Gymnastics transforms the upper extremities into weight-bearing limbs and the wrist is frequently involved in this activity. Wrist injuries occur as a result of this load and often become chronic and recurrent if not appropriately evaluated and managed. These chronic injuries are often a consequence of overuse of the wrist and if not recognized and treated can lead to distal radius growth disturbance and premature closure of the radial epiphysis (Gymnast’s Wrist).
The radius is one of two long bones that make up the forearm. The end of the radius, which is on the thumb side, connects to the wrist joint with a small area of specialized cartilage called the physis or growth plate. The physis is the site of growth and development in children and adolescents. This area is softer than the rest of the bone and therefore susceptible to overuse injuries as the wrist is repeatedly exposed to compressive and shear forces. Gymnastics is a common sport for young athletes that is unique among impact activities in its loading requirements across the wrist. This loading predisposes the skeletally immature gymnast to overuse injury of the wrist including a condition known as Gymnast’s Wrist, or more specifically, distal radial epiphyseal stress syndrome/distal radial epiphysitis.
This overuse injury occurs as a result of repetitive compression, shear and distraction forces through the wrist during high-impact activities such as vaulting, handstands and cartwheels. The radial epiphysis is particularly vulnerable to these stresses as the extended wrist transmits a large amount of load through this region and because the physis is softer than the rest of the radius and more susceptible to microtrauma.
Symptoms include pain with wrist impact activities, swelling, and reduced wrist range of motion. If not treated promptly, the radial epiphysis may close prematurely which results in a shortening of the radius as compared to the ulna, causing the wrist to feel less stable and increasing the risk for future injury.
The clinician can diagnose this injury through a physical examination, x-rays and MRI. Treatment consists of rest from high-impact activities, activity modification and use of a rigid wrist brace that limits dorsiflexion. For patients who want to continue participating in gymnastics and other contact sports, we recommend our wrist guard for tumbling and vaulting that features a hard plastic splint that keeps the wrist in correct anatomical positioning while leaving the fingers and hands free. This provides stabilization without limiting the movement of the wrist and can be removed throughout your recovery process if you are not ready to return to full activity. This product also works great for other sports like volleyball, swimming, tennis and golf that require a strong wrist.
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