 

Download references

Acknowledgments

This project was partially sponsored by the NSW Sporting Injuries Committee. The investigators are grateful to the participants and families for generously providing consent and time to support the project.

Conflicts of interest

None.

Author information

Affiliations

Authors

Corresponding author

Correspondence to L. A. Burt.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Burt, L.A., Naughton, G.A., Greene, D.A. et al. Non-elite gymnastics participation is associated with greater bone strength, muscle size, and function in pre- and early pubertal girls. Osteoporos Int 23, 1277–1286 (2012). https://doi.org/10.1007/s00198-011-1677-z

Download citation

Keywords

  • Artistic Gymnastics
  • Musculoskeletal
  • Peripheral quantitative computed tomography
  • Pre-puberty
  • Upper limb