Gymnasts experience repetitive compressive and torsional loads at the wrist while in hyperextension. In skeletally-immature gymnasts, such loads may predispose to distal radial epiphysitis, otherwise known as Gymnasts Wrist (GW). Although wrist braces have shown to attenuate hand impact forces, adolescent female artistic gymnasts are often underrepresented in these studies. Therefore, this research aims to establish the effectiveness of anti-hyperextension wrist braces for reducing biomechanical risk factors for GW in this population. This cross-sectional study is recruiting 45 healthy adolescent females (age 10–19 years) currently competing in artistic gymnastics at the six to 10 level. Upper extremity kinematics and kinetics are being quantified in participants both with and without bilateral anti-hyperextension wrist braces (Tiger Paws, Albuquerque NM). Hand impact forces and moments are recorded using two floor-embedded, six degree-of-freedom force plates (AMTI, Watertown MA) and a TekscanTM pressure sensor (Flexiforce 5250) during three floor (front handspring, round-off, back handspring) and three vault (front handspring, Tsukahara, Yurchenko) tasks. Segment motions and joint angles are quantified using Theia3D (Kingston ON). Before task completion, participants complete the QuickDASH and SOS-WRIST questionnaires to evaluate previous wrist pain experiences in gymnastics. The PCS-C is also completed to assess participants' pain experiences, namely one's thoughts when in pain. Exit surveys are administered to obtain feedback on the use of braces, including perceptions toward brace comfort, potential performance impacts, whether their continued use is likely, and the extent of participants' previous knowledge toward wrist brace availability. The researchers have no connections and are not receiving any financial gain by using Tiger PawsTM wrist braces. Completed results will be available for presentation at the 2025 COA Annual Meeting. Aligning with previous findings, it is expected that anti-hyperextension wrist braces will reduce the magnitude of wrist impact force, moment, and extension angle during both the floor and vault tasks. However, neither the elbow nor the shoulder joints are expected to exhibit significant changes in these variables when wearing versus not wearing wrist braces. Upon quantifying gymnasts' limb symmetry indices (LSIs), it is expected that there will be leading and non-leading wrist asymmetries in wrist impact force, moment, and extension angle. However, bracing will improve gymnasts' LSIs during each task. Qualitative analysis of exit surveys is expected to reveal that most gymnasts perceive wrist braces as comfortable and to cause no performance impacts. However, because gymnasts are often encouraged to conceal pain/injury, it is expected that participants will report braces as inaccessible and unlikely to be worn. Decreases in wrist impact force, moment, and extension angle may be critical to reducing the risk for GW and its long-term sequalae. Consequently, the current research is foundational as it will provide support for wrist bracing as a potential strategy to reduce GW risk in young female gymnasts, a population that is drastically underrepresented within the current scope of research for this field. Such efforts will promote the health, well-being, and safety of young female gymnasts and are imperative considering the growing calls to safeguard participants in this highly child-populated domain.
DiLeo et al. (Wed,) studied this question.