Protecting Growing Wrists in Young Gymnasts
Understand the condition, spot the warning signs early and follow evidence-based steps to keep training safe and enjoyable.
What is Gymnast’s Wrist?
Gymnast’s Wrist (Distal Radial Physeal Stress Syndrome) is an overuse injury to the growth plate at the end of the radius, the larger forearm bone on the thumb side. Repetitive weight-bearing and deep wrist extension during skills such as handstands, vaults and tumbling place forces that outstrip the tolerance of the still-soft growth plate. Up to 40 % of non-elite gymnasts experience this problem between the ages of 8 and 15.
Why does it happen?
• The growth plate is softer than bone and acts as the weak link when loads are high.
• Supporting body weight on the hands magnifies force to more than twice body weight in some skills.
• Rapid growth spurts, poor flexibility, rushed progressions and dowel grips all increase risk.
• If ignored, chronic inflammation can cause the plate to close early, leaving the ulna relatively longer and creating lifelong wrist pain.
Who is most at risk?
• Girls and boys in artistic, tumbling, cheer or parkour before growth plates close (usually 16 years).
• Athletes training more than 15 hours a week, especially after a sudden jump in hours or new skills.
• Gymnasts with limited wrist extension, weak shoulder-blade muscles or a history of wrist pain.
Early warning signs
• Aching or sharp pain on the thumb side of the wrist during or after weight-bearing skills.
• Swelling or a visible bump just below the wrist crease.
• Stiffness when trying to bend the wrist backwards or do a handstand.
• Painful “L-hold test” (supporting weight on fists, then opening palms).
How is the diagnosis made?
Doctors start with a careful history and examination, checking for tenderness over the growth plate and comparing range of movement with the other side. Standard and comparison X-rays look for growth-plate widening, sclerosis or early closure. MRI may be used in stubborn cases to see bone-marrow swelling or tiny bridges forming across the plate.
Treatment pathway
Phase 1 – Rest and healing (0–6 weeks)
• Stop all wrist weight-bearing and impact.
• Splint or cast if pain is high.
• Ice and anti-inflammatory medicine as advised.
• Maintain shoulder, spine and lower-limb conditioning.
Phase 2 – Mobility and light loading (6–12 weeks)
• Remove splint; regain near-full wrist motion.
• Begin gentle wrist and forearm strengthening with bands and putty.
• Hanging drills (straight-arm hangs, scapular pull-ups) build upper-body support without compression.
Phase 3 – Progressive weight-bearing (12–20 weeks)
• Start plank holds, pike stands and handstands against a wall.
• Limit each skill to five repetitions per session at first.
• Continue forearm and shoulder-girdle strengthening.
Phase 4 – Return to full skills (4–6 months)
• Reintroduce flight elements and vault drills gradually.
• Follow “no pain next day” rule; if sore, repeat the previous step.
• Monitor with periodic X-rays until growth plates close.
Surgery is rarely necessary and considered only when more than 50 % of the plate has closed prematurely or when significant ulnar overgrowth occurs.
Keeping wrists healthy – prevention tips
• Warm up thoroughly and stretch wrist flexors and extensors each session.
• Build shoulder-blade and core strength to share impact forces.
• Use correct hand placement and gradual skill progressions; avoid repeated “bent-arm” handstands.
• Schedule at least one full rest day a week and reduce hours during growth spurts.
• Consider supportive taping or wrist guards for high-load events.
CLINICAL PEARLS / KEY POINTS
• Wrist pain in gymnasts should never be dismissed as “normal”.
• Growth-plate widening on X-ray signals overload well before permanent damage.
• Early rest plus a structured return programme yields excellent long-term outcomes.
• Premature plate closure can make the ulna appear longer, causing future impaction syndromes.
• Strengthening the shoulder complex reduces wrist forces by up to a third.
PATIENT FAQS
Why does my wrist hurt only during handstands?
Handstands force the wrist into deep extension while bearing body weight, concentrating pressure on the growth plate and provoking pain.
Will a splint make my wrist weak?
Short-term immobilisation allows healing; progressive exercises begin as soon as pain settles, preventing lasting weakness.
Can I keep practising bars and beam while resting my wrist?
Non-weight-bearing drills such as swings with straps or leaps on beam are usually safe, but anything that causes pain should be paused.
How long before competitions are safe again?
Most gymnasts return to full routines within four to six months, provided X-rays look normal and strength matches the other side.
Could this injury affect me as an adult?
Not if treated early. Persisting through pain risks early growth-plate closure, leading to uneven bone length and chronic joint problems later in life.
CALL-TO-ACTION
For an expert assessment or tailored rehabilitation plan, phone 020 3384 5588, email Info@TheArmDoc.co.uk or visit www.TheArmDoc.co.uk/gymnasts-wrist. Download free exercise videos and coach resources from our Wrist Rehabilitation hub.
EVIDENCE & GUIDELINES
• British Gymnastics Pain, Injury & Illness Policy (2024)
• Amsterdam MRI Assessment of the Physis protocol (2018)
• Paediatric Sports Medicine Consensus on Physeal Stress Injuries (2025)
DISCLAIMER
This leaflet offers general information and should not replace a full medical consultation. Seek urgent care for sudden swelling, numbness or severe pain, or if symptoms fail to improve with rest.