A Measure of Burnout in Current NCAA Student-Athletes.

Introduction: The prevalence of athletes who specialize in sports has increased in recent years. Substantial literature on youth sports has linked early sport specialization to negative consequences, such as burnout and injury. However, empirical evidence comparing rates of burnout and specialization in NCAA athletes is limited. The purpose of this study was to survey current NCAA Division I student-athletes to compare levels of burnout to sex, year of NCAA eligibility, and age at the beginning of sport specialization. Methods: A self-reported survey was distributed to student-athletes at two NCAA Division I institutions, which included demographics, sport specialization history, injury history, and the Athlete Burnout Questionnaire. Results from the three measures of the Athlete Burnout Questionnaire (reduced sense of accomplishment, exhaustion, sport devaluation) were compared to sex, year of NCAA eligibility, age of beginning sport specialization, and injury history. Results: A total of 267 athletes (95 males and 172 females) completed the survey. Of those, 156 (58.4%) were in their first or second year of NCAA eligibility, and 111 (41.6%) were in their third, fourth, or fifth year. Of the total, 121 (46.4%) reported specializing before the age of 15, and 140 (53.6%) specialized at age 16 or older. Females reported significantly higher levels of exhaustion than males (Difference of means (M) = 0.43, 95% confidence interval (CI) = [0.20, 0.66], p < 0.01). Athletes in their third, fourth, or fifth year of eligibility reported significantly higher levels of sport devaluation (M = 0.27, 95% CI = [0.05, 0.48], p < 0.05) than athletes in their first or second year. Athletes who specialized before age 15 did not report significantly higher levels of burnout than athletes who specialized at age 16 or later. In total, 203 athletes (77.2%) reported experiencing any injury. Athletes who reported a history of experiencing any injury demonstrated significantly higher feelings of reduced sense of accomplishment than athletes with no injury history (Difference of means (M) = 0.24, 95% confidence interval (CI) = [0.03, 0.45], p < 0.05). Conclusions: Athletes were more likely to experience elevated levels of burnout if they reported female sex, older NCAA eligibility, or a past injury history. However, athletes were not more likely to experience increased burnout based on age of beginning specialization. The results demonstrated a need to address burnout in athletes following injury and to be aware that females and older athletes are more prone to burnout.

Differences in Outcomes Between Anterior and Posterior Shoulder Instability After Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis.

BACKGROUND: The glenohumeral joint is one of the most frequently dislocated joints in the body, particularly in young, active adults. PURPOSE: To conduct a systematic review and meta-analysis to evaluate and compare outcomes between anterior versus posterior shoulder instability. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was performed using the PubMed, Cochrane Library, and MEDLINE databases (from inception to September 2019) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were published in the English language, contained outcomes after anterior or posterior shoulder instability, had at least 1 year of follow-up, and included arthroscopic soft tissue labral repair of either anterior or posterior instability. Outcomes including return-to-sport (RTS) rate, postoperative instability rate, and pre- and postoperative American Shoulder and Elbow Surgeons (ASES) scores were recorded and analyzed. RESULTS: Overall, 39 studies were included (2077 patients; 1716 male patients and 361 female patients). Patients with anterior instability had a mean age of 23.45 ± 5.40 years (range, 11-72 years), while patients with posterior instability had a mean age of 23.08 ± 8.41 years (range, 13-61 years). The percentage of male patients with anterior instability was significantly higher than that of female patients (odds ratio [OR], 1.36; 95% CI, 1.04-1.77; P = .021). Compared with patients with posterior instability, those with anterior instability were significantly more likely to RTS (OR, 2.31; 95% CI, 1.76-3.04; P < .001), and they were significantly more likely to have postoperative instability (OR, 1.53; 95% CI, 1.07-2.23; P = .018). Patients with anterior instability also had significantly higher ASES scores than those with posterior instability (difference in means, 6.74; 95% CI, 4.71-8.77; P < .001). There were no significant differences found in postoperative complications between the anterior group (11 complications; 1.8%) and the posterior group (3 complications; 1.6%) (OR, 1.12; 95% CI, 0.29-6.30; P = .999). CONCLUSION: Patients with anterior shoulder instability had higher RTS rates but were more likely to have postoperative instability compared with posterior instability patients. Overall, male patients were significantly more likely to have anterior shoulder instability, while female patients were significantly more likely to have posterior shoulder instability.

Publicly Available Rehabilitation Protocols Designated for Meniscal Repairs Are Highly Variable.

PURPOSE: To compare publicly available rehabilitation protocols designated for meniscal repairs published online to determine the variability in meniscus repair protocols including different types of tears (radial vs nonradial repairs). METHODS: From the Fellowship and Residency Electronic Interactive Database Access System (FREIDA), a list of publicly available academic residency programs and orthopaedic sports medicine fellowships was obtained. With this list, an electronic search using Google was performed looking for meniscal repair rehabilitation protocols. In addition to academic institutions, private practice organizations with published meniscus repair rehabilitation protocols found during the search also were examined. RESULTS: Of 189 academic institutions, a total of 30 academic institutions had protocols that were included. Another 29 private practice programs were subsequently found and included. In total, 59 rehabilitation protocols fit the inclusion criteria. Six of the 59 specified radial repair and 53 did not. For return to full range of motion, nonradial protocols averaged 6.7 weeks and radial protocols averaged 7.3 weeks. For return to full weight-bearing, nonradial protocols averaged 6.2 weeks and radial protocols averaged 7.5 weeks. For return to sport, nonradial protocols averaged 17.8 weeks and radial protocols averaged 23.3 weeks. For time spent in a brace, nonradial protocols averaged 5.7 weeks and radial protocols averaged 6.7 weeks. CONCLUSIONS: Of publicly available meniscal repair rehabilitation protocols, a small percentage (10.2%) changed their protocol in relation to tear type and there was a wide range of timeframes for each rehabilitation component. Protocols for radial tears tended to brace patients longer, limit their range of motion longer, delay full weight-bearing, and delay return to sport. However, it is recognized that some surgeons could be modifying their protocols in relation to tear type without publishing that information online. CLINICAL RELEVANCE: As stated in the purpose, the point of this study was to access only the protocols that would be available to the public. If anything, awareness should be raised for surgeons to look at their existing protocols and update them if they are truly incomplete and outdated. More research needs to be done to structure a rehabilitation protocol that is specific to the meniscal tear type, as the current protocols have a wide range of variance.