Gymnast’s Wrist

Gymnast’s Wrist

Success in gymnastics requires a high volume of training and early specialization. Together, these can take a toll on a young athlete’s growing body. Lindsey Williams, O.T.R., C.H.T., is an occupational therapist who takes care of gymnasts with wrist pain. “I really like working with gymnasts because they are motivated and very compliant with their rest and exercises, but knowing this condition is preventable makes me want to help them catch it before it starts.”

Not too many athletes spend as much time on their hands, so this condition is most common in gymnasts. Because of this, it’s commonly referred to as, “gymnast’s wrist.” Take a few minutes to learn more about this condition and how to recognize early signs and better yet, prevent it.

What is gymnast’s wrist?
Gymnast’s wrist is an overuse injury that causes pain and tenderness in one of the forearm bones, the radius. Distal radial epiphysitis is inflammation in the growth plate near the wrist. This injury is seen, not only in gymnasts, but also in active growing children and teens and is more common in girls than boys. This commonly occurs during periods of rapid growth and/or increased activity.

What causes epiphysitis of the distal radius?
A growth center or epiphyseal plate is an area near the end of long bones that allows for continued growth of a bone. This area is made up of soft cells called cartilage. These weaker cells are at a higher risk of injury.  Repeated stress or compression in this area causes damage and inflammation that can be painful.

Activities that require repetitive weight-bearing through the hands, particularly in extension, include:

  • Tumbling or vaulting
  • Impact or loading in wrist extension with cheerleading and stunting
  • High volume or intensity of training

Treatment is imperative to prevent long-term damage of the wrist. Without treatment, continued trauma to this area can cause the growth plate to become bone (ossify) early which may require surgery in the future to correct. With early and proper treatment, most recover well without surgery.

The initial treatment is rest from impact and weight-bearing activities. A gradual and guided return to normal movement and activities is important.

When pain has improved, an occupational therapist (OT) will guide the progression of exercises, and when cleared by the physician, introduce weight-bearing activities and transition back to sport as strength and pain allow.

How long do symptoms of gymnast’s wrist last?
Untreated, symptoms may persist until completion of growth in this area. In time, stronger bone cells replace the soft cartilage cells, but pain may still come and go for months to years.
To prevent recurrence, it is important to continue the recommended exercises and to avoid excessive training and impact. Pain may come back or worsen during sports or strenuous activities and treatment may be started again. With proper management, most athletes can return to their sport within 3-6 months from the start of treatment.

Can epiphysitis of the distal radius be prevented?
Any athlete that participates in repetitive weight-bearing and loading of the wrist is at risk for this injury.

Some actions to help prevent this include:

  • Warming-up and stretching before participating in weight-bearing activities will reduce stress on joints.
  • Limit or vary physical activities to avoid overtraining and overuse. Spread out training for high-impact activities such as tumbling and vault to separate days and allow a day or two of rest between them.
  • Rest when sore or in pain.
  • Maintain wrist and grip strength to help support the joint and absorb some of the impact.
  • Wear wrist braces such as Tiger Paws® wrist supports to prevent wrist hyperextension and help decrease stress on your wrists.
  • Be aware of changes in wrist pain with increases in training time or when training for a higher level of competition.

 Learn about other overuse injuries in gymnasts.

Share Your Story: Standing Tall

Share Your Story: Standing Tall

Meet Finn, a patient who is seen by our scoliosis and spine experts. Learn more about his journey below. Blog written by Finn.   I was diagnosed with scoliosis years ago. My curve was minor, and I would go to Scottish Rite for Children every six months for checkups. When I was about 10 years old, the curve started to worsen. Scottish Rite made me a back brace, which I would wear when sleeping, to try and prevent the curve from getting worse. My back didn’t cooperate with the brace. I think it’s because the scoliosis suddenly started curving my spine really fast. In less than a year, my curve grew about 20 degrees worse. I knew something wasn’t right. Breathing was getting harder, and I was easily tired. At my next checkup my fears were right, I found out I needed surgery to fix the curve. I also have a condition called osteogenesis imperfecta (OI), which causes me to have brittle bones. Because of this, everything felt extra scary. Would my bones be strong enough? Would I be able to do the things I love doing? So many questions. I think I was in shock.
On the day I found out that I was going to need surgery, Dr. Brooks spent lots of time talking with my family. And then a psychologist. And then child life. Several more team members came to meet us after that. Honestly, it was a fog by the time we left, but my high fear level was much better. The team members were all so positive and that made it easier to wrap my head around what was next. Because of the OI, we needed to make my bones as strong as possible before surgery, so I had an infusion to help with that.
A man wearing a shirt that says #belieber talks to a girl

My back continued to curve at a very fast rate, so my original surgery date was moved up. I was scared, but I really wanted the surgery to be over with. And sure enough, less than three months after finding out that I needed surgery, it was done. Looking back, the waiting was hard, but everything went really fast. I had lots of appointments to get ready for surgery, making sure everything was planned out. 

For me, making sure my true identity was understood, was another very important part. I am a transgender 13-year-old boy. I have a really hard time when I am misgendered. Getting my preferred gender and name to be used has been a battle at other places. Making sure my identity was honored was a priority for me and was a priority for the team at Scottish Rite. It’s hard enough being in the hospital without being misgendered.

The entire team was focused on making me as comfortable as possible, in every way possible.

Dr. Brooks told me I would be up and walking the day of my surgery or the very next morning. And I was! He also told me I would most likely stay for three nights, but I was able to go home after only two nights. Before my surgery, I went to sleep shorter than my mom and I woke up from surgery taller than her! Dr. Brooks told me I would be mostly recovered in three months and totally recovered in six months. I’m four months post surgery and almost completely recovered! Pretty soon I will be able to do everything I did before surgery. I’m already taller than I had been, and my lungs feel free to breathe. I also no longer have a scoliosis curve!  

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.

At the Forefront of Innovation: Spinal Surgery at Scottish Rite for Children

At the Forefront of Innovation: Spinal Surgery at Scottish Rite for Children

Hearing that your child needs spinal surgery for scoliosis brings a flood of questions and a lot of uncertainty. Using the newest technology and innovative methods, the experts at Scottish Rite for Children are some of the best pediatric orthopedic surgeons in the world. Our leaders support your child throughout treatment, making their spinal surgery a success from start to finish.

We provide a multidisciplinary, patient-centered approach to scoliosis treatment. Spinal maturity; the degree, extent and location of the curve; and the potential for progression are all considered when determining treatment.

Types of Scoliosis

  •  Adolescent idiopathic scoliosis (AIS) –  the most common form of scoliosis that occurs in children ages 10 to 18
  • Congenital scoliosis –  scoliosis that is present at birth and is due the intra-uterine formation of abnormally shaped/formed vertebrae
  • Early-onset scoliosis – scoliosis that occurs before the age of 9
  • Neuromuscular scoliosis –  secondary scoliosis that develops because of an underlying medical condition that adversely affects the brain, nerves, or muscles
  • Syndromic Scoliosis: An underlying genetic syndrome that causes the scoliosis

Additionally, scoliosis can be categorized by the following:

  • Thoracic scoliosis –  curve in the middle, or thoracic, part of the spine
  • Lumbar scoliosis – curve in the lower, or lumbar, part of the spine
  • Thoracolumbar scoliosis – curve in both the spine’s lower thoracic and upper lumbar parts

When Surgery is Needed for Scoliosis

Depending on the child and the severity of their curve, surgery may be the best treatment option. While not all cases of scoliosis require surgery, the following factors are an indication that surgery is needed:

  • Your curve is greater than 50 degrees, and/or
  • You have significant growth remaining
  • Your curve progressed to 50 degrees despite compliance with brace wear
  • You have a underlying neuromuscular or syndromic condition.

The most common type of surgery performed for scoliosis is a spinal fusion. In a spinal fusion, the curved vertebrae are fused together to create a single, solid bone. This stops the growth in the abnormal part of the spine and prevents the curve from worsening. Metal rods attached by screws, hooks or wires are used to hold the spine in place until the bone heals. In all spinal fusions, a bone graft is used to help promote the fusion and the bones grow together to create one solid bone.

Having Spinal Surgery at Scottish Rite

Led by Daniel J. Sucato, M.D., M.S., our Center for Excellence in Spine employs six pediatric orthopedic surgeons who specialize in spinal surgery for scoliosis. Our diverse team of surgeons works together to create individualized treatment plans for each patient and ensure that the child and the family know what to expect each step of the way. Multiple departments work together to provide a multidisciplinary approach to care and treatment. Orthopedics, Psychology, Physical Therapy and more will address all your child and their needs to ensure they are prepared for surgery. Our psychologists help our patients cope with having surgery and address their feelings about their procedure, giving children the opportunity to express their emotions. Following surgery, our team works with your child to make recovery as easy as possible.

Tackling the Most Complex Cases

New and innovative techniques allow our experts to tackle the most difficult cases.  This includes Magnetic Expanded Growth Rods (MCGR), Halo Gravity Traction (HGT), Vertebral Body Tethering (VBT), and Posterior Spinal Fusion (PSF). Our experts have experience treating complex cases, such as treating patients with a curve of over 100 degrees.

Road to Recovery

Following surgery, our team begins the recovery process with the patient. Using different pain management techniques. Our physicians are dedicated to seeing each patient through their recovery.

After a spinal fusion, it is common to need to minimize bending or heavy lifting. Our surgeons will go over limitations and discuss the importance of proper aftercare. Our team works with each patient to determine readiness to return to activities and coaches them through the recovery process.

How to Learn More and Become a Patient

Learn more about our Center for Excellence in Spine and scoliosis treatment.

Learn how to and how to make an appointment with one of our world-renowned experts.

Get to Know our Staff: Jason Sawa, Inpatient Nursing Unit

Get to Know our Staff: Jason Sawa, Inpatient Nursing Unit

What is your job title/your role at Scottish Rite for Children?  
I am in the inpatient care coordinator. 

What do you do on a daily basis or what sort of duties do you have at work?  
I ensure the needs of the patient and family are met during their inpatient stay and at discharge. I meet with patient families upon admission to discuss their plan of care and expected discharge needs. I’m one part of an extraordinary team that helps our families have a great experience while staying with us as an inpatient and that they are set up for success when they are ready to go home.

What was your first job? How long have you worked here?
My first job was at KFC, and I’ve been at Scottish Rite since 2004. 

What makes Scottish Rite such a special place to work?
I love seeing how the kiddos progress with the treatments they receive here. I also think it takes a wonderful group of people to keep Scottish Rite special, so I think my co-workers are invaluable. 

What would your dream job be if you were not in the medical field? 
I would love to be a pilot and travel the world. 
 
Where is the most interesting place you’ve been?
My favorite place to vacation is any place that has sunshine and a beach. 
 
What is your favorite game or sport to watch and play?
My favorite team is the six-time Super Bowl Champions Pittsburgh Steelers. 

What’s one fun fact about yourself?
I love buying new release items – from shoes to vinyl records to seeing a movie the night it premieres

Share Your Story: I Got This

Share Your Story: I Got This

Meet Ella, a patient who is treated by our experts in the Center for Excellence in Clubfoot and Foot Disorders. Learn more about her journey below. Blog written by Ella’s mother, Lindsay.  I was about halfway through my pregnancy when we found out that our baby, Ella, would be born with a clubfoot. Our standard anatomy scan revealed we were going to have a baby girl, plus indicated there might additional issues going on.  

Our doctor referred us to a specialist, where we learned that Ella most likely had a rare heart condition called Tetralogy of Fallot, in addition to clubfoot. In order to confirm the heart condition, her little heart needed more time to grow and develop. That waiting period was very stressful, but after a couple of weeks and many prayers, we learned that Ella had a healthy heart. She still had clubfoot, so we then went to a different specialist in Oklahoma City.     As soon as she was born, we started her clubfoot treatment. I wanted to be on top of things and give her the very best possible outcome. Immediately following her birth, Ella’s left foot was casted for four weeks. She then had an Achilles tenotomy procedure, where the Achilles tendon was cut so the ankle

During this time, I remember feeling a lot of guilt because our doctor would tell my husband and me that we needed to be doing more. More stretching and more exercises with Ella. My mom intuition kicked in, and I had a bad gut feeling that something just wasn’t right. Her little foot literally wouldn’t stretch anymore, so I consulted with a physical therapist who confirmed my feelings.     Ella underwent another Achilles tenotomy in January of 2019, followed by a tibial osteotomy in December of 2019. During the tibial osteotomy, her tibia was cut and repositioned. This caused Ella to be in extreme pain. We did not have a very good experience at that original hospital, and that was when that I started to research other hospitals and learned about Scottish Rite for Children.  

I reached out to a respected doctor that I know, and he referred us to Scottish Rite. He told us that the doctors at Scottish Rite were the absolute best! And they are! Ella’s first appointment with Dr. Riccio was in the fall of 2020. At that time, he told us what we didn’t want to hear – another surgery would be necessary for Ella. We had been through so much with our first doctor and hospital that I was very uncertain and had lots of anxiety about what to do.    After much prayer, we decided to schedule a tendon transfer and release surgery with Dr. Riccio.

He could sense that I was afraid, and I was so touched with how he took the time to talk to us and help ease my fears.

The day of her surgery, I was a complete mess. I had stayed up all night, going down a dark rabbit hole on the internet. I will never forget when Dr. Riccio walked in the pre-op area and said, “I got this”. After her surgery, he came to talk with us in recovery and had a huge smile on his face as he walked into the room. He told us that he thought we were going to be very happy with the results. Those memories will be in my mind forever. We are thrilled with the results! We are FOREVER thankful to Dr. Riccio and his entire team. The kindness Ella experienced with the Child Life team was also life changing. Our entire family thanks God for Dr. Riccio and I tell anyone who has a child with clubfoot to go to see him immediately!  

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.