Rehabilitation and Return to Sport of Female Athletes

Breast injuries in women's sports: a scoping review of a female-specific sports injury

OBJECTIVES

Breast injuries are female-specific injuries that occur across a range of women's sports. Literature investigating this important women's breast health issue is scarce. This review aimed to collate and summarise published research on breast injuries in women's sports, highlighting the limitations and gaps in the literature.

DESIGN

Scoping review.

METHODS

Studies were included if they investigated breast injuries sustained by female athletes or the use of breast protective equipment in sports.

RESULTS

Eight of the 152 studies identified met the inclusion criteria. Six were retrospective cross-sectional survey studies, and two were case studies. Breast injury prevalence ranged from 26 % to 58 % and was higher in contact/combat sports than in non-contact sports. Most injuries were deemed mild-moderate in severity because most athletes continued to play, albeit with a perceived negative effect on performance. In rare cases, injuries were severe with long-term consequences and required surgical intervention. Breast injury mechanism was sport-specific, and management and prevention strategies were extremely limited, with a very low percentage of injuries reported (~10 %) and a lack of breast injury surveillance.

CONCLUSIONS

The paucity of research and lack of awareness and understanding of breast injuries highlights the urgent need for education within women's sports and further research to develop evidence-based management and prevention strategies. Recommendations for future research include assessment of sport-specific mechanisms and incidence, the use of standardized clinical assessment of breast injury severity, long-term consequences, and inclusion of sub-groups of female athletes, such as females with breast implants, developing breasts, and lactating breasts.

Return to Play in the Professional Athlete

The management of any injury in elite athletes poses unique challenges distinct from the general population because the goal is rapid recovery and return to play (RTP) while simultaneously managing residual symptoms and minimizing risk of reinjury. The time required for treatment, recovery, and return to peak performance can have consequences for both the athlete and his or her team: financial implications, psychological stressors, team dynamics, and future performance. RTP after an injury in the professional athlete requires a complex decision-making process with many stakeholders. Several factors influence this decision, not the least of which is the type and mechanism of injury. This article provides an overview of the RTP process including nonmedical factors that may influence this decision, common injuries seen in professional athletes, injury patterns particular to certain popular sports, and imaging guidelines for such injuries.

Adaptation to full weight-bearing following disuse in rats: The impact of biological sex on musculoskeletal recovery

With the technological advances made to expand space exploration, astronauts will spend extended amounts of time in space before returning to Earth. This situation of unloading and reloading influences human physiology, and readaptation to full weight-bearing may significantly impact astronauts' health. On Earth, similar situations can be observed in patients who are bedridden or suffer from sport-related injuries. However, our knowledge of male physiology far exceeds our knowledge of female's, which creates an important gap that needs to be addressed to understand the sex-based differences regarding musculoskeletal adaptation to unloading and reloading, necessary to preserve health of both sexes. Using a ground-based model of total unloading for 14 days and reloading at full weight-bearing for 7 days rats, we aimed to compare the musculoskeletal adaptations between males and females. Our results reveal the existence of significant differences. Indeed, males experienced bone loss both during the unloading and the reloading period while females did not. During simulated microgravity, males and females showed comparable muscle deconditioning with a significant decline in rear paw grip strength. However, after 7 days of recovery, muscle strength improved. Additionally, sex-based differences in myofiber size existing at baseline are significantly reduced or eliminated following unloading and recovery.

Return-to-Sport Outcomes After Anterior Cruciate Ligament Surgical Treatment May Be Improved by Attention to Modifiable Factors and Consideration of Nonmodifiable Factors

Today, we who treat athletes are able to effect immediate, significant improvement in anterior cruciate ligament (ACL) patient outcomes, regardless of surgical technique, by careful determination of when an athlete is ready to return to sport. "Prehabiliation," bracing, time after surgery to various rehabilitation activities, time after surgery until return to sport, functional testing, strength testing including limb symmetry indices, psychological readiness, age, gender, and type of sport are all factors influencing successful return to sport after ACL injury and treatment. Age and gender are not modifiable, and for some athletes, type of sport may be nonnegotiable. However, each of these factors could be thoughtfully considered before returning an athlete to sport after ACL treatment. All the other factors listed above, from prehab to bracing to strength to psychological readiness, may be modifiable.