Gymnast’s Wrist

  • Elspeth Ashley V. Hart
  • Kate W. NellansEmail author
Part of the Contemporary Pediatric and Adolescent Sports Medicine book series (PASM)


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.


Gymnast wrist Distal radial physeal stress syndrome Ulnar impaction syndrome Ulnocarpal abutment Grip lock Dorsal wrist impingement 


  1. 1.
    Hecht SS, Burton M. Medical coverage of gymnastics competitions. Curr Sports Med Rep. 2009;8(3):113–8.CrossRefGoogle Scholar
  2. 2.
    USA Gymnastics. Start here, go anywhere. 2017. [Cited 2017 August 10th].
  3. 3.
    Webb BG, Rettig LA. Gymnastic wrist injuries. Curr Sports Med Rep. 2008;7(5):289–95.CrossRefGoogle Scholar
  4. 4.
    Chawla A, Wiesler ER. Nonspecific wrist pain in gymnasts and cheerleaders. Clin Sports Med. 2015;34(1):143–9.CrossRefGoogle Scholar
  5. 5.
    Poletto ED, Pollock AN. Radial epiphysitis (aka gymnast wrist). Pediatr Emerg Care. 2012;28(5):484–5.CrossRefGoogle Scholar
  6. 6.
    Caine DJ, Maffulli N. Epidemiology of pediatric sports injuries. Basel, Switzerland: Karger Medical and Scientific Publishers; 2005.CrossRefGoogle Scholar
  7. 7.
    Overlin A, Chima B, Erickson S. Update on artistic gymnastics. Curr Sports Med Rep. 2011;10(5):304–9.CrossRefGoogle Scholar
  8. 8.
    Caine D, Roy S, Singer KM, Broekhoff J. Stress changes of the distal radial growth plate: a radiographic survey and review of the literature. Am J Sports Med. 1992;20(3):290–8.CrossRefGoogle Scholar
  9. 9.
    DiFiori JP, Puffer JC, Aish B, Dorey F. Wrist pain in young gymnasts: frequency and effects upon training over 1 year. Clin J Sport Med. 2002;12(6):348–53.CrossRefGoogle Scholar
  10. 10.
    Mandelbaum BR, Bartolozzi AR, Davis CA, Teurlings L, Bragonier B. Wrist pain syndrome in the gymnast: pathogenetic, diagnostic, and therapeutic considerations. Am J Sports Med. 1989;17(3):305–17.CrossRefGoogle Scholar
  11. 11.
    DiFiori JP, Puffer JC, Aish B, Dorey F. Wrist pain, distal radial physeal injury, and ulnar variance in young gymnasts: does a relationship exist? Am J Sports Med. 2002;30(6):879–85.CrossRefGoogle Scholar
  12. 12.
    DiFiori JP, Caine DJ, Malina RM. Wrist pain, distal radial physeal injury, and ulnar variance in the young gymnast. Am J Sports Med. 2006;34(5):840–9.CrossRefGoogle Scholar
  13. 13.
    Keller MS. Gymnastics injuries and imaging in children. Pediatr Radiol. 2009;39(12):1299.CrossRefGoogle Scholar
  14. 14.
    Marshall S, Covassin T, Dick R, Nassar L, Agel J. Descriptive epidemiology of collegiate women’s gymnastics injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train. 2007;42(2):234.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Guerra MRV, Estelles JRD, Abdouni YA, Falcochio DF, Rosa JRP, Catani LH. Frequency of wrist growth plate injury in young gymnasts at a training center. Acta Ortopedica Bras. 2016;24(4):204–7.CrossRefGoogle Scholar
  16. 16.
    De Smet L, Claessens A, Lefevre J, Beunen G. Gymnast wrist: an epidemiologic survey of ulnar variance and stress changes of the radial physis in elite female gymnasts. Am J Sports Med. 1994;22(6):846–50.CrossRefGoogle Scholar
  17. 17.
    Bezek EM, VanHeest AE, Hutchinson DT. Grip lock injury in male gymnasts. Sports Health. 2009;1(6):518–21.CrossRefGoogle Scholar
  18. 18.
    Amaral L, Claessens A, Ferreirinha J, Maia J, Santos P. Does ulnar variance change with age and what is the influence of training and biological characteristics in this change? A short-term longitudinal study in Portuguese artistic gymnasts. Clin J Sport Med. 2014;24(5):429–34.CrossRefGoogle Scholar
  19. 19.
    Caine D, Howe W, Ross W, Bergman G. Does repetitive physical loading inhibit radial growth in female gymnastics. Clin J Sport Med. 1997;7(4):302–8.CrossRefGoogle Scholar
  20. 20.
    Samuelson M, Reider B, Weiss D. Grip lock injuries to the forearm in male gymnasts. Am J Sports Med. 1996;24(1):15–8.CrossRefGoogle Scholar
  21. 21.
    Wolfe MR, Avery D, Wolfe JM. Upper Extremity Injuries in Gymnasts. Hand clinics. 2017;33(1):187–97.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Sports Medicine/OrthopedicsBoston Children’s HospitalBostonUSA
  2. 2.Department of Orthopedic SurgeryNorthwell Health, Hofstra-Northwell Medical SchoolGreat NeckUSA

Personalised recommendations