Wrist injury prevention and treatment
The opinions of some sports medicine specialists who have long studied wrist injuries in gymnasts are summarized below with respect to injury prevention and clinical management. Perhaps the best recent articles on the subject are these:
- DiFiori JP, Caine DJ, Malina RM. Wrist pain, distal radial physeal injury, and ulnar variance in the young gymnast. Am J Sports Med. 2006 May;34(5):840-9.
- DiFiori JP. Overuse injury and the young athlete: the case of chronic wrist pain in gymnasts. Curr Sports Med Rep. 2006 Jun;5(4):165
The authors suggest several preventive measures, including these:
- decrease training loads and skill progressions during periods of rapid growth (for many girls that's about age 12; these authors suggest measuring the athlete every three months, and moderating training during the growth spurt)
- increase in training should not occur in a stepwise progressive manner (training should cycle)
- early detection and treatment
- knowledgeable personnel (e.g. athletic trainers) should be available to assist gymnasts
These authors state that there are no direct data on the effect of bracing regarding protection from repetitive loading, but they note that it is plausible that by reducing loading across the joint, bracing could be beneficial.
It may be that many gymnasts consider use of wrist supports only when the situation has already progressed pretty far. (Although DiFiori's studies show that half of young, beginning to midlevel gymnasts experience wrist pain of at least six months duration, very few of those injured kids ever see a physician for their wrist injuries. In studies of young, nonelite gymnasts 5 to 16 years of age, 42% to 63% of gymnasts with wrist pain reported that the symptoms caused them to limit workouts or reduce training time.) By then, simply adding
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If these specialists in adolescent sports injuries are correct that wrist pain in gymnasts is caused by overuse, there seems to be little evidence to support the idea that wrist pain is caused by weak wrists, or that strengthening the wrists will solve the problem; similarly, there seems to be little support for the idea that wearing
Link Removed will weaken the wrists and lead to further problems.
Instead, these specialists draw on two decades of study of gymnastic wrist injuries to offer some recommendations for clinical management of gymnastics-related wrist pain:
- gymnasts with persistent or recurrent wrist pain should be evaluated by a sports medicine specialist who is familiar with gymnastics
- avoid doing what hurts
- consider taking some time off (six weeks if there is radiographic evidence of injury)
- reduce training volume; slowly return to the former level, adding last those elements that had formerly caused pain
These recommendations
do not include continuing training at the injured gymnast's current training volume while either adding wrist braces or performing wrist exercises.