Grethe Myklebust

• Heiestad, Hege; Moseid, Christine Holm & Myklebust, Grethe (2022). Skadefri-klubbkvelder i Norge - erfaringer, utfordringer og muligheter: En tverrsnittstudie. Fysioterapeuten. ISSN 0016-3384. 89(7), p. 30–35. Full text in Research Archive Show summary

  Hensikt: I artikkelen presenteres erfaringer fra Skadefri-klubbkvelder i idrettsklubber i Norge. Vi har kartlagt deltageres kunnskap om skadeforebyggende trening og bruk av Skadefri før og etter en slik klubbkveld, samt sett på hva som fremmer eller hemmer skadeforebyggende trening hos klubbkveld-deltagerne. Design, materiale og metode: Tverrsnittsstudie gjennomført i 2020-2021. Deltagere på Skadefri-klubbkvelder besvarte et spørreskjema om bruk og kjennskap til skadeforebyggende trening, om Skadefris nettside og applikasjon, utfordringer og barrierer knyttet til skadeforebyggende trening og en oppsummerende vurdering av Skadefri klubbkvelden. Deltakerne var utøvere, trenere og foreldre fra over 30 ulike idretter i Norge. Resultat: Totalt 1825 respondenter. Ikke alle respondentene besvarte alle spørsmålene i spørreskjemaet. Over halvparten (58 %) kjente til Skadefri fra før, og 45 % av disse brukte allerede nettside og/eller app i egen treningshverdag. Totalt gjennomførte 63% jevnlig skadeforebyggende trening før klubbkvelden, mens nesten alle (98%) ønsket å bruke kunnskapen om skadeforebyggende trening etter klubbkvelden. De største barrierene for bruk av skadeforebyggende trening var kunnskapsmangel og usikkerhet om hvordan man kan gjennomføre skadeforebyggende trening i praksis. Konklusjon: Skadefri-klubbkvelder kan være et nyttig lavterskel-tiltak som stimulerer til økt kunnskap om skadeforebyggende trening og gir større trygghet om hvordan skadeforebyggende trening kan gjennomføres i praksis.

• Ageberg, Eva; Brodin, Eva M; Linnéll, Jennie; Moesch, Karin; Donaldson, Alex & Adébo, Emme [Show all 15 contributors for this article] (2022). Cocreating injury prevention training for youth team handball: bridging theory and practice. BMJ Open sport & exercise medicine. ISSN 2055-7647. 8(2). doi: 10.1136/bmjsem-2021-001263. Full text in Research Archive Show summary

  Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ uses an ecological participatory design incorporating the perspectives of multiple stakeholders throughout the project. Within the I-PROTECT project, the current study aimed to describe the development of holistic injury prevention training specifically for youth handball players through using knowledge from both end-users (coaches and players) and researchers/handball experts. Employing action evaluation within participatory action research, the cyclical development process included three phases: research team preparation, handball expert-based preparation and end-user evaluation to develop injury prevention training incorporating both physical and psychological perspectives. To grow the knowledge of the interdisciplinary research team, rethinking was conducted within and between phases based on participants’ contributions. Researchers and end-users cocreated examples of handball-specific exercises, including injury prevention physical principles (movement technique for upper and lower extremities, respectively, and muscle strength) combined with psychological aspects (increase end-user motivation, task focus and body awareness) to integrate into warm-up and skills training within handball practice. A cyclical development process that engaged researchers/handball experts and end-users to cocreate evidence-based, theory-informed and context-specific injury prevention training specifically for youth handball players generated a first pilot version of exercises including physical principles combined with psychological aspects to be integrated within handball practice.

• Fredriksen, Hilde; Cools, Ann & Myklebust, Grethe (2021). Er et kort styrketreningsprogram for skulderens utadrotatormuskulatur, gjennomført som en del av håndballtreningen, tilstrekkelig for å øke den muskulære styrken hos unge håndballspillere? In Nyheim, Kurt Tomas (Eds.), Book of Abstract - Idrettsmedisinsk høstkongress 2021. NIMF.
• Moksnes, Håvard; Ardern, Clare L.; Kvist, Joanna; Engebretsen, Lars; Risberg, May Arna & Myklebust, Grethe [Show all 7 contributors for this article] (2021). Assessing implementation, limited efficacy, and acceptability of the BEAST tool: A rehabilitation and return-to-sport decision tool for nonprofessional athletes with anterior cruciate ligament reconstruction. Physical Therapy in Sport. ISSN 1466-853X. 52, p. 147–154. doi: 10.1016/j.ptsp.2021.08.011. Full text in Research Archive Show summary

  Objectives: To assess the implementation, limited efficacy, and acceptability of the BEAST (better and safer return to sport) tool – a rehabilitation and return-to-sport (RTS) decision tool after anterior cruciate ligament reconstruction (ACLR) in nonprofessional athletes. Design: Prospective cohort. Participants: 43 nonprofessional pivoting sport athletes with ACLR. Main outcome: Clinician- and athlete-experienced implementation challenges (implementation), changes in quadriceps power, side hop and triple hop performance from 6 to 8 months after ACLR (limited efficacy), athletes’ beliefs about the individual rehabilitation and RTS plans produced by the BEAST tool (acceptability). Results: The BEAST tool was developed and then implemented as planned for 39/43 (91%) athletes. Hop and quadriceps power performance improved significantly, with the largest improvement in involved quadriceps power (standardised response mean 1.4, 95% CI:1.1–1.8). Athletes believed the rehabilitation and RTS plan would facilitate RTS (8.2 [SD: 2.0]) and reduce injury risk (8.3 [SD: 1.2]; 0 = not likely at all, 10 = extremely likely). Conclusion: The BEAST tool was implemented with few challenges and adjustments were rarely necessary. Athletes had large improvements in quadriceps power and hop performance on the involved leg. Athletes believed that the individual rehabilitation and RTS plans produced by the tool would facilitate RTS and reduce injury risk.

• Møller, Merete; Zebis, Mette K.; Myklebust, Grethe; Lind, Martin; Wedderkopp, Niels & Bekker, Sheree (2021). “Is it fun and does it enhance my performance?” – Key implementation considerations for injury prevention programs in youth handball. Journal of Science and Medicine in Sport. ISSN 1440-2440. 24(11), p. 1136–1142. doi: 10.1016/j.jsams.2021.04.017. Full text in Research Archive Show summary

  Objectives: We aimed to determine the use of injury prevention exercises and injury prevention exercise programs in Danish youth handball and investigate coach and player experiences, beliefs and attitudes of injury and their prevention. Design: A mixed-methods design consisting of cross-sectional quantitative surveys and qualitative interviews. Methods: We surveyed 481 youth (14–18 years old) handball players and their 33 coaches about their use of injury prevention exercises, and attitudes towards injury and their prevention. Additionally, we interviewed five coaches and three players about barriers and motivational factors for implementing injury prevention programs. Results: Players (71%) and almost all coaches reported performing injury prevention exercises for the shoulder, knee, and ankle. Yet few players (4%) and coaches (1%) reported performing the established full injury prevention programs systematically. Players were willing to implement programs to reduce injury risk (84% agreed) and enhance performance (88% agreed). Key factors influencing program uptake were lack of awareness of evidence-based injury prevention programs and lack of handball-specific exercises. Coaches and players identified continued education and training as vital facilitators in this setting, and all coaches agreed that injury prevention should be an essential part of coach education. Conclusions: While Danish youth handball players and coaches seemed to recognize the importance of injury prevention, the use of established programs was marginal. Experiences, beliefs, and attitudes about injury and injury prevention influenced program uptake and should be addressed through continued education and training in this context in combination with making the programs more handball specific.

• Mashimo, Sonoko; Yoshida, Naruto; Moriwaki, Tatsu; Takegami, Ayaka; Suzuki, Keita & Fong, Daniel Tik-Pui [Show all 8 contributors for this article] (2021). Injuries in Japanese university handball: a study among 1017 players. Research in Sports Medicine: An International Journal. ISSN 1543-8627. doi: 10.1080/15438627.2021.1937164. Full text in Research Archive Show summary

  The aim of this study was to examine the injury profile of Japanese university handball players. In this cross-sectional study, a total of 1017 participants who played in the 2018 Japanese National University Handball Championship were followed. The incidence within the previous year was 0.59 [95% CI, confidence interval: 0.56–0.62] per player per year. The ankle (33.3%), knee (23.6%), and shoulder/clavicle (12.6%) were the body regions most affected by traumatic mechanisms, while the lumbar spine/lower back (26.0%), knee (15.7%), and shoulder (15.0%) were the body regions most affected by overuse mechanisms. Sprain (30.7%), ligamentous rupture (23.2%), and fracture (11.8%) were the main types of traumatic injuries, and stress fracture (25.0%) and lesion of meniscus or cartilage (25.0%) were the main types of overuse injuries. Female players were 1.5 times more likely (OR, odds ratio: 1.55 [95% CI: 1.20–2.01]) to experience an injury than their male counterparts, and line players were also 1.5 times more likely (OR: 1.49 [95% CI: 1.00–2.21]) to experience an injury than their wing counterparts. This study showed that there is a need for increased injury prevention efforts in Japanese handball, especially among female players.

• Arundale, Amelia J. H.; Silvers-Granelli, Holly J. & Myklebust, Grethe (2021). ACL injury prevention: Where have we come from and where are we going? Journal of Orthopaedic Research. ISSN 0736-0266. doi: 10.1002/jor.25058. Full text in Research Archive Show summary

  Anterior cruciate ligament (ACL) injuries are one of the most common and severe knee injuries across sports. As such, ACL injury prevention has been a focus of research and sports medicine practice for the past three‐plus decades. Examining the current research and identifying both clinical strategies and research gaps, the aim of this review is to empower clinicians and researchers with knowledge of where the ACL injury prevention literature is currently and where it is going in the future. This paper examines the mechanism of ACL injury prevention, screening, implementation, compliance, adherence, coronavirus, and areas of future research. Clinical significance: The time lag between research and practical implementation in general healthcare settings can be as long as 17 years; however, athletes playing sports today are unable to wait that long. With effective programs already established, implementation and adherence to these programs is essential. Strategies such as coaching education, increasing awareness of free programs, identifying barriers, and overcoming implementation obstacles through creative collaboration are just a few ways that could help improve both ACL injury prevention implementation and adherence.

• Fredriksen, Hilde; Cools, Ann & Myklebust, Grethe (2021). No added benefit of 8 weeks of shoulder external rotation strength training for youth handball players over usual handball training alone: A randomized controlled trial. Journal of Orthopaedic and Sports Physical Therapy. ISSN 0190-6011. 51(4), p. 174–187. doi: 10.2519/JOSPT.2021.9957. Show summary

  Objective: To assess the effectiveness of a short (5–10 minutes) shoulder external rotation (ER) strength program, using elastic bands, in adolescent handball players. Design: Randomized controlled trial. Methods: The sample included 6 adolescent handball teams (3 female, 3 male) with a total of 92 players and a mean age of 16.6 years. Players were randomized within teams to an intervention group, which completed a shoulder ER strengthening program of 2 exercises performed 3 times per week after handball training for 8 weeks, or a control group of no treatment. The primary outcome was the between-group difference in shoulder ER strength change, measured as isometric strength using a handheld dynamometer from preintervention to postintervention (8 weeks). Secondary outcomes were between-group differences in internal rotation (IR) strength and the ER/IR strength ratio from preintervention to postintervention. Results: The estimated between-group difference in dominant-shoulder ER strength was 0.06 N/kg (95% confidence interval [CI]: −0.01, 0.14) in favor of the intervention group. The estimated between-group differences in the ER/IR ratio and IR strength were 0.03 (95% CI: −0.02, 0.08) and 0.02 (95% CI: −0.08, 0.13), respectively.

• Rafnsson, Elis Thor; Myklebust, Grethe; Bahr, Roald & Arnason, Arni (2021). No relationship between a movement screening test and risk of overuse problems in low back, shoulder, and knee in elite handball players - A prospective cohort study. Translational Sports Medicine (TSM). ISSN 2573-8488. doi: 10.1002/tsm2.245. Full text in Research Archive Show summary

  Many handball studies have reported injuries that cause absence from participation. In this prospective cohort study on elite Icelandic male players, the aim was to examine the prevalence of overuse problems in low back, knee, and shoulder. Sixteen Icelandic teams were invited. Thirteen teams agreed to participate. The OSTRC overuse questionnaire was distributed every second week during 32-week period. In addition, the 9+ Screening Test was performed on 130 players. In total, 229 players participated with a weekly average response rate of 72%. The average weekly prevalence for shoulder was 28% (95% CI 25% to 31%), for knee 33% (95% CI 30% to 36%), and for low back 32% (95% CI 29% to 35%). Substantial problems were 10% (95% CI 9% to 11%) in shoulder and knee and 11% (95%CI 10% to 12%) in low back. Only 1% (95% CI 1% to 2%) of the overuse problems caused time loss from participation. In total, 61% of the players played with at least one overuse problem and 25% with one affecting their performance. There was no association between the 9+ Screening Test score and overuse problems among Icelandic male handball players.

• Bjørndal, Christian T.; Bache-Mathiesen, Lena Kristin; Gjesdal, Siv; Moseid, Christine Holm; Myklebust, Grethe & Luteberget, Live (2021). An Examination of Training Load, Match Activities, and Health Problems in Norwegian Youth Elite Handball Players Over One Competitive Season. Frontiers in Sports and Active Living. ISSN 2624-9367. 3. doi: 10.3389/fspor.2021.635103. Full text in Research Archive Show summary

  Talent development is integral to the policy and organizational practice of competitive sport, but has also been associated with excessive amounts of training and competition, and athlete injuries and illnesses. The lack of available prospective data on the training and match activities of youth athletes and their health problems is therefore of concern. The aim of this study was two-fold: (a) to examine the amount and frequency of training load, match activities, injury and illness incidence, and prevalence among Norwegian youth elite handball players over the course of the 2018–2019 competitive season; and (b) to explore whether the injury rates are related to the sex or competition level of players, or their membership of the youth international team. We recruited 205 handball players (64% female, 36% male), aged 15–18 years (17.2 years ± 0.9) from five different sport school programs in southeast Norway. Data were collected daily from September 2018 to May 2019, during the competitive handball season. The variables included types of athlete activities, the number of activities, the rating of perceived exertion (RPE), and the duration of training and matches. Injury and illness data were collected weekly using the Oslo Sports Trauma Research Center (OSTRC) questionnaire. The mean number of matches per week per player was 0.9 ± 1.29; the number of weekly training events was 6.1 ± 4.4; and the mean weekly session RPE was 986 ± 1 412 arbitrary units. The players reported a total of 472 injuries, and the mean number of injuries per player was 2.3 ± 2.9. The results demonstrated a 53% weekly injury prevalence, of which 38% were categorized as substantial injuries. Male players and players who participated at the highest level of senior competition and/or the youth international team reported significantly lower weekly incidences of health problems, compared to other players. Our findings showed that players enrolled in sport school programs are exposed to high training and competition loads, and that both general and substantial health problems are common. The potential implications for talent development and future research are discussed.

• Rossi, Marleena; Pasanen, Kati; Heinonen, Ari; Äyrämö, Sami; Leppänen, Mari & Myklebust, Grethe [Show all 9 contributors for this article] (2021). The standing knee lift test is not a useful screening tool for time loss from low back pain in youth basketball and floorball players. Physical Therapy in Sport. ISSN 1466-853X. 49, p. 141–148. doi: 10.1016/j.ptsp.2021.01.017. Full text in Research Archive Show summary

  Objectives: The aim of this study was to investigate the association between pelvic kinematics during the standing knee lift (SKL) test and low back pain (LBP) in youth floorball and basketball players. Design: A prospective cohort study. Setting: Finnish elite youth floorball and basketball players. Participants: Finnish elite youth female and male floorball and basketball players (n = 258, mean age 15.7 ± 1.8). Main outcome measures: LBP resulting in time loss from practice and games was recorded over a 12-month period and verified by a study physician. Associations between LBP and sagittal plane pelvic tilt and frontal plane pelvic obliquity during the SKL test as measured at baseline were investigated. Individual training and game hours were recorded, and Cox’s proportional hazard models with mixed effects were used for the analysis. Results: Cox analyses revealed that sagittal plane pelvic tilt and frontal plane pelvic obliquity were not associated with LBP in floorball and basketball players during the follow-up. The hazard ratios for pelvic tilt and pelvic obliquity ranged between 0.93 and 1.08 (95% CIs between 0.91 and 1.07 and 0.83 and 1.29), respectively. Conclusions: Pelvic movement during the SKL test is not associated with future LBP in youth floorball and basketball players.

• Rossi, Marleena; Pasanen, Kati; Heinonen, Ari; Äyrämö, Sami; Räisänen, Anu & Leppänen, Mari [Show all 10 contributors for this article] (2020). Performance in dynamic movement tasks and occurrence of low back pain in youth floorball and basketball players. BMC Musculoskeletal Disorders. ISSN 1471-2474. 21. doi: 10.1186/s12891-020-03376-1. Full text in Research Archive Show summary

  Background: Prospective studies investigating risk factors for low back pain (LBP) in youth athletes are limited. The aim of this prospective study was to investigate the association between hip-pelvic kinematics and vertical ground reaction force (vGRF) during landing tasks and LBP in youth floorball and basketball players. Methods: Three-hundred-and-eighty-three Finnish youth female and male floorball and basketball players (mean age 15.7 ± 1.8) participated and were followed up on for 3 years. At the beginning of every study year the players were tested with a single-leg vertical drop jump (SLVDJ) and a vertical drop jump (VDJ). Hip-pelvic kinematics, measured as femur-pelvic angle (FPA) during SLVDJ landing, and peak vGRF and side-to-side asymmetry of vGRF during VDJ landing were the investigated risk factors. Individual exposure time and LBP resulting in time-loss were recorded during the follow-up. Cox’s proportional hazard models with mixed effects and time-varying risk factors were used for analysis. Results: We found an increase in the risk for LBP in players with decreased FPA during SLVDJ landing. There was a small increase in risk for LBP with a one-degree decrease in right leg FPA during SLVDJ landing (HR 1.09, 95% CI 1.02 to 1.17, per one-degree decrease of FPA). Our results showed no significant relationship between risk for LBP and left leg FPA (HR 1.04, 95% CI 0.97 to 1.11, per one-degree decrease of FPA), vGRF (HR 1.83, 95% CI 0.95 to 3.51) or vGRF side-to-side difference (HR 1.22, 95% CI 0.65 to 2.27) during landing tasks. Conclusions: Our results suggest that there is an association between hip-pelvic kinematics and future LBP. However, we did not find an association between LBP and vGRF. In the future, the association between hip-pelvic kinematics and LBP occurrence should be investigated further with cohort and intervention studies to verify the results from this investigation.

• Liaghat, Behnam; Bencke, Jesper; Zebis, Mette K.; Sørensen, Henrik; Myklebust, Grethe & Wedderkopp, Niels [Show all 8 contributors for this article] (2020). Shoulder Rotation Strength Changes From Preseason to Midseason: A Cohort Study of 292 Youth Elite Handball Players Without Shoulder Problems. Journal of Orthopaedic and Sports Physical Therapy. ISSN 0190-6011. 50(7), p. 381–387. doi: 10.2519/jospt.2020.9183. Show summary

  Objective: To investigate change in shoulder rotation strength from preseason to midseason during a competitive season in youth elite handball players without shoulder problems. Design: Prospective cohort study. Methods: Players (n = 292, 45% female, 14–18 years of age) without shoulder problems from Danish youth elite handball clubs were assessed in the preseason and midseason. We measured isometric shoulder strength using handheld dynamometry in internal rotation (IR) and external rotation (ER) in supine, with the shoulder abducted 90° in neutral rotation and in 30° of IR. The primary outcome was the change in corresponding ER/IR ratio. Results: The mean ER/IR ratios increased from preseason to midseason in neutral rotation (male player difference, 0.02; 95% confidence interval [CI]: −0.01, 0.06; female player difference, 0.05; 95% CI: 0.01, 0.09) and in 30° of IR (male player difference, 0.15; 95% CI: 0.11, 0.20; female player difference, 0.12; 95% CI: 0.07, 0.17). The change in ER/IR ratio may be explained by an increase in ER strength in female players and a decrease in IR strength in male players. The amount of change in ER/IR ratio over the season was greater than individual measurement error metrics for 45% to 66% of the players. Conclusion: Shoulder rotation strength ratios changed during a competitive season in Danish youth elite handball players.

• Fredriksen, Hilde; Cools, Ann; Bahr, Roald & Myklebust, Grethe (2020). Does an effective shoulder injury prevention program affect risk factors in handball? A randomized controlled study. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 30(8), p. 1423–1433. doi: 10.1111/sms.13674. Show summary

  Background: Shoulder problems are common in handball, but injury risk reduction is possible by implementing a prevention program. However, player compliance to the program remains a challenge, with feedback from players that the program is too time consuming. Aim: To develop a more efficient program, we aimed to assess the effect of the Oslo Sports Trauma Research Center shoulder injury prevention program on external rotation (ER) strength and internal rotation (IR) range of motion (ROM), considered to represent key risk factors for injury. Methods: Four youth handball teams (three females, one males, 57 players, mean age 17.1 years) were randomized to an intervention or control group. The intervention program was conducted three times per week as a part of handball warm‐up for 18 weeks, supervised by physical therapists. The main outcome variables were the between‐group differences in ER strength and IR ROM change from baseline to postintervention. Isometric ER strength was measured with a handheld dynamometer and IR ROM with a digital goniometer. Results: Mean dominant shoulder isometric ER strength increased both in the intervention (10%) and the control group (6%) during the intervention, but there was no significant group by time interaction (group difference: 0.06 N/kg (95% CI: −0.04 to 0.17). IR ROM did not change in either group during the intervention. Conclusion: The Oslo Sports Trauma Research Center shoulder injury prevention program did not affect the risk factors ER strength and IR ROM. The preventive effect of the program must therefore be due to other factors.

• Fredriksen, Hilde; Cools, Ann & Myklebust, Grethe (2020). Development of a short and effective shoulder external rotation strength program in handball: A delphi study. Physical Therapy in Sport. ISSN 1466-853X. 44, p. 92–98. doi: 10.1016/j.ptsp.2020.05.005. Show summary

  Background: Weakness of the shoulder external rotators (ER) is one of the main risk factors for shoulder pain in handball. Short, effective shoulder ER strength programs the players will adhere to are lacking. Objectives: to develop a short and effective shoulder ER strength program, handball players will adhere to. Methods: We conducted a modified Delphi study, including experts in the field of shoulder, strength training and handball. In the first round, the experts were asked to rate eight pre-defined shoulder ER exercises on efficacy and adherence and to suggest other preferred exercises. In round two, they were asked to rate the new exercises from round one. In round three, they received a statistical summary of the panels scores, their own score and a summary of the suggestions. Based on the feedback, the experts were asked to revise their response. Results: Sixteen experts completed three rounds with 100% response rate. Twenty-eight exercises were rated. We reached consensus for both efficacy and adherence for two exercises, ER in 90° abduction in a bent-over squat position and ER in 90° abduction combined with horizontal abduction and trunk rotation in a push-up position. Conclusion: We reached consensus for both efficacy and adherence for two exercises.

• Clarsen, Benjamin Matthew; Bahr, Roald; Myklebust, Grethe; Andersson, Stig Haugsbø; Docking, Sean & Drew, Michael [Show all 19 contributors for this article] (2020). Improved reporting of overuse injuries and health problems in sport: an update of the Oslo Sport Trauma Research Center questionnaires. British Journal of Sports Medicine. ISSN 0306-3674. 54(7), p. 390–396. doi: 10.1136/bjsports-2019-101337. Full text in Research Archive Show summary

  In 2013, the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O) was developed to record the magnitude, symptoms and consequences of overuse injuries in sport. Shortly afterwards, a modified version of the OSTRC-O was developed to capture all types of injuries and illnesses—The Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H). Since then, users from a range of research and clinical environments have identified areas in which these questionnaires may be improved. Therefore, the structure and content of the questionnaires was reviewed by an international panel consisting of the original developers, other user groups and experts in sports epidemiology and applied statistical methodology. Following a review panel meeting in October 2017, several changes were made to the questionnaires, including minor wording alterations, changes to the content of one question and the addition of questionnaire logic. In this paper, we present the updated versions of the questionnaires (OSTRC-O2 and OSTRC-H2), assess the likely impact of the updates on future data collection and discuss practical issues related to application of the questionnaires. We believe this update will improve respondent adherence and improve the quality of collected data.

• Sundgot-Borgen, Jorunn; Sundgot-Borgen, Christine; Myklebust, Grethe; Sølvberg, Nina & Torstveit, Monica Klungland (2019). Elite athletes get pregnant, have healthy babies and return to sport early postpartum. BMJ Open sport & exercise medicine. ISSN 2055-7647. 5(1). doi: 10.1136/bmjsem-2019-000652. Full text in Research Archive Show summary

  Objectives: To enhance knowledge on pregnancy and return to sport in the postpartum period in elite female athletes. Methods: 34 Norwegian elite athletes (33.1 years) and 34 active controls (31.5 years) were asked about training and competitive history, pregnancy-related issues, injuries, body dissatisfaction (BD), drive for thinness (DT), eating disorders (ED) and practical experiences, through a questionnaire and interview. Independent samples T-tests or χ² tests for between-group differences and paired-samples T-tests and repeated measures analysis of variance for within group differences were used. Results: No group differences in fertility problems, miscarriage, preterm birth or low birth weight were found. Both groups decreased training volume all trimesters and the first two postpartum periods compared with prepregnancy, and more athletes returned to sport/exercise at week 0–6 postpartum. We found no group differences in complications during pregnancy and delivery, but athletes reported fewer common complaints. Four athletes experienced stress fracture postpartum. Athletes had higher BD and DT postpartum, while controls reduced DT score. Number of athletes with clinical ED was reduced postpartum, while constant in controls. Athletes were not satisfied with advice related to strength training and nutrition during pregnancy. Conclusion: Elite athletes and active controls get pregnant easily, deliver healthy babies and decrease training during pregnancy and the first postpartum periods compared with prepregnancy. Most athletes and every third control returned to sport or exercise at week 0–6 postpartum. Athletes report stress fractures and increased BD and DT, but decreased ED postpartum. However, since relatively few athletes were included these findings need further investigation.

View all works in Cristin

• Myklebust, Grethe (2024). Barriers to injury prevention programs - and how to overcome them?
• Myklebust, Grethe (2024). 25 Years of injury prevention, from the young athletes to the professionals.
• Myklebust, Grethe; Munkvold, Emilie; Hägglund, Martin; Bahr, Roald; Møller, Merete & Bjørndal, Christian Thue [Show all 7 contributors for this article] (2024). Why does it work? Proposed mechanisms of effect in injury prevention programs in football and handball: a scoping review of 84 studies.
• Myklebust, Grethe (2024). Ikke-operativ behandling ved skulderlidelser .
• Myklebust, Grethe (2024). Ikke-operativ behandling ved ACL-ruptur .
• Myklebust, Grethe (2024). Skadeforebygging kne .
• Myklebust, Grethe (2024). Nevromuskulær trening.
• Myklebust, Grethe & Møller, Merete (2024). 87 international championship medals and 25 years later – present state of injury prevention in handball 2024 with future perspectives.
• Bjørndal, Christian Thue; Myklebust, Grethe; Møller, Merete & Grindem, Hege (2024). Unveiling the significance of sociocultural dynamics in youth sport injury research: a comprehensive narrative review.
• Sjølie, Emilie Scholten; McKay, Carly; Gjesdal, Siv; Grindem, Hege; Myklebust, Grethe & Bjørndal, Christian Thue [Show all 7 contributors for this article] (2024). Targeting injury prevention behavior in youth handball and football: perspectives from 528 players and 337 coaches - a cross sectional study.
• Sjølie, Emilie Scholten; McKay, Carly; Gjesdal, Siv; Grindem, Hege; Myklebust, Grethe & Bjørndal, Christian Thue [Show all 7 contributors for this article] (2024). Injury prevention behavior in youth handball and football: perspectives from 528 players and 337 coaches - a cross sectional study.
• Sjølie, Emilie Scholten; Møller, Merete; Grindem, Hege; Myklebust, Grethe & Bjørndal, Christian Thue (2023). Injury prevention and injury prevention behavior in youth handball and football.
• Hausken-Sutter, Solveig Elisabeth Sand; Bjørndal, Christian Thue; Myklebust, Grethe; Møller, Merete & Grindem, Hege (2023). Gjennomførbarhetsstudie - metode og resultat.
• Bjørndal, Christian Thue; Myklebust, Grethe; Møller, Merete & Grindem, Hege (2023). Gjennomførbarhetsstudie - metode og resultat.
• Møller, Merete; Grindem, Hege; Bjørndal, Christian Thue & Myklebust, Grethe (2023). Injury prevention and injury prevention behavior in youth handball and football.
• Myklebust, Grethe (2023). Barriers to ACL prevention programs and how to overcome them.
• Myklebust, Grethe (2023). The athlete experience of ACLR rehabilitation.
• Tveiten, Caroline Emilie Van Woensel Ko; Jakobsen, Rune Bruhn; Bache-Mathiesen, Lena Kristin; Persson, Andreas; Myklebust, Grethe & Engebretsen, Lars [Show all 7 contributors for this article] (2023). Kommer utøvere på alle nivåer tilbake til vridningsidrett etter ACL rekonstruksjon?
• Øverland, Maja Sterlin; Myklebust, Grethe; Harøy, Joar & Heiestad, Hege (2023). Skadefri-klubbkveld! Kunnskap om og bruk av skadeforebygging etter deltakelse på klubbkveld.
• Tveiten, Caroline Emilie Van Woensel Ko; Jakobsen, Rune Bruhn; Bache-Mathiesen, Lena Kristin; Persson, Andreas; Myklebust, Grethe & Engebretsen, Lars [Show all 7 contributors for this article] (2023). Kommer utøvere på alle nivåer tilbake til vridningsidrett etter ACL rekonstruksjon?
• Moen, Christian; Myklebust, Grethe; Munkvold, Emilie; Hägglund, Martin; Bahr, Roald & Møller, Merete [Show all 8 contributors for this article] (2023). Hvorfor virker de? Effektmekanismer i skadeforebyggende programmer i fotball og håndball.
• Moseid, Christine Holm; Myklebust, Grethe & Møller, Merete (2023). Den kvinnelige idrettsutøveren. Trening, helse og prestasjon. In Sandbakk, Øyvind Bucher; Solli, Guro Strøm & Staff, Hanne Cesilie (Ed.), Den kvinnelige idrettsutøveren. Fagbokforlaget. ISSN 9788245036930. p. 93–102.
• Sjølie, Emilie Scholten; McKay, Carly; Gjesdal, Siv; Grindem, Hege; Myklebust, Grethe & Bjørndal, Christian Thue [Show all 7 contributors for this article] (2023). Similar injury prevention behavior in youth handball and football: a cross-sectional study of 865 coaches and players.
• Bahr, Roald & Myklebust, Grethe (2023). The Oslo Sports Trauma Research Centre (OSTRC).
• Myklebust, Grethe (2023). Ikke-operativ behandling ved skulderlidelser.
• Myklebust, Grethe (2023). Ikke-operativ behandling ved ACL-ruptur.
• Myklebust, Grethe (2023). Skadeforebygging kne.
• Myklebust, Grethe (2023). Nevromuskulær trening.
• Myklebust, Grethe (2023). Idrettskader - kjønnsforskjeller - hvordan forebygge?
• Myklebust, Grethe (2022). Akutte skader - kan de forebygges?
• Moseid, Christine Holm; Myklebust, Grethe & Heiestad, Hege (2022). Skadefri-ambassadøropplæring.
• Moseid, Christine Holm; Heiestad, Hege; Jakhelln, Emilie Bratt & Myklebust, Grethe (2022). Nærmere best - et undervisningsverktøy for toppidrettskolene.
• Myklebust, Grethe & Heiestad, Hege (2022). Skadefri-ambassadør-utdanning.
• Heiestad, Hege & Myklebust, Grethe (2022). Skadefri ambassadørutdanning.
• Moseid, Christine Holm; Jakhelln, Emilie Bratt & Myklebust, Grethe (2022). Skadefri-ambassadør-opplæring.
• Hausken, Solveig Elisabeth Sand; Bjørndal, Christian Thue; Myklebust, Grethe; Møller, Merete & Grindem, Hege (2022). Sosiale og kulturelle forhold kan påvirke idrettsskader.
• Moen, Christian; Myklebust, Grethe; Hagglund, Martin; Bahr, Roald; Møller, Merete & Bjørndal, Christian Thue [Show all 7 contributors for this article] (2022). Biomedisinsk perspektiv på skadeforebygging.
• Sjølie, Emilie Scholten; Gjesdal, Siv; McKay, Carly; Grindem, Hege; Myklebust, Grethe & Bjørndal, Christian Thue [Show all 7 contributors for this article] (2022). Holdninger og atferd: skader og skadeforebygging.
• Myklebust, Grethe (2022). Forebygging av kneskader i idrett - tips til klinikerne.
• Myklebust, Grethe & Moseid, Christine Holm (2022). Hvordan skaper vi mer robuste spillere junior-senior?
• Myklebust, Grethe & Moseid, Christine Holm (2022). Implementering - spredning av sikringskost - spredning av kunnskap og bruk av kunnskap.
• Myklebust, Grethe & Moseid, Christine Holm (2022). Unge utøvere -NB! - et utviklingsverktøy for trenere .
• Myklebust, Grethe & Moseid, Christine Holm (2022). Forebyggende trening i håndball - hva funker - "hard facts".
• Myklebust, Grethe & Moseid, Christine Holm (2022). Tall og tips - håndballforskning - hvor står vi i dag?
• Myklebust, Grethe (2022). Primary prevention in handball and soccer - how can we prevent injuries in female athletes?
• Heiestad, Hege; Myklebust, Grethe; Funnemark, Kaja & Moseid, Christine Holm (2022). Closing the gap on injury prevention: the Oslo Sports Trauma Research Centre four-platform model for translating research into practice. British Journal of Sports Medicine. ISSN 0306-3674. 56(9), p. 482–483. doi: 10.1136/bjsports-2021-104998.
• Myklebust, Grethe (2022). Ikke-operativ behandling ved skulderlidelser.
• Myklebust, Grethe (2022). Ikke-operativ behandling ved ACL ruptur.
• Myklebust, Grethe (2022). Skadeforebygging kne.
• Myklebust, Grethe (2022). Nevromuskulær trening.
• Fredriksen, Hilde; Cools, Ann & Myklebust, Grethe (2021). Er et kort styrketreningsprogram for skulderens utadrotatormuskulatur, gjennomført som en del av håndballtreningen, tilstrekkelig for å øke den muskulære styrken hos unge håndballspillere?
• Fredriksen, Hilde; Cools, Ann; Bahr, Roald & Myklebust, Grethe (2021). Does the Oslo Sports Trauma Research Center shoulder injury prevention program affect the risk factors external rotation strength and internal rotation range of motion? A randomized controlled study among adolescent handball players . British Journal of Sports Medicine. ISSN 0306-3674. 55. doi: 10.1136/bjsports-2021-IOC.16.
• Liaghat, Behnam; Bencke, Jesper; Zebis, Mette K.; Sørensen, Henrik; Myklebust, Grethe & Wedderkopp, Niels [Show all 7 contributors for this article] (2021). Shoulder rotation strength changes from preseason to midseason - a cohort study of 292 youth elite handball players without shoulder problems. British Journal of Sports Medicine. ISSN 0306-3674. 55. doi: 10.1136/bjsports-2021-IOC.73.
• Liaghat, Behnam; Bencke, Jesper; Zebis, Mette K.; Sørensen, Henrik; Myklebust, Grethe & Wedderkopp, Niels [Show all 8 contributors for this article] (2021). Shoulder rotation strength changes from preseason to midseason: a cohort study of 292 youth elite handball players without shoulder problems.
• Fredriksen, Hilde; Cools, Ann; Bahr, Roald & Myklebust, Grethe (2021). Does the Oslo Sports Trauma Research Center shoulder injury prevention program affect the risk factors external rotation strength and internal rotation range of motion?
• Myklebust, Grethe (2021). Injury prevention strategies for the lower extremities in handball: More than just a throwing sport! .
• Myklebust, Grethe (2021). Preventing knee injuries in female youth team sports.
• Myklebust, Grethe (2021). Ikke-operativ behandling ved skulderlidelser.
• Myklebust, Grethe (2021). Ikke-operativ behandling ved acl-ruptur.
• Myklebust, Grethe (2021). Skadeforebygging kne.
• Myklebust, Grethe (2021). Top tips for ACL injury prevention.
• Myklebust, Grethe; Grindem, Hege & Ardern, Clare (2021). Keys to success for ACL injury prevention, rehabilitation and return to sport.
• Myklebust, Grethe (2021). Injury prevention - what do we know and what do we do?
• Myklebust, Grethe (2021). Hvordan holde spillere skadefri?
• Myklebust, Grethe (2021). Smerte og trenings-/idrettsskader .
• Myklebust, Grethe (2020). Prevention & rehabilitation of knee injuries. Prevention of shoulder injuries in Handball Players .
• Myklebust, Grethe (2020). Return to Play in Elite Sport.
• Myklebust, Grethe (2020). Nevromuskulær trening.
• Grindem, Hege & Myklebust, Grethe (2020). Be a champion for your athlete's health. Journal of Orthopaedic and Sports Physical Therapy. ISSN 0190-6011. 50(4), p. 173–175. doi: 10.2519/jospt.2020.0605.
• Myklebust, Grethe (2020). Chair: Athlete health - The alarm bells are ringing!
• Myklebust, Grethe (2020). Skadeforebygging kne.
• Myklebust, Grethe (2020). Ikke-operativ behandling ved skulderlidelser.
• Myklebust, Grethe (2020). Chair: Fra idrettsskader til forebygging til formidling.
• Myklebust, Grethe (2020). Håndballforskning på NIH.
• Fredriksen, Hilde; Myklebust, Grethe & Cools, Ann (2021). Prevention of shoulder injuries in handball - the challenge of implementation of preventive measures. Norges idrettshøgskole.
• Myklebust, Grethe & Kjærgaard, Oda (2021). ACL-skader i norsk topphåndball i perioden 1989-2017, - omfang og omstendigheter . Norges idrettshøgskole.
• Moseid, Christine Holm; Myklebust, Grethe & Strømholt, Ingjerd (2021). Bruk av SKADEFRI og skadeforebyggende trening før, rett etter og tre måneder etter deltagelse på klubbkveld i regi av SKADEFRI - en deskriptiv studie . Norges idrettshøgskole.
• Myklebust, Grethe; Moksnes, Håvard & Smevik, Martin (2021). Forsikringsregistrerte skader i fotball . Norges idrettshøgskole.
• Myklebust, Grethe; Fredriksen, Hilde & Sivertsen, Ewa (2021). Skade og sykdom blant pre-profesjonelle og profesjonelle, ballett- og moderne dansere; en litteraturstudie . Norges idrettshøgskole.
• Myklebust, Grethe & Nergaard, Kristine (2021). Skadeforekomst i norsk friidrett, gymnastikk og turn og svømming - en gjennomgang og sammenligning av forsikringsrapporterte skader . Norges idrettshøgskole.
• Myklebust, Grethe & Kristensen, Signe (2021). Forsikringsregistrerte håndballskader i Norge, i perioden 2012-2020 . Norges idrettshøgskole.
• Moseid, Christine Holm; Myklebust, Grethe & Eriksen, Marit R. (2021). Kunnskap om og bruk av skadeforebyggende trening blant norske håndball- og fotballtrenere for ungdom - en tverrsnittstudie . Norges idrettshøgskole.
• Myklebust, Grethe; Moksnes, Håvard & Eikbu, Simen Schei (2021). Fysisk prestasjonsnivå i 40 meter sprint, retningsforandringer og spenst hos kvinnelige fotballspillere i Toppserien . Norges idrettshøgskole.

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