Customizing Functional Rehabilitation and Return to Sport in the Female Overhead Athlete

Stephanie L Boudreau, Laura L Mattes, Natalie A Lowenstein, Elizabeth G Matzkin, Reg B Wilcox 3rd, Stephanie L Boudreau, Laura L Mattes, Natalie A Lowenstein, Elizabeth G Matzkin, Reg B Wilcox 3rd

Abstract

Participation of female athletes in sports at all levels continues to grow exponentially, as well as the injuries they experience during play. A literature review does outline return to sport guidelines, yet few studies address the potential need for differences between male and female athletes. This commentary is a review of the literature that outlines various sports that involve both male and female overhead athletes and potential differences in upper-extremity injuries and strengths and weaknesses between sexes. This information proposes the potential need to customize return-to-sport guidelines and screens that include recommendations for overhead female athletes within their specific sport, following both injury as well as surgical intervention.

Level of evidence: V.

© 2021 The Authors.

Figures

Fig 1
Fig 1
Functional Movement System (FMS): Seven test positions/activities of the FMS. (A) Deep squat. (B) In-line lunge. (C) Hurdle step. (D) Shoulder mobility. (E) Active straight‐leg raise. (F) Trunk stability pushup. (G) Rotary stability.
Fig 2
Fig 2
The Closed Kinetic Chain Upper Extremity Stability Test measures speed, agility, and/or power but requires upper quarter stability to perform without symptoms.
Fig 3
Fig 3
The Upper Quarter Y-Balance Test is a closed kinetic chain assessment of upper extremity mobility, stability, and proprioception.
Fig 4
Fig 4
The Seated Medicine Ball Throw Test measures unilateral upper-extremity power.
Fig 5
Fig 5
The Functional Throwing Performance Index measures the accuracy of overhand throwing athletes.
Fig 6
Fig 6
The One Arm Hop Test measures strength, power, and stability in contact athletes.
Fig 7
Fig 7
The Pushup Test measures muscular endurance of the upper body muscles.

References

    1. Chimera N.J., Smith C.A., Warren M. Injury history, sex, and performance on the functional movement screen and Y balance test. J Athl Train. 2015;50:475–485.
    1. Uhorchak J.M., Scoville C.R., Williams G.N., Arciero R.A., St Pierre P., Taylor D.C. Risk factors associated with noncontact injury of the anterior cruciate ligament: A prospective four-year evaluation of 859 West Point cadets. Am J Sports Med. 2003;31:831–842.
    1. Balachandar V., Marciniak J.L., Wall O., Balachandar C. Effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and anterior cruciate ligament injury risk: A systematic review. Muscles Ligaments Tendons J. 2017;7:136–146.
    1. Herzberg S.D., Motu'apuaka M.L., Lambert W., Fu R., Brady J., Guise J.M. The effect of menstrual cycle and contraceptives on ACL injuries and laxity: A Systematic review and meta-analysis. Orthop J Sports Med. 2017;5 2325967117718781.
    1. Vafadar A.K., Côté J.N., Archambault P.S. Sex differences in the shoulder joint position sense acuity: A cross-sectional study. BMC Musculoskelet Disord. 2015;16:273.
    1. Keen A.D., Drinkwater B.L. Irreversible bone loss in former amenorrheic athletes. Osteoporos Int. 1997;7:311–315.
    1. Logue D.M., Madigan S.M., Melin A., et al. Low energy availability in athletes 2020: An updated narrative review of prevalence, risk, within-day energy balance, knowledge, and impact on sports performance. Nutrients. 2020;12(3)
    1. Elliott-Sale K.J., Tenforde A.S., Parziale A.L., Holtzman B., Ackerman K.E. Endocrine effects of relative energy deficiency in sport. Int J Sport Nutr Exerc Metab. 2018;28:335–349.
    1. Brook E.M., Tenforde A.S., Broad E.M., et al. Low energy availability, menstrual dysfunction, and impaired bone health: A survey of elite para athletes. Scand J Med Sci Sports. 2019;29:678–685.
    1. Melin A.K., Heikura I.A., Tenforde A., Mountjoy M. Energy availability in athletics: Health, performance, and physique. Int J Sport Nutr Exerc Metab. 2019;29:152–164.
    1. Kox L.S., Kuijer P.P., Kerkhoffs G.M., Maas M., Frings-Dresen M.H. Prevalence, incidence and risk factors for overuse injuries of the wrist in young athletes: A systematic review. Br J Sports Med. 2015;49:1189–1196.
    1. Thompson L.V. Skeletal muscle adaptations with age, inactivity, and therapeutic exercise. J Orthop Sports Phys Ther. 2002;32:44–57.
    1. Thompson L.V. Effects of age and training on skeletal muscle physiology and performance. Phys Ther. 1994;74:71–81.
    1. Warren M.P., Brooks-Gunn J., Fox R.P., Holderness C.C., Hyle E.P., Hamilton W.G. Osteopenia in exercise-associated amenorrhea using ballet dancers as a model: A longitudinal study. J Clin Endocrinol Metab. 2002;87:3162–3168.
    1. Hanson B.E., Joyner M.J., Casey D.P. Sex-related differences in rapid-onset vasodilation: Impact of aging. J Appl Physiol (1985) 2021;130:206–214.
    1. Anderson B.E., Neumann M.L., Huxel Bliven K.C. Functional movement screen differences between male and female secondary school athletes. J Strength Cond Res. 2015;29:1098–1106.
    1. Borms D., Cools A. Upper-extremity functional performance tests: Reference values for overhead athletes. Int J Sports Med. 2018;39:433–441.
    1. Nelson C.E., Rayan G.M., Judd D.I., Ding K., Stoner J.A. Survey of hand and upper extremity injuries among rock climbers. Hand (N Y) 2017;12:389–394.
    1. O'Connor S., Huseyin O.R., Whyte E.F., Lacey P. A 2-year prospective study of injuries and illness in an elite national junior tennis program. Phys Sportsmed. 2020;48:342–348.
    1. Butler R., Arms J., Reiman M., et al. Sex differences in dynamic closed kinetic chain upper quarter function in collegiate swimmers. J Athl Train. 2014;49:442–446.
    1. Shih Y.F., Wang Y.C. Spiking kinematics in volleyball players with shoulder pain. J Athl Train. 2019;54:90–98.
    1. Vincent H.K., Zdziarski L.A., Vincent K.R. Review of lacrosse-related musculoskeletal injuries in high school and collegiate players. Sports Health. 2015;7:448–451.
    1. Myers N.L., Sciascia A.D., Kibler W.B., Uhl T.L. Volume-based interval training program for elite tennis players. Sports Health. 2016;8:536–540.
    1. Goldbeck T.G., Davies G.J. Test-retest reliability of the closed kinetic chain upper extremity stability test: A clinical field test. J Sport Rehabil. 2000;9:35–45.
    1. Tucci H.T., Martins J., Sposito Gde C., Camarini P.M., de Oliveira A.S. Closed Kinetic Chain Upper Extremity Stability test (CKCUES test): A reliability study in persons with and without shoulder impingement syndrome. BMC Musculoskelet Disord. 2014;15:1.
    1. Hegedus E.J., Vidt M.E., Tarara D.T. The best combination of physical performance and self-report measures to capture function in three patient groups. Phys Ther Rev. 2014;19:196–203.
    1. Cramer J., Quintero M., Rhinehart A., et al. Exploration of score agreement on a modified Upper Quarter Y-Balance Test kit as compared to the Upper Quarter Y-Balance Test. Int J Sports Phys Ther. 2017;12:117–124.
    1. Westrick R.B., Miller J.M., Carow S.D., Gerber J.P. Exploration of the y-balance test for assessment of upper quarter closed kinetic chain performance. Int J Sports Phys Ther. 2012;7:139–147.
    1. Gorman P.P., Butler R.J., Plisky P.J., Kiesel K.B. Upper Quarter Y Balance Test: Reliability and performance comparison between genders in active adults. J Strength Cond Res. 2012;26:3043–3048.
    1. Chmielewski T.L., Martin C., Lentz T.A., et al. Normalization considerations for using the unilateral seated shot put test in rehabilitation. J Orthop Sports Phys Ther. 2014;44:518–524.
    1. Harris C., Wattles A.P., DeBeliso M., Sevene-Adams P.G., Berning J.M., Adams K.J. The seated medicine ball throw as a test of upper body power in older adults. J Strength Cond Res. 2011;25:2344–2348.
    1. Davies G.J., Dickoff-Hoffman S. Neuromuscular testing and rehabilitation of the shoulder complex. J Orthop Sports Phys Ther. 1993;18:449–458.
    1. Reinold M.M., Wilk K.E., Reed J., Crenshaw K., Andrews J.R. Interval sport programs: Guidelines for baseball, tennis, and golf. J Orthop Sports Phys Ther. 2002;32:293–298.
    1. Axe M.J., Windley T.C., Snyder-Mackler L. Data-based interval throwing programs for collegiate softball players. J Athl Train. 2002;37:194–203.
    1. Falsone S.A., Gross M.T., Guskiewicz K.M., Schneider R.A. One-arm hop test: Reliability and effects of arm dominance. J Orthop Sports Phys Ther. 2002;32:98–103.
    1. Negrete R.J., Hanney W.J., Pabian P., Kolber M.J. Upper body push and pull strength ratio in recreationally active adults. Int J Sports Phys Ther. 2013;8:138–144.
    1. Morrison G., Ashworth B., Taylor-Kaveney T. The validity of the sphygmomanometer for shoulder strength assessment in amateur rugby union players. Phys Ther Sport. 2021;47:59–65.
    1. Ashworth B., Hogben P., Singh N., Tulloch L., Cohen D.D. The Athletic Shoulder (ASH) test: Reliability of a novel upper body isometric strength test in elite rugby players. BMJ Open Sport Exerc Med. 2018;4

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