From the Guidelines
Gymnast wrist, a stress injury affecting the growth plate at the distal radius in young gymnasts, should be treated with rest from weight-bearing activities on the wrists for 4-6 weeks, followed by a gradual return to gymnastics over another 4-6 weeks, as recommended by recent guidelines 1. The treatment approach for gymnast wrist involves a combination of rest, ice application, pain management with over-the-counter medications like ibuprofen (200-400mg every 6-8 hours with food), and the use of wrist splints or braces to manage symptoms.
- Key aspects of treatment include:
- Rest from weight-bearing activities to reduce stress on the growth plate
- Ice application for 15-20 minutes several times daily to reduce pain and inflammation
- Pain management with ibuprofen
- Use of wrist splints or braces for support
- Physical therapy is also crucial for recovery and prevention, focusing on wrist strengthening and proper technique to minimize the risk of recurrence and long-term complications. The condition occurs due to repetitive weight-bearing on outstretched hands during gymnastics, creating excessive compression forces on the growth plates, which are weaker than surrounding bone in growing children, as discussed in studies on overuse injuries in skeletally immature gymnasts [1, Dwek et al., 2009].
- Prevention strategies are essential and include:
- Proper technique training
- Adequate warm-up routines
- Limiting training hours appropriate to age and skill level
- Using wrist supports during practice to reduce the risk of injury.
From the Research
Gymnast Wrist Injuries
- Gymnast wrist injuries are common due to the repetitive motion, high impact loading, axial compression, torsional forces, and distraction in varying degrees of ulnar or radial deviation and hyperextension that the wrist is exposed to during gymnastic activities 2.
- The most common gymnastic wrist conditions include distal radius stress injuries, scaphoid impaction syndrome, dorsal impingement, scaphoid fractures, scaphoid stress reactions/fractures, capitate avascular necrosis, ganglia, carpal instability, triangular fibrocartilage complex tears, ulnar impaction syndrome, and lunotriquetral impingement 2.
- Injury rates among gymnasts are among the highest of any sport at the high school and collegiate level per athletic exposure, with the wrist having increased injury risk due to repetitive physical stresses predisposing it to acute injury, overuse, and degenerative damage 3.
Prevention and Management
- Prompt evaluation and management is necessary to avoid the negative sequelae that can often accompany these injuries 3.
- General guidelines for overuse injury prevention include limiting excessive loading of the wrist, maintaining wrist joint flexibility, an emphasis on proper technique, and incorporating wrist and general core strengthening 3.
- A wrist brace can be an effective way to decrease wrist pain while performing gymnastics, with one study showing a significant reduction in pain (P = .002; 53.5%) while wearing the braces for training on the pommel, floor, and parallel bars 4.
Long-term Effects
- The chronic injuries are due to repetitive loading of the musculoskeletal system, and their incidence rises as participation and level of competition rises 5.
- More attention needs to be directed toward prevention, but many of these injuries seem to be inherent to the sport as it transforms the upper extremities into weight-bearing limbs 5.
- Follow-up evaluation after skeletal maturity and retirement from active participation is needed to elucidate the long-term effect of gymnastics on the wrist 5.