Overuse injury and the young athlete: the case of chronic wrist pain in gymnasts

Conclusions

Chronic wrist pain in young gymnasts is an example of an overuse injury that can affect the physis. Yet, it remains unclear the extent to which this injury results in altered growth of the wrist leading to positive ulnar variance and its sequelae. Although these findings are unique to young gymnasts, there are several other examples of similar overuse injuries involving the physis including those of the proximal humerus, proximal tibia, and distal femur. In addition to these clinical descriptions, basic science studies have also described the negative effects of high intensity loading on immature bone.

The data summarized above provide a clinical model that an important issue that surrounds intensive training of skeletally immature athletes. Though the data remain somewhat limited, they highlight the important role of training intensity and the vulnerable period of the adolescent growth spurt in the genesis of overuse injuries. Further studies are needed to determine the long-term consequences of these findings, and also to delineate speci.c preventive measures, such as the modi.cation of training during periods of rapid growth, that will reduce the occurrence of overuse injuries in young athletes.