Gymnast's Wrist

Gymnast’s wrist is an overuse injury among gymnasts with open growth plates caused by the repeated compression and loading of wrists during practice and competition.

There are two bones in the forearm: the radius and the ulna. Each of these bones have growth plates, softer areas of cartilage where bone growth takes place. Until the growth plates harden into solid bone, they are especially vulnerable to injury. Gymnast’s wrist is a stress fracture of the growth plate of the radius.

If caught early, gymnast’s wrist can heal with rest and immobilization. But ignoring wrist pain and continuing to strain the wrists can lead to more serious injury. For instance, continuing to practice with gymnast’s wrist can cause the radius to stop growing while the ulna continues to grow, a serious and painful condition that may require surgery. 

Gymnast’s wrist is also sometimes accompanied by other injuries, such as a tear of the triangular fibrocartilage complex (TFCC), the cartilage that supports and stabilizes the wrist.

Athletes are most vulnerable to gymnast’s wrist during growth spurts. Not surprisingly, this injury is most common among gymnasts around the ages of 10 to 12. However, older adolescents can develop gymnast’s wrist as well.

Moving up a level, practicing more difficult skills, and suddenly increasing training time or intensity can also put athletes at risk of gymnast’s wrist.

Do not ignore wrist pain — see a sports medicine clinician for a diagnostic exam.

While it’s not unusual to feel sore after a gymnastics practice, wrist pain that persists from practice to practice should be examined by an orthopedic or sports medicine clinician.

Gymnast’s wrist begins as pain on the thumb side of the wrist. Symptoms tend to develop over time and may include:

• Wrist tenderness
• Decreased wrist range of motion
• Wrist pain when bearing weight or when the wrist is extended (bent backward)
• Swelling and inflammation
• Decreased grip strength

Any number of gymnastics skills, such as back or front handsprings and vaulting, put the wrists under one to two-and-a-half times an athlete’s body weight (depending on the skill). The repeated impact of practicing high-impact skills over and over can cause a child’s growth plate to become injured.

Typically, a clinician can diagnose gymnast’s wrist with a physical exam and X-rays. It’s possible your child’s clinician will order an MRI, though usually this is not necessary.

When caught early, gymnast’s wrist can heal with complete rest and immobilization for four to six weeks. Your child’s clinician may put your child’s arm in a cast or splint to stabilize their wrist during this period.

More severe cases of gymnast’s wrist require longer rest periods or even surgery to rebalance the alignment of the wrist.

Once your child’s wrist is no longer tender to the touch or painful when bearing weight or hanging from a pull-up bar, they can begin physical therapy to rebuild wrist strength and mobility.

To help gymnasts safely return to gymnastics after recovering from gymnast’s wrist, experts in gymnastics medicine at Boston Children’s Hospital have developed a return-to-gymnastics protocol for athletes recovering from gymnastics injuries. The protocol helps gymnasts gradually rebuild strength in their wrists, arms, and shoulders to protect against future injury.

Your child’s clinician may recommend the use of wrist guards during recovery. However, it’s important to know that wrist guards do not prevent gymnast’s wrist and should only be used if recommended by a clinician who understands gymnastics and gymnastics injuries.

Yes. Proper technique and targeted exercises to strengthen the upper body can reduce the impact of gymnastics on the wrists.

Focusing on sleep, hydration, proper nutrition, and managing stress can also reduce the chance of injury in gymnastics.

Pay extra attention to wrist pain and consider reducing the number of hours per week your child practices when they’re going through a period of rapid growth.

Most importantly, have your child take a break and seek care if their wrists remain continually sore from practice to practice.

Learn more about this on our sports injury prevention website.

Boston Children’s Sports Medicine Division has the country’s first and only Gymnastics Medicine Clinic, a sport-specific clinic for the diagnosis, treatment, and prevention of gymnastics injuries.

Our sports medicine team includes physicians, orthopedic surgeons, physician assistants, nurse practitioners, physical therapists, podiatrists, athletic trainers, sports psychologists, dietitians, and many others who collaborate in every aspect of our patients’ care and recovery.
We also work closely with The Micheli Center for Sports Injury Prevention, part of the Sports Medicine Division. Through research and clinical training, The Micheli Center offers practical strategies to help injured athletes return to play stronger and healthier.