Link Between the Female Athlete Triad and Gymnastics-Related Injury in Retired Collegiate Gymnasts

Abstract

Objectives: To compare gymnastics-related injuries between former collegiate gymnasts who did and did not report components of the female athlete triad (Triad) during college, including disordered eating or menstrual irregularity. We hypothesized that athletes reporting these 2 triad symptoms would have higher rates of time loss injury and injuries requiring surgery. Design: Retrospective case–control. Setting: Online survey. Patients: Four hundred seventy former collegiate gymnasts. Interventions: Athletes completed online survey distributed through social media. Main Outcome Measures: Participants were grouped based on self-reported menstrual irregularity and disordered eating during college. We compared time loss injuries, injuries resulting in surgery, and injury locations between the groups using χ2 analyses. Results: Seventy percent (n = 328) of participants in this study reported a time loss college injury without surgery, and 42% (n = 199) reported an injury during college that required surgical treatment. A significantly greater proportion of gymnasts with only disordered eating reported a time loss gymnastics injury (without surgery) compared with those who reported only menstrual irregularity during college (79% vs 64%; P =0 .03). A significantly greater proportion of the disordered eating–only group reported a spine injury compared with the menstrual irregularity–only group (P = 0.007) and the group who reported neither menstrual irregularity nor disordered eating (P = 0.006). Conclusions: College gymnasts who experienced disordered eating were more likely to experience a nonsurgical time loss injury while in college, as well as spine injury compared with those with menstrual irregularity. Sports medicine providers should be aware of the association between injuries and individual components of Triad in gymnasts beyond bone stress injuries.