Spondylogenetic disorders in gymnasts

Most gymnasts (mainly females) suffer from low back pain. This low back pain comes from
hyperextended positions in the lumbar spine during somersaults. Trunk and legs have to
resorb big amounts of forces during every training. In this study Weber pronounce that stress
fractures occure in pars articularis (little bridge between articular processes). The gymnast
only feel pain no more, but this mikrofracture have already occured. In the bone osteoclastic
activities are going on, later osteoblastic activities take them over. It is a long period and the
pain gets stronger because muscles and other tissues are fatigued. The reason of being
fatigued is that these tissues need to resorp more forces as the skeletal system is insufficient.
As time is going more forces affect the skeletal system again and a full fracture occures.
When forces affect in this hyperextended posture, posterior elements are more concered than
the anteriors.
The main risk factor is hyperlordotic lumbar spine. Gymnasts with hyperlordotic spine
indicates more forces on posterior elements in a simple standing position as well, than
gymnasts without it. If that gymnast is a children, more attention is needed for their therapy
because their bones are not strong enough. Competitive gymnastic is very dangerous, because
they practice long-long hours and many days and it is easier to develope pain and fractures.
Symptoms can be triggered in a one-leg stance with hyperextended lumbar spine. It is a test
for pars articularis and a sign too, if the compression between the processes causes pain.
Flexion in the lumbar spine do not cause pain but unbending does.
The next test is the Straight Leg Raise test (SLR) when the gymnast has to lay on their back
one leg stays stengthened on the bed and the other leg is raised with extended knee. We need
to take notice on weekness of the abdomen muscles or pain. But it is a modified test because
usually a 90-degree leg elevation is not a big challenge for a gymnast.
To prevent these mechanisms, stabilization of the lumbar spine must be given to gymnasts as
a therapy. It helps to create a muscle corset for lumbar spine and above-mentioned tissues
will not be fatigued any longer. This way more forces could be absorped equally in skeletal
and muscle systems.

On the other hand muscle imbalances can be eliminated so that hyperextended and rotated
positions will not cause a serious problem any more.

Nine of these 11 had accompanying spina bifida occulta, and six of the 11 had experienced
prior back pain significant enough to interfere with training.