Swimmers Are At Risk For Stress Fractures? A Systematic Review

Abstract

Background: Stress fractures occur most commonly in the weight-bearing bones of the lower extremities. Swimming, a non-weight-bearing activity, is a potential activity form which associated with stress fractures? Objective: This systematic review aims to provide an answer in the above question and also to identify the reported cases of stress fractures among swimmers. Method: A systematic and comprehensive search was conducted using PubMed and Research Gate databases before January 2017. The search process was completed using the keywords: “stress fracture”, “stress injury”, “fatigue fracture”, “swimming” and “swimmers”. Results: There have been only 10 studies describing stress fractures in swimmers. This rare type of injury is commonly diagnosed in the ribs of young competitive swimmers, irrespective of their preferred swimming stroke. The etiology is multifactorial and includes a combination of intrinsic and/or extrinsic factors. Conclusion: Although any sport activity can potential cause a stress fracture, competitive swimming seems to be relatively safe in this respect. Rib stress fractures appear as the most common stress fracture in competitive swimmers that clinicians should consider. A prompt diagnosis can shorten the time required for healing and decrease the risk of complication.

Rehabilitation After Surgical Treatment of Pectoralis Major Rupture in a CrossFit® Practitioner: A Case Report

“…19 The success experienced by this athlete with the provided protocol is important considering that the pectoralis major is essential to strenuous activities. 8 The results of this case report are similar to two previous case reports that described a post-op protocol for a pectoralis major rupture in a male snowboarding athlete and in a soldier of the US army. 8,20 Those protocols had duration of sixteen 8 and twenty-four weeks, 20 and similar to the one used in the current case report, were performed to control pain, avoid adherence formation, gain range of motion, restore muscle power, and to return to daily activities/sport.…”

“…8 The results of this case report are similar to two previous case reports that described a post-op protocol for a pectoralis major rupture in a male snowboarding athlete and in a soldier of the US army. 8,20 Those protocols had duration of sixteen 8 and twenty-four weeks, 20 and similar to the one used in the current case report, were performed to control pain, avoid adherence formation, gain range of motion, restore muscle power, and to return to daily activities/sport. In both cases, the participant had full active and passive range of motion, muscle power symmetry according to isometric dynamometry and returned to his previous level of athletic activities at the end of the treatment.…”

“…In both cases, the participant had full active and passive range of motion, muscle power symmetry according to isometric dynamometry and returned to his previous level of athletic activities at the end of the treatment. 8,20 Ninety percent of CrossFit ® practitioners that have had an upper limb surgical procedure returned to sport, 12 and several authors have shown the benefits of the surgical management for pectoralis major injuries. 18,21,22 In fact, surgical treatment of a complete tendon tear has been consistently superior to non-surgical options, particularly in young individuals.…”

“…18,21,22 In fact, surgical treatment of a complete tendon tear has been consistently superior to non-surgical options, particularly in young individuals. 8,17 Thus, the choice for the surgical treatment followed by the rehabilitation protocol executed was chosen for the injury presented by the athlete. Cross-Fit ® practitioners commonly present with a high degree of intrinsic motivation, enjoyment of the challenges associated with the sport, and athletic affiliation 23 which together contribute to the adherence and maintenance of this activ-ity.…”

“…7 Despite the prevalence of muscle injuries in CrossFit ® , no report regarding pectoralis major injury in CrossFit ® practitioners was found in the literature. The pectoralis major is commonly injured in sports such as snowboarding, 8 football, and weightlifting. 9 Injury to the pectoralis major region is related to highintensity and external overload and occurs usually in men in sports involving abduction and external rotation of the glenohumeral joint.…”