Gymnastic Wrist Injuries

Abstract

During gymnastic activities, the wrist is exposed to many different types of stresses, including repetitive motion, high impact loading, axial compression, torsional forces, and distraction in varying degrees of ulnar or radial deviation and hyperextension. Many of these stresses are increased during upper extremity weight-bearing and predispose the wrist to high rates of injury during gymnastics. Distal radius stress injuries are the most common and most documented gymnastic wrist conditions. Other conditions include scaphoid impaction syndrome, dorsal impingement, scaphoid fractures, scaphoid stress reactions/fractures, capitate avascular necrosis, ganglia, carpal instability, triangular fibrocartilage complex tears, ulnar impaction syndrome, and lunotriquetral impingement. It is important to diagnose quickly and accurately the specific injury to initiate expediently the proper treatment and limit the extent of injury. In addition, a gymnast's training regimen should also include elements of injury prevention.

The influence of hand positions on biomechanical injury risk factors at the wrist joint during the round-off skills in female gymnastics

“…Table 1 and Figure 2A and 2B show that for both techniques the second contact limb is exposed to higher load, demonstrated by a significant increase in peak wrist joint axial compressive force and loading rates. One of the most common mechanisms of wrist injuries is a compressive force applied to a dorsiflexed wrist (Webb & Rettig, 2008). From an injury perspective these observations concur with the comments of Davidson et al (2005) who stated that peak impact forces are among the fundamental injury risk factors associated with the wrist joint in gymnastics.…”

“…Gymnasts are often involved in activities requiring weight-bearing with their wrist in dorsiflexion, such as the beam, tumbling, vault, and floor routines. During these activities the wrist is exposed to mechanical stress, including repetitive motion, high impact loading, axial compression, torsional forces, hyper-dorsiflexion, ulnar and radial deviations, and is the most frequently injured site in the upper extremity of female gymnasts followed by the elbow (Webb & Rettig, 2008). Previous studies show that during gymnastics weightbearing activities expose the wrist to forces that can exceed twice body weight (BW) and loading rates up to 16 times BW (Markoff, Shapiro, Mandelbaum, & Teurling, 1990;Koh, Grabiner, & Weiker, 1992).…”

Cinemática de variáveis de técnica-chave nos flic flacs de ginastas de elite

“…Indeed, a linear back projection is important for the generation of momentum and horizontal velocity 9 . Additionally, considering that in gymnastics the upper extremities are regularly used to sustain body weight, a correct execution of all phases (above all the IHS) is necessary not only for a successful performance, but also to avoid (or reduce) macro-and micro-injuries during the execution of floor exercises 4,6,8,19,21 . Indeed, the upper limbs must amortize the body weight and instantly create a push off: thus the arm alignment become crucial to avoid additional stresses used to correct the error.…”

“…As shown by Kerwin & Trewartha 19 , wrist movements and torque are particularly important in gymnasts while reaching the handstand. In particular, even if upper extremity injuries account only for 15-25% of gymnastic injuries 4,5 , wrist pain from overuse injuries (stress fracture and distracting injury in particular), 6 appears to be very common, and to have a negative effect on gymnastic training, reducing its intensity and duration 8,21 . Lower extremity injuries account for most of gymnastic injuries (up to 70%) 4,5 : ankles, the most frequently involved joints, sustain repetitive loading during the execution of floor exercises.…”

“…The gymnasts are therefore required several hours of technical, strength, and flexibility training to obtain the best results 3 . Previous studies mostly analyzed the risk and the incidence of injuries during the execution of this closed-skill sport [4][5][6][7] , and investigated the biomechanical characteristics of several technical elements [8][9][10][11][12][13] . Also, the anthropometric and physical features of elite gymnasts have been studied 1,14 .…”