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What is Gymnast Wrist ?
- Gymnast Wrist is an injury involving a growth plate in the forearm. A growth plate is an area of cartilage that is replaced by bone after a child reaches young adulthood and stops growing.
- Gymnast Wrist involves the growth plate that connects the wrist to the forearm bone on the thumb side of the hand (radius). It happens when this growth plate gets inflamed and irritated from stress or overuse. The condition can cause the growth plate to widen, close, or stop growing, which can result in deformity.
- Gymnast Wrist is also called Wrist epiphysitis.
- Gymnast wrist is an overuse injury (from chronic pressure on joints). Physeal widening, metaphyseal irregularity, and sclerosis can be seen.
- Early physeal bridging and radius growth disturbance may occur if not treated.
What is the equivalent of gymnast wrist in the shoulder?
- Little leaguer’s shoulder is an overuse injury in throwers. Subtle findings, similar to gymnast wrist, may be seen on MRI.
What are the causes?
- Gymnast Wrist is caused by activities that put a lot of stress on the wrists, such as gymnastic tumbling and vaulting.
What increases the risk of Gymnast Wrist?
Your child may be at greater risk of Gymnast Wrist if he or she is:
- A gymnast.
- A weight lifter.
What are the symptoms of Gymnast Wrist?
Symptoms of Gymnast Wrist include:
- Pain.
- Weakness.
- Tenderness to the touch.
- Swelling.
- Limited movement of the wrist.
- Inability to put pressure on the wrist.
You may notice that your child changes his or her form or technique to cope with the injury.
Children with Gymnast Wrist sometimes lose interest in their sport or avoid practice.
How is this diagnosed?
Gymnast Wrist can be diagnosed based on:
- Your child’s symptoms.
- Your child’s medical history.
- A physical exam.
- Tests,
such as:
- An X-ray. This may be done to rule out a broken bone (fracture).
- A CT scan. This may be done to look for other injuries.
- An MRI. This may be done to rule out injuries to soft tissue.
How is Gymnast Wrist treated?
Gymnast Wrist may be treated with:
- Rest. Your child may be asked to avoid any activities that put weight or pressure on the wrist for at least 4 weeks.
- Ice and elevation. Icing the wrist can help to ease swelling and pain. Raising the wrist above the heart helps reduce swelling.
- A cast or splint. Wearing a cast or splint keeps the wrist from moving while it heals. It also forces your child to avoid putting pressure on the wrist.
- Physical therapy. Physical therapy helps strengthen the wrist and restore range of motion.
- Medicine. Your child’s health care provider may prescribe anti-inflammatory medicines, like ibuprofen, to reduce pain and swelling.
Follow these instructions at home:
If your child has a splint:
- Have your child wear it as told by your child’s health care provider. Remove it only as told by your child’s health care provider.
- Loosen the splint if your child’s fingers tingle, become numb, or turn cold and blue.
- Do not let your child’s splint get wet if it is not waterproof.
- Keep the splint clean.
If your child has a cast:
- Do not let your child stick anything inside the cast to scratch his or her skin. Doing that increases his or her risk of infection.
- Check the skin around the cast every day. Tell your child’s health care provider about any concerns.
- You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
- Do not let your child’s cast get wet if it is not waterproof.
- Keep the cast clean.
Managing pain, stiffness, and swelling
- If
directed, apply ice to the injured area.
- Put ice in a plastic bag.
- Place a towel between your child’s skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times a day.
- Have your child gently move his or her fingers often to avoid stiffness and to lessen swelling.
- Have your child raise (elevate) the wrist above the level of the heart while sitting or lying down.
- Give over-the-counter and prescription medicines only as told by your child’s health care provider.
Activity
- Your child should return to normal activities as told by his or her health care provider. Ask your child’s health care provider what activities are safe for your child.
- Have your child do exercises as told by his or her health care provider.
General instructions
- Do not let your child put pressure on any part of the cast until it is fully hardened. This may take several hours.
- Do not allow your child to use the injured limb to support his or her body weight until your child’s health care provider approves.
- If your child’s cast or splint is not waterproof, cover it with a watertight covering when he or she takes a bath or a shower.
- Keep all follow-up visits as told by your child’s health care provider. This is important.
How is Gymnast Wrist prevented?
To prevent Gymnast Wrist from developing again, make sure your child:
- Warms up and stretches before being active.
- Cools down and stretches after being active.
- Gives his or her body time to rest between periods of activity.
- Uses equipment that fits him or her.
- Acts safely and responsibly while being active to avoid falls.
- Eats a healthy diet and drinks plenty of fluids to help the body recover after physical activity.
- Uses properly maintained safety gear and equipment when playing sports. Gymnasts should use hand grips, wrist guards, and braces. They should also train in facilities that have proper floor padding.
- Maintains
physical fitness, including:
- Strength.
- Flexibility.
- Cardiovascular fitness.
- Endurance.
Contact a health care provider if:
- Your child’s wrist pain and swelling does not get better or it gets worse.
Get help right away if:
- Your child cannot move his or her wrist due to pain.
Gymnast Wrist Rehabilitation
Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do notbegin these exercises until told by your health care provider.
Strengthening exercises
These exercises build strength and endurance in your wrist. Endurance is the ability to use your muscles for a long time, even after they get tired.
Exercise A: Wrist flexion
- Sit with your left / right forearm supported on a table and your hand resting palm-up over the edge of the table.
- Hold a few kilograms of weight in your left / right hand. Or, hold a rubber exercise band or tube in both hands. Your other hand will hold the band and provide resistance. Take up slack so there is a slight tension in the exercise band or tube when you start.
- Slowly move your palm up toward your forearm.
- Hold this position for a few seconds.
- Slowly lower your hand back to the starting position.
Repeat a few times. Complete this exercise a few times a day.
Exercise B: Wrist extension
- Sit with your left / right forearm supported on a table and your hand resting palm-down over the edge of the table.
- Hold a few kilograms weight in your left / right hand. Or, hold a rubber exercise band or tube in both hands. Your other hand will hold the band and provide resistance. Take up slack so there is a slight tension in the exercise band or tube when you start.
- Slowly move the back of your hand up toward your forearm. If you have any discomfort, stop this motion early each time, with the goal of no pain.
- Hold this position for a few seconds.
- Slowly lower your hand to the starting position.
Repeat a few times. Complete this exercise a few times a day.
Exercise C: Ulnar deviation
- Sit with your left / right forearm supported and your thumb facing up. Your hand should be able to move down over the table edge.
- Hold your other arm in front of you and a rubber exercise band or tube between your hands. There should be a slight tension in the exercise band or tube when you start.
- Move your left / right wrist so your pinkie travels toward the floor. Try to move only your hand and wrist and keep the rest of your arm still.
- Hold this position for a few seconds.
- Slowly return your wrist to the starting position.
Repeat a few times. Complete this exercise a few times a day.
Exercise D: Hand turns, pronated
- Sit with your left / right forearm supported on a table or other surface, with your hand resting face-up over the edge of the table.
- Hold a hammer in your left / right hand. The closer your hand is to the head of the hammer, the easier the exercise will be.
- Without moving your elbow, slowly turn your palm and hand down toward the table.
- Slowly return to the starting position.
Repeat a few times. Complete this exercise a few times a day.
Exercise E: Hand turns, supinated
- Sit with your left / right forearm supported on a table or other surface.
- Hold a hammer in your left / right hand. The closer your hand is to the head of the hammer, the easier the exercise will be.
- Rest your hand over the edge of the table with your palm facing down.
- Without moving your elbow, slowly turn your palm and hand up toward the ceiling.
- Slowly return to the starting position.
Repeat a few times. Complete this exercise a few times a day.