Impingement Syndromes of the Wrist
Dorsal wrist impingement is the most common injury to a CrossFitters, Olympic Weightlifter or Gymnasts wrist. The injury results from the repetitive combination of hyperextension (extending or straightening the joint beyond its normal range of motion) and axial loading, (placing force on the joint or bone).
The injury occurs when the dorsal (back) edge of the radius impinges on (strikes) the wrist bones. This individuals pain can intensify such as during a handstand. When injury occurs, the client feels pain and tenderness on the backside of the wrist. The pain usually subsides after training has ended.
Scaphoid impaction syndrome may occur because of repetitive hyperextension stresses(weightlifting/gymnastics). This mechanism is also responsible for avascular necrosis of the capitate in weightlifters. Impaction of the dorsal pole of the lunate on the distal radius is also seen in gymnasts.
Distal radial stress fracture
Distal radial stress fractures are commonly associated high impact forces, incurred from excessive hyperextension of the wrist with weight, such as cleans, for example, can cause compression on the wrist,
causing small fractures (breaks) in the radius (the bone on the thumb side of the forearm). Pain and tenderness are often felt around the entire circum‐ference of the radius just above the wrist. The pain is experienced at the onset of participation and progresses as activity continues.
The injury is often caused by repeated microtrauma (minor trauma) due to axial loading and hyperextension of the wrist. Therefore, it is important to have the injury evaluated when the pain is first felt. Postponing a visit to a physiotherapist like those at Evolutio can lead to a more serious injury and a longer recovery time.
Treatment depends on the severity of the symptoms and the fracture. Resting and avoiding compressive loading routines is the mainstay of treatment. A splint or cast for immobilization may help. An athlete may return to participation after full range of motion has returned and the pain and tenderness have subsided.
After returning to sport, it is important to monitor the wrists for recurring symptoms. Any recurrence of symptoms will require additional treatment, particularly, a rest period from participation. Surgery is not always necessary; however, severe injury and failure to see a physiotherapist right away often result in a longer rehabilitation time and rest from activities
Alex Drew is a Physiotherapist and Founder of Evolutio which strives to provide 'Innovation in Athlete Treatment and Education'. Evolutio has just opened at 11/3 Bromham Place Richmond for treatment and advice for all sporting athletes, CrossFit athletes, Powerlifters and Olympic Lifters.