We do a lot of work with Gymnasts at the Apex Centre. Gymnast wrist, or distal radius epiphysitis, is a repetitive use injury most commonly seen in young gymnasts. As many as 80 percent of young gymnasts will suffer chronic wrist pain at some point due to the load being placed on the wrist when tumbling, vaulting, and working on routines requiring an apparatus. The condition is directly related to age — the younger the child is when training begins, the greater the likelihood will be of developing the condition.
What Is Gymnast Wrist?
Gymnast wrist is painful inflammation on the thumb side of the wrist due to repetitive weight-bearing on the hands when the wrist is extended. Having the wrist in this position jams the growth plate to the carpal bones in the wrist, leading to pain. The growth plate is the area at the end of long bones that bone grows from.
In children this area is soft and cartilaginous and therefore more prone to damage. With repetitive loads on this growth plate, growth of the radius may be stunted, causing it to be shorter than the ulna. When this happens, the ulna now bears more weight than the radius, leading to chronic pain in the wrist.
The young gymnast will usually develop this problem either when he or she increases training intensity or more commonly after moving to a higher competitive level. The more impact activities (tumbling and vaulting) performed during training, the more potential trauma seen at the growing wrist. Besides pain, the young gymnast may notice swelling or a reduced range of motion at the wrist.
Cause And Symptoms of Gymnast Wrist
The condition is caused by repetitive jamming of the growth plate against the carpals, and occurs when the wrist is placed in it’s closed packed position (full wrist extension) and the joint is weight-bearing, such as with vaulting, and tumbling.
In technical terms, the growth plate at the end of the radius is getting jammed up against the carpal bones of the wrist, most prominently the scaphoid and lunate. Pain and Inflammation can take place in one or all of these structures.
Detection and Treatment
Gymnast wrist has a distinctive x-ray signature, with the growth plate appearing widened and the borders appearing poorly defined. In more severe cases there can be evidence of stunted growth plate progression. By far the greatest risk with this kind of condition is permanent growth loss in the affected bones.
Early detection and recognition is key to minimizing the long-term effects of compromising the growth plate. If left untreated and the athlete chooses to push through pain, the growth of the radius may be stunted.
Rest is essential in treating gymnast wrist, specifically the discontinuation of any weight-bearing activity associated with the wrist. Stopping the repeated wrist trauma associated with weight-bearing activities gives the affected bones and chance to recover before permanent damage occurs. In some cases it may be necessary to cast the wrist of a young gymnast in order to completely deter them from weight-bearing activities. During the rest period pain management and supervised exercise progression can begin and will help to speed recovery.
How Apex Can Help
Treatment for gymnast wrist involves conservative methods aimed at resting the joint and reducing inflammation. Once pain is under control, the athlete’s range of motion can be restored. Our team will create a progressive, individualized exercise plan to regain strength and build confidence.
The health professionals at the Apex Centre have had specific experience treating gymnasts. If your young gymnast has experienced wrist pain over a sustained period of time we may be able to help.
Therapies utilized may include: