Criteria for returning to gymnastics following an upper extremity injury: A scoping review

Gymnastics is a unique athletic activity requiring different loading and weight bearing patterns through the entire body, especially the upper extremity (UE). Available literature on return to sport following a UE injury is predominately focused on return to throwing. Criteria regarding athlete appropriateness to return to UE weight bearing is limited. The purpose of this scoping review is to explore return to gymnastics and weight bearing following a UE injury. Computerized searches were performed using online databases. Grey literature, non-medical database sources and relevant study reference lists were manually reviewed. For screening and full-text determinations, two authors independently voted on inclusion based on established eligibility criteria and a third blinded author was used to resolve conflicts. Data related to interventions including any relevant protocols, outcomes, and return to sport criteria were extracted. In total, 1420 titles were retrieved. After duplicate removal, 1000 studies were screened, 40 were retained for final inclusion. Of the included studies, 8 specified return to gymnastics criteria. Limited and low-quality evidence of return to gymnastics following a UE injury was identified. The lack of evidence restricts clinical determination of readiness for return to UE loading making clinical care of gymnasts variable and potentially less effective.