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First published on February 21, 2006, doi:10.1177/0363546505284848
This version was published on May 1, 2006
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The American Journal of Sports Medicine 34:840-849 (2006)
© 2006 American Orthopaedic Society for Sports Medicine

Clinical Sports Medicine Update

Wrist Pain, Distal Radial Physeal Injury, and Ulnar Variance in the Young Gymnast

John P. DiFiori, MD*,{dagger}, Dennis J. Caine, PhD{ddagger} and Robert M. Malina, PhD, FACSM§

From the {dagger} Division of Sports Medicine, Department of Family Medicine, University of California, Los Angeles, Los Angeles, California, the {ddagger} Department of Physical Education, Health and Recreation, Western Washington University, Bellingham, Washington, and § Tarleton State University, Stephenville, Texas

* Address correspondence to John P. DiFiori, MD, Division of Sports Medicine, Department of Family Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 725, Los Angeles, CA 90266 (e-mail: jdifiori{at}mednet.ucla.edu).

In gymnastics, the wrist joint is subjected to repetitive loading in a weightbearing fashion. In this setting, chronic wrist pain is quite common. Because gymnasts ordinarily enter the sport at very young ages and train for several years before skeletal maturity is attained, the growth plates of the wrist are at risk for injury. In addition, imaging studies have identified evidence of injury to the distal radial physis and the development of positive ulnar variance. Recent studies provide more information on the relationships between these findings, as well as factors that may predispose some gymnasts to wrist pain. This article provides a comprehensive review of these issues and offers suggestions for management, preventive measures, and future research.

Key Words: wrist pain • physis • ulnar variance • gymnastics • growth plate






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