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Background:   Over 1,500 collegiate gymnasts compete each year. Injury rates among these athletes are high, yet little is known about their long-term health outcomes.Hypothesis/Purpose:   The purpose of our study was to describe health-related outcomes of former collegiate gymnasts and to evaluate how early sport specialization, concussion history, and disordered eating (DE) influence current health. We hypothesized that gymnasts who specialize early would report more injuries and would have worse physical health currently; that gymnasts who sustained concussions will be more likely to seek mental health treatment during their sport careers; and that gymnasts with DE would report more injuries.Methods:   473 former female collegiate gymnasts completed a survey (Table 1) that was distributed through social media. Participants were grouped according to early (  or equal to 14 years) specialization, whether they sustained a concussion during gymnastics participation, and whether they reported a history of DE or not. We determined the number of participants who had time-loss injuries, menstrual dysfunction, reasons for retirement from sport, functional outcome measures, and whether participants had sought mental health care during college.Results:   The median age of gymnastics specialization was 8 years [interquartile range=6-11 years]. A significantly greater proportion of early specializers sustained injuries requiring surgery (60% vs. 44%; p=0.02), however, the proportion of time-loss injuries sustained during college, reasons for retirement, and current pain and physical function scores did not significantly differ between the early and late specializers (Table 2). Forty-two percent of participants sustained a concussion. Those with a concussion were more likely to have sought mental health treatment during college (32% vs. 23%; p=0.03), and to have a diagnosis of anxiety disorder (16% vs. 9%; p=0.01) than those with no concussion history (Table 3). Thirty-four percent reported DE during college. Those in the DE group had an increased risk of osteoporosis during college (4% vs 0%; p=0.003), secondary amenorrhea (16% vs 9%; p=0.02), and had an increased risk of time-loss injury (78% vs 65%; p=0.004) (Table 4). In addition, they had worse PROMIS pain (11.5 vs 10.2; p=0.007) and physical function scores (12.2 vs 11; p=0.01) after college.Conclusion:   It is important for clinicians, coaches, and gymnasts to be aware of the risks of early specialization, concussions, and DE, all of which are common in former collegiate gymnasts. Counseling regarding these risks and prevention strategies for these health problems should be a focus of further research. [Table: see text][Table: see text][Table: see text][Table: see text]

HEALTH OUTCOMES AMONG FORMER FEMALE COLLEGIATE GYMNASTS: THE INFLUENCE OF SPORT SPECIALIZATION, CONCUSSION, AND DISORDERED EATING