Wrist overuse in young athletes: Exploring diagnostic strategies

The three parts of this thesis addressed three research questions, in order to provide diagnostic strategies for early identification of overuse injuries of the wrist in young athletes. The first part focused on the epidemiology of effects of wrist-loading sports performance during youth, by aiming to answer the question what the extent is of the risks and benefits of performing wrist-loading sports at a young age. In the second part we aimed to answer the question what relevant signals and limitations are relating to overuse wrist injuries in young athletes, in order to incorporate them in a self-report tool. The third part focused on answering the question what diagnostic imaging techniques can improve the early diagnosis of overuse wrist injuries and their potential consequences in young athletes.
The research reported in these eight chapters has elaborated numerous strategies to improve the early diagnosis of overuse injuries of the wrist in young athletes, providing a self-report tool and qualitative as well as quantitative imaging techniques. In addition, the three perspectives presented in this thesis have illustrated the diagnostic challenges for young athletes, in particular their difficulties in reporting injuries and the normalization of pain in youth sports. Among clinicians and researchers, there is a clear need for uniform definitions and validated diagnostic methods for early identification of overuse wrist injuries. Furthermore, the definition of ‘normal’ – with regard to symptoms as well as diagnostic imaging – needs to be refined to be better applicable to young athletes. A multidisciplinary approach is essential to overcome these challenges, combine these diagnostic strategies and involve athletes, coaches, trainers, parents, and physicians alike.