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DALLAS - At around 5-foot-nothing, Olga, Nadia, Mary Lou and now Carly are giants in name only. While gymnastics favors the tiniest athletes, new research suggests that the rigors of elite training may make them even more pixielike than usual.
The findings are the latest volley in the debate over long-term consequences of intensive gymnastics training. While many doctors worry about the immediate threats of injuries or eating disorders, others are investigating possibly subtler aftershocks on the body.
The newest study, released this month, suggests that gymnasts may end up being somewhat shorter than even their genetics would dictate. The scientists also report that top-level gymnasts have evidence of delayed maturation of their bones.
Researchers acknowledge that the upper tiers of any competitive sport can strain a growing skeleton, yet gymnastics receives unusual attention because the top competitors tend to be adolescents. In addition, competitive gymnastics involves constant pounding on growing bones and joints, sometimes 30 or so hours a week among the most serious contenders.
"There's enough evidence to convince me that some of these kids experience injury, and in those cases the bone will stop growing," says Dr. Dennis Caine from Western Washington University in Bellingham.
But growth in gymnasts is complicated to study because the tallest athletes often weed themselves out.
"A tinier individual with really strong legs is going to get a lot higher in the air," Dr. Caine says. Russian gymnast Svetlana Khorkina, at a towering 5 feet 5 inches, is considered unusually tall.
Bone growth is a product of genetics, hormones, nutrition and other factors. Weight-bearing exercise in general makes bones stronger. But some doctors worry that an elite gymnast's growth may struggle under repeated pounding on sensitive joints. Also, many top-level athletes have delayed puberty, which robs hormones from bones as they mature.
The latest study of gymnasts' bones, appearing in the September issue of The Journal of Clinical Endocrinology & Metabolism, comes from Greek researchers who studied competitors during the 2002 European Championships. They used data from X-rays, peers and other sources to calculate where each person should fall in height and skeletal maturity.
The study suggested that the gymnasts may be about half an inch shorter than they would have been otherwise. The researchers also found that the age of the athletes' bones lagged behind their chronological age.
"The earlier they started their gymnastics, the worse it was," says Dr. Apostolos Vagenakis of the University of Patras Medical School. "If they started late 9, 10 years old the damage was much less."
But he and others acknowledge that the question of delayed or stunted growth among gymnasts remains controversial. Last year, in the journal Pediatric Exercise Science, experts in the field summarized their take on the research. A team from England and Canada concluded that "gymnastics training probably does not inhibit growth." They cited evidence that the growth of gymnasts does not differ markedly from that of nontraining girls who mature late. Plus, they say, gymnasts' heights cannot be compared to the general population because of the nature of the sport.
Dr. Caine and his colleagues took the opposite view, writing that "some (not all) gymnasts are at risk and experience reduced growth and delayed maturation." As evidence of the potential damage, they point to extreme instances in which the bone growth in gymnasts' wrists has simply shut down.
No one claims to know with certainty because most studies take snapshots across groups of gymnasts, and don't track girls as they mature. "We really need to follow these kids over a longer period of time," he says.
And neither is it clear whether any damage would heal naturally when gymnasts leave intensive training. In women, bones generally reach their peak strength in young adulthood and then begin a steady decline that accelerates after menopause.
Dr. Carolyn Becker, who specializes in bone conditions at Columbia University School of Medicine in New York, says many of the women she treats were athletes in their teens. "Is this because they never achieved their peak bone mass? We don't know."
She points out that exercise in general, however, is good for bones. The concern among doctors is mostly for young athletes who train so hard that they interfere with normal growth and puberty.
Athletics among preteens "is a very positive thing," Dr. Caine says. Also, he says, gymnastics is sometimes the target of undue criticism because it involves heavy training of children. However, he adds, "we need to be monitoring kids who are training at advanced levels more closely." For them, issues like nutrition and adequate rest may be paramount. "We want to promote the optimal growth and development of these kids."
HEIGHTS OF CURRENT OLYMPIC MEDALISTS
Silver: Svetlana Khorkina, age 25, 5 feet 5 inches
Gold: Carly Patterson, age 16, 5 feet
Bronze: Zhang Nan, age 18, 4 feet 10 inches
(c) 2004, The Dallas Morning News. Distributed by Knight Ridder/Tribune News Service.