The Association of Finger Growth Plate Injury History and Speed Climbing in Youth Competition Climbers

Meyers, Rachel N.; Howell, David R.; Provance, Aaron J.

doi:10.1016/j.wem.2020.06.008

Cited by 14 publications

(14 citation statements)

References 12 publications

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“…The mean age of our patients was 14.7 ± 1.5 years and is within the time frame of epiphyseal closure of the fingers 34 and is consistent with the literature. 1,14,25 The risk of finger EGPI correlates with puberty, which most often will occur at an age of 13 to 15 years but has large interindividual variability. 5,35,38 As a consequence of the different maturation of boys and girls, these injuries could also occur at different times.…”

Section: Discussionmentioning

confidence: 99%

“…Until today, treatment mostly consisted of nonoperative therapy 14 and a stepwise return to climbing. 25 In some cases, when a nonoperative therapy did not lead to a osseous fusion, a surgical spot-drilling epiphysiodesis treatment has been described. 11,34 To date, guidelines for the decision making regarding the treatment of this injury are lacking, especially for how long a nonoperative therapy is possible and when a secondary surgical procedure should be performed.…”

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confidence: 99%

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Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers

Schöffl

Flohé

et al. 2021

Am J Sports Med

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Background: Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending. Purpose: To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers. Study Design: Case series; Level of evidence, 4. Methods: On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d’Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score. Results: Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3. Conclusion: The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers

Schöffl

Flohé

et al. 2021

Am J Sports Med

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“…Table 3 summarizes the results of 19 imaging studies which provide prevalence estimates or comparative data on PPSIs involving the shoulder, wrist and fingers of baseball players [133][134][135], divers [136], gymnasts [26,27,[137][138][139][140][141][142][143][144][145][146], and climbers [147][148][149][150][151]. Cross-sectional data are also provided in one case series study [26] and one case-control study [135].…”

Section: Cross-sectional Studiesmentioning

confidence: 99%

“…In imaging studies which did not report current or past symptoms, the prevalence of radiographic abnormalities consistent with PPSIs ranged from 5 to 83% [27,51,135,137,139,140,148,149]. Athletes in this category included baseball players (prevalence range 0-21.7%) [133,135], divers (52.6%) [136], gymnasts (10-83%) [27,137,139,140], and climbers (5-47%) [148,149,151]. Notably, the prevalence of stress reaction (e.g., subchondral sclerosis/ increased thickness of physis) was greater in German Junior National Team (GJNT) climbers (47%) than recreational climbers (RC) (28%).…”

Section: Unknown Symptomatologymentioning

confidence: 99%

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review

et al. 2021

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Background Overuse injuries are common in sporting children and adolescents. These injuries are a particular concern when they involve the epiphyseal-physeal-metaphyseal (EPM) complex given their potential to disturb skeletal growth. Specifically, the limits of mechanical tolerance of the EPM complex to repetitive stress may be exceeded by the intense and continuous training characteristic of many youth sports today. Objective This article describes the present status of knowledge on the occurrence and outcome of primary periphyseal stress injuries (PPSIs) affecting the EPM complex in the extremities of children and adolescents involved in youth sports. Methods A comprehensive review of the sports medicine literature was conducted to determine the nature and extent of PPSIs affecting the EPM complex of the extremities among youth sports participants and the potential for consequent skeletal growth disturbance and resultant limb deformity associated with these injuries. Results Our initial search uncovered 128 original published scientific articles reporting relevant data on PPSIs. There were 101 case reports/series, 19 cross-sectional, 1 case-control, and 7 cohort studies with relevant data. The case reports/series studies reported 448 patients with PPSIs involving the extremities. Children and adolescents representing a variety of high impact repetitive youth sports activities-including baseball, badminton, climbing, cricket, dance, gymnastics, rugby, soccer, swimming, tennis, and volleyball-may sustain PPSIs involving the shoulder, elbow, hand and wrist, knee, and ankle and foot. Although incidence data from prospective cohort studies are lacking, data arising from cross-sectional studies suggest that PPSIs may be common in select groups of youth athletes-including the shoulder in baseball players (0-36.6%), wrist in gymnasts (10-83%) and platform divers (52.6%), and fingers in rock climbers (5-58%). Notably, not all stress-related skeletal changes detected on imaging were symptomatic in these studies. When diagnosed and treated with an appropriate period of rest and rehabilitation, most patients studied were able to return to their sport activities. However, our data also show that 57/448 PPSIs (12.7%) produced growth disturbance, and that 28/448 patients (6.2%) underwent surgery for their injuries. Absence of treatment, delayed presentation and diagnosis, and non-compliance with a rest regimen were common in cases that produced growth disturbance. Conclusions PPSIs may affect the extremities of children and adolescents engaged in a variety of youth sports, especially at advanced levels of training and competition. Most skeletally immature patients with PPSIs respond well to timely treatment; however, in extreme cases, PPSIs can progress to produce skeletal growth disruption which may necessitate surgical intervention. Clearly, establishing the early diagnosis of PPSIs and providing timely treatment of these injuries are needed to ensure the skeletal health of youth sports participants. Rigorous prospective lo...

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“…In the same cohort, 43.9% of reported injuries were acute (trauma) and 56.1% relate to persistent (overuse) conditions. In youth climbers, speed climbing has been associated with finger growth plate injuries (48). This may be related to the high contact forces associated with speed climbing.…”

Section: Injury Risk Profilesmentioning

confidence: 99%

Strength and Conditioning Considerations for Speed Climbing

Ehiogu

Krawczyk²,

Tallent

2022

Strength &Amp; Conditioning Journal

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Climbing has developed into a professional sport with worldwide participation. Olympic climbing consists of lead climbing, speed climbing, and bouldering. The objective of speed climbing is to reach the top of the route in the fastest time. Speed climbing has not been subjected to the same level of investigation as other types of climbing. A strength and power base underpins performance in speed climbing. This physiological and mechanical basis provides the foundations for effective program design for the speed climber. Effective programming should incorporate a longterm planning approach that is based on a needs analysis of the sport and the climber's physical qualities. The development of high performance will involve the sequential application of regional hypertrophy, maximal strength, explosive strength training, plyometrics, and climbing-specific training to a varying degree.

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The Association of Finger Growth Plate Injury History and Speed Climbing in Youth Competition Climbers

Cited by 14 publications

References 12 publications

Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers

Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review

Strength and Conditioning Considerations for Speed Climbing

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