Having participated in gymnastics for more than a decade, 15-year-old Amanda understands the importance of doing it properly with the right equipment and a good coach.

"If you're going to do something that you don't know how to do and you haven't trained for, there's a really big chance you can get hurt doing it," said Amanda. "So you might want to stick to doing it in a place where you have coaches who are watching you." Amanda speaks from experience. She's had her share of injuries, including a sprained ankle, sprained wrist and tendonitis in both wrists. Most recently, she turned to Nationwide Children's Hospital Sports Medicine to help her recover from a more serious stress fracture in her back, caused by repetitive stress on her vertebrae.

Amanda is one of thousands of gymnasts who have been injured as a result of the sport. In the first national study of gymnastics-related injuries, researchers at the Center for Injury Research and Policy (CIRP) at the Research Institute at Nationwide Children's Hospital looked at injury rates over a 16-year period. They found that nearly 27,000 gymnasts end up in hospital emergency rooms each year.

"We don't typically think of gymnastics as a dangerous sport," said Lara McKenzie, Ph.D., MA, a principal investigator at the Center for Injury Research and Policy. "In fact, many parents consider it an activity, but it has the same clinical incidence of catastrophic injuries as ice hockey." Amanda has since recovered from her injuries and is back in the gym doing what she loves. Aware of the injury risk with gymnastics and all sports, Amanda works closely with her coaches to practice safely and reduce her chances of getting hurt. "I think the risk of injury is very serious, but as long as you take the steps to be safe, you should be okay," she said. For Amanda, those steps include taking part in drills, continuing to practice and improve basic skills, and listening to her coaches' advice. She also practices under the supervision of trained spotters and coaches.

"Gymnastics is very important to me," said Amanda. "I have developed strong relationships with my coaches and teammates. Also, it provides a lot of healthy exercise."

PEDIATRIC ADVANCEMENTS: Study finds gymnastics is among riskiest sports for girls
More than 600,000 children participate annually in school-sponsored and club-level gymnastics competitions in the United States.

Yet gymnastics continues to be overlooked in terms of potential for injury, while having one of the highest injury rates of all girls' sports.

A study was conducted by researchers in the Center for Injury Research & Policy (CIRP) at the Research Institute at Nationwide Children's Hospital and published in the April electronic issue of Pediatrics. The study examined data on children 6 to 17 years old who were treated in hospital emergency departments for gymnastics-related injuries between 1990 and 2005. According to the findings, an average of 27,000 injuries are reported each yearčnearly 426,000 injuries during the 16-year period.

The majority of the gymnastics injuries 40 percent occurred at school or a place of recreation/sports. Girls were more likely than boys to sustain upper extremity injuries, while head and neck injuries were more common in boys. Fractures and dislocations were most common for children 6 to 11 years of age, and strains and sprains were more frequent in the 12 to 17 age group.

"Our study suggests prevention and reduction of gymnastics injuries may be achieved by the establishment and universal enforcement of rules and regulations for gymnasts, coaches and spotters," said study senior author

Lara McKenzie, Ph.D., MA, principal investigator in CIRP at Nationwide Children's Hospital.

FAST FACTS: Basic tips for preventing sports injuries, no matter the sport:
Wear the right gear Start preseason conditioning Stretch before and after play Take breaks and hydrate Stop the activity if there's pain
When injuries do occur, seek medical attention and remember RICE:

REST
Do not use the injured area until seen by a physician for further evaluation. ICE
Apply ice to the injured area to help decrease pain and swelling. Use ice for 15 to 20 minutes at a time for the first 48 to 72 hours after injury. Never sleep with ice on an injury. COMPRESSION
Elastic wrap or a compression sock should be used to reduce swelling. Watch for numbness, discoloration or temperature changes (loosen wrap if needed). Do not sleep with a wrap on the injured area. ELEVATION
Prop injured area higher than the heart.
Nationwide Children's Sports Medicine offers Personal Best, a sports-injury prevention program to help young athletes stay healthy and improve performance. To learn more or register, log onto NationwideChildrens.org