Recently, there has been an increase in high sports performance among young athletes, and the volume and intensity of the training process are correspondingly increasing [1]. It is known that physical activity associated with sports activities causes significant morphofunctional changes in the athlete’s body. At the moment, the issue of early sports specialization of children is being actively discussed; the question arises of how justified early sports training technologies are. Early sports specialization, when the harmonious connections in the “sports load - body” system are disturbed, can significantly change the individual trajectory of growth and development of the child and, unfortunately, not in a positive direction [2,3]. It must be borne in mind that high athletic results achieved at a young age are not a physiological pattern, but primarily the result of talent, genetic endowment, and a very strong character, the highest psychological stability. However, unfortunately, such results are very rarely stable, and given the physical stress that a fragile body experiences to achieve it, it is unlikely to contribute to strengthening the child’s health.

In connection with early sports specialization and the widespread use of large volume and intensity training loads, the problems of medical support for children's and youth sports are becoming increasingly relevant [4]. Many people forget that a child’s body differs from an adult’s body in a number of morphological, functional and adaptive features, and if this factor is underestimated, it can not only slow down the growth of athletic performance, but also lead to serious disorders health and physical development [5]. In the presented article, much attention will be paid to early sports specialization in rhythmic gymnastics, since it is generally accepted that this sport is characterized by an earlier onset of sports training.
Exercises in rhythmic gymnastics require great flexibility, dexterity, and coordination of movements. Children are selected for sports sections in preschool and primary school age. In addition, athletes reach a professional level already at the age of 12–13, when active processes of growth and maturation of the child’s body are observed. Early specialization, lack of fat mass, extreme flexibility and a large number of hours of training are predisposing factors to the occurrence of injuries [6]. Damage to the lumbar spine and back injuries are the main cause of lower back pain, which, according to statistical data provided by Dubrovsky V.I. [7], up to 85% of female athletes complain. According to Bikchurin N.M. (2018), visits from young gymnasts with complaints of back pain amounted to 21% of all requests [8]. There is a clear relationship between age and the frequency of seeking medical help. Thus, athletes 16 years and older visited the medical office almost three times more often than gymnasts 12–13 years old. It should be noted that the greatest number of injuries is typical for the age group of 16 years and older, and an increase in injuries begins to be observed in the age group of 12-13 years [8]. Among the causes of pain is excessive extension in the lumbar spine, and achieving maximum amplitudes during movement can lead to acute injury. Frequent excessive extension, flexion and twisting of the lower back can lead to micro- and macro-injuries of the vertebrae and intervertebral discs. The most common problems in the lower back of gymnasts: spondylolysis, spondylolisthesis, compression fractures, damage to the locking plates of the vertebral body, protrusion intervertebral discs, sprains of the musculo-ligamentous apparatus, osteochondrosis [9,10].
The results of a study by Ruda (2012) showed that 62.0% of gymnasts experience pain in the lumbar spine after training, 29.3% during training, and 43.4% after performing stretching exercises. For most female athletes, the pain disappears after rest, and 6.3% of gymnasts noted that the pain did not go away even after rest, so they had to turn to anti-inflammatory therapy [13].
Analysis of medical examination cards of female rhythmic gymnastics athletes [9,13] made it possible to identify spinal injuries (67.2%) of female athletes according to their location: cervical region - 2.1%, thoracic region - 9.8%, lumbar region - 55.3%. The main causes of injuries in rhythmic gymnastics include [9] – the unpreparedness of the gymnast’s body for the type of load due to its physiological indicators or as a result of a discrepancy between the state of health and the proper level; violation of the technique of performing certain gymnastic elements, which may be due to ignorance of the basic principles of their implementation, or reluctance to master them; false methodology for conducting educational and training sessions, which is especially important for young athletes; neglect of the method of improving the strength indicators of the muscles of certain segments of the body that bear the main physical loads while performing complex gymnastic elements at a high rhythm.
The data presented indicate the need to optimize medical supervision in the training process of gymnasts in order to study the mechanism and causes of sports injuries, including back injuries, in young gymnasts and develop measures to prevent injuries.
The author's concerns are caused by the increasing number of cases of borrowing special physical exercises used in the training of gymnasts into choreographic practice for the training of ballet dancers and the earlier start of professional specialization. Concerns are associated with different specifics and biomechanics of movements that are superficially similar, but carry fundamental differences. And the most important thing is the age at which the career of a professional dancer and professional gymnast begins and ends.
Purpose of the study: to evaluate the similarity of physical exercises from the special training of gymnasts in the training of a ballet dancer and to show the negative impact of certain exercises on the functional state of the lumbar spine.
Research objectives: determine the degree of borrowing of physical exercises from the special training of gymnasts in the process of training a ballet dancer; show the negative impact of physical exercises of professional training of gymnasts on the physical health of children involved in choreography; identify errors in the selection of physical exercises for training ballet dancers; to justify an acceptable set of exercises for the lumbar spine for use in the process of training ballet dancers.
Materials and methods: The study included 60 children (girls) aged 12-15 years, engaged in rhythmic gymnastics and students of choreographic schools. Study participants were selected randomly. The only selection criterion, other than age, was mandatory attendance at a sports section in artistic gymnastics or regular classes in classical choreography at a specialized school. The interview method was used using a self-developed questionnaire, with an emphasis on identifying factors that, in our opinion, could influence the general condition of the child. Basically, the questions were aimed at indicating specific physical exercises and the frequency of their implementation in the process of preparing the child.
In the study group, children were divided into two groups. The first was made up of children involved in choreography (30 people (50%) and the other - children involved in rhythmic gymnastics - 30 people (50%). The average age of the first group was 13.10.7, the second 13.51.0. The average duration of choreography classes for the first group was 6.70.9 years, for the second group 7.71.2 years for gymnastics.
Results: When analyzing the data obtained, certain similarities in the selection of physical exercises were identified, but the frequency and number of repetitions differed. Thus, gymnasts devoted almost 2 times more time to performing such general physical exercises for training the back and abdominal muscles, such as body raises with fixed lower limbs, lower limb raises with a fixed body, hyperextension in the lumbar region while lying on the stomach (hyperextension).
Children from both groups in 100% of cases indicated that they perform the following exercises on the abdominal muscles: raising the lower limbs with a fixed body; lifting the body with fixed lower limbs; simultaneous lifting of both the lower limbs and the body (fold). Only some children, in addition to the above exercises, added twisting with the lumbar region pressed and bending to the sides while lying on their back. Analyzing the exercises indicated as exercises for training the back, children in 100% of cases listed movements associated with hyperextension of the lumbar spine, for example, lying on your stomach, with your lower limbs fixed, bend your back as far as possible and hold it in this position; lying on your stomach, overdeveloped lumbar spine and back, throw your legs back and up, touching your head with your feet (scorpio); lying on your stomach, hold yourself with your upper limbs by your lower limbs, hyperextending at the waist, rocking back and forth (basket). Of all the studied children of the first group, only 30% indicated that they perform isometric exercises on the muscles of the lumbar spine (plank). While children from the second group perform in 57% of cases.
At the same time, all the children indicated that they consider it necessary to repeat all the above exercises as homework, that is, they are not limited to performing them only during training.
Answering the question: “Have you ever experienced back pain?” - 40% of children from the first group gave a positive answer, while 53% of the surveyed gymnasts from the second group answered positively, which is significantly lower than the data given in the literature by Dubrovsky V.I. [7]. To the question: “Did back pain prevent you from fully exercising?” 41% of the choreography group who experienced back pain responded positively, and 75% of the gymnastics group.
A wide variety of answers were received to the question: “Why do you think your back hurts?” The answers were similar for both the first and second groups. Most of the answers leaned towards increased loads and insufficient rest between workouts.
Discussion: analyzing the responses received, where the children describe what exercises they perform, the author conducted a detailed analysis of each exercise.
Exercises for the abdominal muscles. The two rectus abdominis muscles form two muscle bundles lying in the anterior abdominal wall on either side of the midline. They start from the costal arch and the xiphoid process and the second place of attachment is the upper edge of the pubic crest. If we take into account that the main function of the muscle fiber is contraction, then the result of the concentric work of the rectus abdominis muscle will be a decrease in the distance between the places of its attachment. That is, with a fixed pelvis, the lower edge of the chest approaches, and with a fixed chest, the pubic crest approaches it.
Most of the exercises on the abdominal muscles listed in the questionnaires were associated with movement in the hip joint, either raising the lower limbs with a fixed body, or raising the body with a fixed lower limb. But the muscles of the anterior abdominal wall, including the rectus abdominis muscle, do not cross the hip joint, and therefore do not cause movement in it.
The above movements in the hip joint are achieved through concentric contraction of the iliacus and psoas muscles. The psoas muscle, which flexes the lumbar spine relative to the pelvis and emphasizes lumbar lordosis, further strengthening it due to its increased tone. Increased tone of the iliacus and psoas muscles has a compression effect on the lumbar spine, in particular on the intervertebral discs. And a violation of the centering of the vertebrae due to increased lordosis and excessive anterior tilt of the pelvis is one of the reasons for the development of protrusions and intervertebral disc herniation. Which, according to Anisimova (2011) and Vengerova (2009), is one of the most common problems with the lumbar region among gymnasts [9,10].
Lack of fixation of the legs and/or bending them does not eliminate the load on the lower back, but only reduces it. Especially if the exercises involve a high pace.
As an alternative to the above exercises for the abdominal muscles, you can use low-amplitude movements, which record maximum activation of the abdominal muscles. In the range of 170° - 130° (until the shoulders, or more precisely the seventh cervical vertebra, rise from the floor to a height of about 26 cm.) The advantage of performing the exercise using this technique is a small angle of flexion in the lower back equal to 3°, versus 40° with a full rise of the body. The vertebral compression forces are reduced by 20%, and the vertebral displacement forces are reduced by 80 - 90%, compared to lifting the body with straight legs [11]. Moreover, such exercises are significantly (p <0.001) inferior to full body lifts only in the activation of the rectus muscle thighs, and the activity of the abdominal muscles (rectus and both obliques) does not differ according to the averaged electromyogram values ​​[12].
Exercises for the lower back muscles. The muscles located in the back of the lumbar region are divided into three layers: deep (paravertebral muscles), providing stability to the lumbar region; intermediate (serratus muscles); superficial layer, their action is associated with extension of the lumbar spine, in addition, they actively emphasize lumbar lordosis, pulling it back.
The lumbar spine is anatomically not intended for amplitude movements, as evidenced by its structure (body, legs, processes). The average volume of rotation is 10° (5 in each direction), the average volume of extension is 30°.
Most of the exercises that children perform, based on the questionnaire, were aimed at increasing the possible limit of extension and training the superficial layer of muscles that perform extension in the lumbar spine.
By increasing the range of possible movements in the lumbar segments and not performing exercises on the deeper muscle layers that ensure stability of the lumbar spine, children get back pain at the age of 13-14 years. The main sports structural groups of elements must be performed with an amplitude exceeding the physiological norm [13], which leads to an increased likelihood of injury to the spine, especially the lumbar region. This is especially present under heavy physical exertion, stressful situations, inappropriate development of physical qualities, imbalance of strength and flexibility in the symmetrical parts of the body of gymnasts [9, 13, 14].
According to the author, back pain with regular exercise of this kind, and even more so with weights, is a pattern and requires further study. The problem of early sports specialization is the child’s inability to perform special elements correctly, due to the anatomical and functional immaturity of the central nervous system. 5-7 years is the age when a child needs to be given general physical exercises and to train general physical qualities.
The literature quite fully describes the means of physical rehabilitation used in the program for the prevention of injuries to the lumbar spine, including [9,10]: special physical exercises for the formation of a strong muscle corset, and trained muscles provide external immobilization of the unstable lumbar motion segment, reduce the load on the spine during daily activity and sports activities; special exercises contain isometric and isotonic muscle contraction, ideomotor exercises; learning to control the condition of your body by performing special poses with breathing control, a set of special exercises aimed at decompressing intervertebral structures.
As an example, the plank exercise with breathing control. For younger children, you can limit yourself to resting on your knees, since it will be difficult to support your entire body with support on your forearms and feet. It is important to remember that in the plank it is necessary to maintain all 4 physiological curves of the spine, and not to keep a straight back, as many believe (this refers to those methodological errors in conducting training sessions) [9]. Complicate the exercise with diaphragmatic breathing and decreasing the support points. Let's say, while inhaling deeply, perform a passé through the side, controlling the neutral position of the lumbar spine.

Conclusions: Given the high prevalence of lumbar pain with regular repetition of certain exercises, a more thorough study of this problem is required. If possible, it is necessary to replace exercises that have undesirable consequences for the musculoskeletal system with more isolated ones, especially when these exercises belong to the section of general physical training and not special ones. Pay more attention to exercises aimed at stabilizing the lumbar spine, namely exercises on deeper muscle layers in combination with breathing. We recommend that trainers and persons conducting classes with children aimed at general physical training regularly include physical rehabilitation complexes in their training programs aimed at preventing injuries to the lumbar spine.

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Back pain as a result of incorrectly selected physical activity