Overuse Elbow Injuries in Youth Gymnasts

Five-Year Follow-Up of Adolescent Gymnasts After Surgical Treatment of Osteochondritis Dissecans of the Elbow

PURPOSE

Elbow osteochondritis dissecans (OCD) is well-studied in throwing athletes; however, there are limited data regarding gymnasts with capitellar OCD lesions. We aimed to determine the overall rate of return to competition following surgical treatment of capitellar OCD lesions and to determine the relationship, if any, between arthroscopic grade of lesion and ability to return to competition.

METHODS

A medical chart Current Procedural Terminology query from 2000 to 2016 yielded data on 55 competitive adolescent gymnasts who were treated surgically for elbow OCD lesions in a total of 69 elbows. Retrospective chart review was used to collect data on preoperative and postoperative symptoms and surgical treatment. Patients were contacted to complete questionnaires (Modified Andrews Elbow Scoring System, Disabilities of the Arm, Shoulder, and Hand) on return to sport. Current elbow function and follow-up data were available for 40 of 69 elbows.

RESULTS

Average age at time of surgery was 12.1 years with 18 of 55 (33%) of patients competing at a pre-elite level of gymnastics (level 9 or 10 of 10) before surgery. Nine out of 31 gymansts (29%) underwent bilateral surgery for OCD lesions. Average OCD lesion size was 10 mm. Thirty-one of 40 elbows (78%) were treated with debridement back to a stable cartilage rim with microfracture, and nine of 40 elbows (22%) were treated with debridement alone. Thirty-six of 40 patients (90% returned to competitive gymnastics with all returning patients competing at or above the same level after surgery. Among the patients who were followed up, 29 of 30 patients (97%) reported some difficulty with specific events on return to competition.

CONCLUSIONS

The rate of return to sport for gymnasts at 90% is similar to that observed in other sports. This study suggests that elbow OCD lesions are not career-ending injuries for adolescent gymnasts; however, gymnasts should not expect a fully asymptomatic return to all events in a sport.

TYPE OF STUDY/LEVEL OF EVIDENCE

Therapeutic IV.

Development and validation of an overuse injury questionnaire for youth athletes: The Youth Overuse Injury Questionnaire

OBJECTIVE

To develop and validate the Youth Overuse Injury Questionnaire (YOvIQ).

DESIGN

A cross-sectional study.

SETTING

Online platforms.

PARTICIPANTS

Two content experts (in sports injury epidemiology and in sports science and medicine) and seven end-users (youth volleyball athletes) provided feedback during development of the YOvIQ. 227 competitive youth athletes across 14 different sports assessed the psychometric properties of the YOvIQ.

MAIN OUTCOME MEASURES

Participants completed both YOvIQ and the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O2) for anatomical areas of the shoulder, elbow, lower back, knee, and ankle/foot. Validity was assessed via convergent validity. Reliability was assessed using internal consistency estimation and interclass correlation coefficient.

RESULTS

Following feedback from content experts, examples and quantitative symbolization were added to the options in YOvIQ, with positive feedback from end-users. Convergent validity between YOvIQ and the OSTRC-O2 was demonstrated with non-significant differences (P ≥ .05) and significant correlations (P < 0.001) for prevalence and severity scores. YOvIQ demonstrated internal consistency for prevalence (Cronbach's alpha coefficient >0.70) and moderate-to-good reliability for severity scores (ICC: 0.51 to 0.88) for shoulder, lower back, and knee.

CONCLUSIONS

The YOvIQ is a valid and reliable instrument to identify overuse injuries to the shoulder, lower back, and knee in youth athletes.

Analysis of Research Trends on Elbow Pain in Overhead Sports: A Bibliometric Study Based on Web of Science Database and VOSviewer

The publications on elbow pain (EP) in overhead sports are increasing. The results of previous studies mostly focus on the influence of EP in the ball game and throwing sports. Thus, a bibliometric analysis of these publications may show the direction of hot topics and future research trends. The purpose of this study is to identify the research trends on EP in overhead sports. For the methods, the first step is to use the main keywords of 'Elbow pain' and 'Overhead sport' merging auxiliary vocabulary to reach the relevant global publications between 1970 and 2022 in the Web of Science (WoS) database. The literature data set is imported into EndNote literature manager software to remove duplication. Secondly, the duplication-reduced articles are imported to an Excel sheet according to the inclusion and exclusion criteria of this study. In the third step, VOSviewer software is applied as the main analysis tool in extracting data for analysis from the articles. Then, the main research results for three aspects are obtained by VOSviewer software which extracted and analyzed the parameters of author name, article title, publication journal, keywords, organization, publication country/region, and the sum of times cited from 455 qualified papers. The study found that the United States of America made the most outstanding contribution to this theme study. The research on EP in overhead sports in China requires more attention from scholars. EP in swimming is a new research direction worthy of attention. In conclusion, the research results prove the growth trend of EP in overhead sports. The EP problem not only exists in the ball game and throwing sports but also swimming. Sport commercialization and the involvement of related professional sports organizations determine the degree of EP's attention in a specific sport and the development of solutions. The development of a region or country also affects the depth and scope of EP study. Clinical research development and in-depth exploration are one of the bases to solve EP problems. Non-clinical action is beneficial to EP patients, but it still needs to be explored and studied.

Burnout and Mental Interventions among Youth Athletes: A Systematic Review and Meta-Analysis of the Studies

(1) Background: The subject of athlete burnout is often discussed among sports psychologists. Interventions to reduce this phenomenon are still under investigation with follow-ups. Thus, the purpose of the current meta-analysis is to examine psychological interventions that was carried out to decrease or eliminate burnout syndrome in young athletes. (2) Methods: Scientific electronic databases were searched, and five published studies published between January and June 2022 that met the criteria were selected. The systematic review and meta-analyses followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Cochrane collaboration tool for assessing the risk of bias was used to assess the studies' quality. Metafor, a package of the R statistical program, was used to perform the analysis. (3) Results: Cognitive behavioral therapy- and mindfulness-based interventions effectively reduced most dimensions of burnout. Moreover, online interventions were significantly more beneficial in this reduction. (4) Conclusions: There should be more high-quality studies on the effectiveness of psychological interventions in reducing burnout, mainly because it leads to tremendous physical and psychological problems for athletes and their coaches; therefore, it requires particular interventions and prevention strategies.