Gymnast’s Wrist

Abstract

Gymnastics is a unique sport as the wrist becomes a weight-bearing joint. Gymnasts may train at an elite level prior to skeletal maturity, placing the gymnast’s wrist at risk for a specific group of disorders. Chronic overload of an immature distal radius can lead to inflammation of the distal radius physis, resulting in “gymnast wrist.” If not properly treated, this can cause growth arrest of the radius and overgrowth of the ulna, leading to ulnar impaction syndrome. Additionally, gymnasts may suffer chronic dorsal wrist pain, often due to repetitive wrist hyperextension, dorsal capsular impingement, and posterior interosseous nerve irritation. Acutely, the use of poorly fitting dowel grips can cause “grip lock,” resulting in forearm fractures. This chapter will discuss the etiology of conditions specifically affecting a gymnast’s wrist, physical exam findings, appropriate imaging, and treatment options. Additionally, guidelines for returning a gymnast to upper extremity weight-bearing activities are suggested.