Preseason Upper Extremity Range of Motion and Strength in Relation to In-Season Injuries in NCAA Division I Gymnasts.

Background: Gymnastics is a demanding sport that places unique forces on the upper extremity. The repetitive nature of the sport and the high-impact forces involved may predispose the gymnast to overuse injuries. Risk factors for injuries in gymnastics are not well understood.
Purpose/hypothesis: The purpose of this study was to ascertain whether preseason upper extremity range of motion (ROM) and strength differ between National Collegiate Athletic Association (NCAA) Division I collegiate gymnasts who sustain an in-season upper extremity injury and those who do not. We hypothesized that gymnasts who sustain an upper extremity injury would demonstrate reduced ROM and strength compared with noninjured gymnasts.
Study Design: Cohort study; Level of evidence, 3.
Methods: Over 4 seasons, from 2014 to 2018, a total of 15 female NCAA Division I collegiate gymnasts underwent preseason upper extremity ROM (shoulder: flexion, internal and external rotation; elbow: extension; wrist: extension) and strength (shoulder: internal and external rotation, and middle and lower trapezius) testing. Overuse upper extremity injuries were tracked in each subsequent season. Gymnasts were dichotomized into injured and noninjured groups, and a 2 × 2 analysis of variance was used to measure differences in preseason measures between the groups as well as within arms (injured vs noninjured arm for the injured group; dominant vs nondominant arm for the noninjured group).
Results: A total of 12 overuse upper extremity injuries (10 shoulders; 2 wrist / forearm) occurred during 31 gymnast-seasons. There were no significant interactions for preseason ROM and strength measurements between groups (injured vs noninjured) or within arms (injured and noninjured arm for the injured group; dominant and nondominant arm for the noninjured group; P = .07).
Conclusion: Preseason upper extremity ROM and strength were not different between gymnasts who sustained an in-season upper extremity overuse injury and those who did not. It is possible that ROM and strength measures used to screen other overhead athletes may not capture the unique features and requirements of gymnastics. Further, it may be challenging to discern differences in clinical measures of ROM and strength in gymnastics populations owing to the bilateral nature of the sport.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This research was performed as a component of a sports residency project at the University of Florida. Funding for this study was received from a Career Development Award (to F.P.) sponsored by the Academy of Orthopaedic Physical Therapy and from the Rehabilitation Research Career Development Program, sponsored by the National Institutes of Health (K12 HD055929 to F.P.). M.M. has received educational payments and consulting fees from Arthrex. K.W.F. has received educational payments from Arthrex and CGG Medical; consulting fees from Arthrex, Exactech, and Flexion Therapeutics; nonconsulting fees from Arthrex and CGG Medical; and speaking fees from Arthrosurface. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
(© The Author(s) 2021.)