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A Growth Plate Under a Bodyweight Load, and What Happens If It Closes Early
Gymnast’s wrist is a stress injury to the growth plate at the end of the radius, caused by repeated weight-bearing on the hands with the wrist bent back. It shows up as back-of-wrist pain during handstands, vaults and tumbling in a child or teen who is still growing.
Treatment is a full stop on weight-bearing through the hands: at least 4 to 6 weeks, and often 3 months or more if the X-ray has changed. Then a gradual, staged return.
A young gymnast with back-of-wrist pain when weight-bearing has a growth plate problem until someone proves otherwise.
Get this one wrong and the cost doesn’t show up this season. It shows up at 25 or 30, as pain on the little-finger side of the wrist from two forearm bones that no longer end level.
Where are you right now?
- Your child’s wrist hurts on handsprings or vault: read “What are the symptoms of gymnast’s wrist?”
- The X-ray showed a growth plate change: go to “How long does gymnast’s wrist take to heal?”
- Wondering what they can still do in the gym: read “Can they still train?”
- It started with a fall: skip to the red flags at the bottom.
What is gymnast’s wrist?
Gymnasts, cheerleaders, tumblers and breakers do something almost nobody else does: they stand on their hands.
A wrist that was designed to grip and position is instead taking full bodyweight, repeatedly, with the wrist bent right back. In a fully grown adult that causes wear. In a child it lands on a growth plate.
Growth plates are cartilage, and cartilage is weaker than the bone around it, so in a growing athlete the growth plate is where the injury goes.
Same principle as little league elbow.
Different joint, same rule: in a young athlete, the weak link is the part that’s still growing.
What are the symptoms of gymnast’s wrist?
- Pain on the back of the wrist with weight-bearing. Handstands, back handsprings, vaulting, tumbling, push-up positions.
- Worse the further the wrist bends back, which is why handstands and vaults hurt most.
- Sore afterwards, sometimes fine during, and settling with a few days off…which is precisely why it gets ridden out.
- Tenderness pressing over the back of the wrist, an inch or so above the joint line on the thumb side.
- Sometimes swelling, and sometimes less backward bend than the other wrist.
How is gymnast’s wrist diagnosed?
- Examination. Pressing directly over the growth plate, comparing wrist movement with the other side, and checking the little-finger side too.
- X-ray of BOTH wrists. In an established case the growth plate looks widened and irregular rather than a crisp line. Comparing with the other wrist is what makes the change visible.
- MRI. Sometimes used when the X-ray is normal but the pain keeps coming back, because it shows stress in the growth plate before the X-ray does. See your wrist MRI report explained.
This is where the Closing Window Method earns its keep: name the window your condition runs on, find where you are in it, and act while it’s still open.
- Pain only, X-ray normal (window OPEN). Rest works well here, and the timeline is shortest.
- X-ray shows a widened, irregular growth plate (CLOSING). Still recoverable, but the rest is longer and the return slower.
- The growth plate has closed early (SHUT). The goal changes from protecting growth to managing the difference in bone length, with a surgeon involved.
Can gymnast’s wrist stop a bone growing?
Yes. Ridden out for long enough, the growth plate at the end of the radius can close early, meaning the bone stops growing before it’s finished growing. This is a worrisome statement, by the way.
The ulna beside it keeps growing on schedule.
So you end up with two forearm bones that no longer end level. The ulna now sits proud, driving into the wrist on the little-finger side and taking load it was never meant to carry.
A few millimeters of difference in where two bones end, created in a teenager, becomes a lifetime of ulnar-sided wrist pain in an adult.
The consequences show up years later as TFCC problems, ulnar impaction, chronic pain on the little-finger side, and sometimes surgery to shorten the ulna to undo a difference that didn’t need to happen.
That’s the argument for taking a teenager’s sore wrist seriously even when they can still compete on it.
How is gymnast’s wrist treated?
Unglamorous and effective, provided the first item is actually done.
- STOP weight-bearing on the hands. Not “reduce”. Not “light training”. A full stop. This is the treatment; everything else is support.
- Keep training everything else. Legs, core, flexibility, conditioning, and bar work that doesn’t load the wrist bent back, if the doctor agrees. This matters for compliance as much as fitness, because an athlete who is still training will accept a rest from tumbling far more readily than one who has been benched.
- Splint if it hurts in daily life, though many don’t need one once the loading stops.
- Then rebuild. Wrist and forearm strengthening through range, progressive loading from partial weight-bearing toward full, and only then back to skills.
- Then change what caused it. Training volume, the number of high-impact repetitions, wrist supports for tumbling, and technique on landings.
Returning to a full handstand program with the same volume that caused it is how these recur, and each recurrence adds risk to that growth plate.
Can they still train?
- Yes: legs, core, flexibility, running, trampoline without hand landings, and beam work without hands, if the coach can program it.
- Not yet: handstands, vault, tumbling, bars, push-ups and anything else that puts body weight through the hands.
- Braces and wrist supports: a support that limits how far the wrist bends back can help comfort on the way back. It doesn’t heal the growth plate, and it’s not a reason to train through pain.
How long does gymnast’s wrist take to heal?
Conservative ranges. The doctor managing your child’s wrist may set different ones. Use theirs.
- Pain only, normal X-ray (OPEN): no weight-bearing on the hands for at least 4 to 6 weeks.
- Growth plate changes on X-ray (CLOSING): often around 3 months off weight-bearing, sometimes longer, usually with a repeat X-ray before any return.
- Graded return: then several more weeks of building back up, step by step, before full skills and full volume.
A half-stop doesn’t shorten this. It just restarts the clock.
Exercises for gymnast’s wrist
No exercise here should hurt. Pain during or the next morning means stop and drop back.
During the rest period:
- Active wrist range. Forearm on a table, bend the wrist up and down slowly, pain-free only. 10 reps, 2 to 3 times a day.
- Forearm rotation. Elbow tucked in, turn palm up, then palm down. 10 reps, 2 to 3 times a day.
- Gentle grip. Squeeze a soft ball, wrist straight. 10 reps, once a day.
Once daily life is pain-free and pressing on the growth plate no longer hurts:
- Isometric holds. Wrist straight, push up, down and to each side against the other hand without moving. Hold 10 seconds, 5 reps each direction, once a day.
- Wrist curls and reverse curls. Forearm supported, a 1 to 2 lb weight. 2 to 3 sets of 10 to 15, every other day, adding weight slowly.
- Forearm rotation with a light hammer or weighted bar, held near the head. 2 sets of 10, every other day.
When can my child go back to gymnastics?
Not on a date. On criteria. All of these first:
- No pain in daily life, and none when pressing over the growth plate.
- Full backward bend, matching the other wrist.
- Strength close to the other side.
- The doctor has cleared it, including a repeat X-ray if the first one showed changes.
Then a staged return, roughly a week per step, moving up only if there’s no pain during the session or the next morning. Pain means drop back a step for a few days.
- Step 1: weight shifts on hands and knees, on fists or parallettes with the wrist straight.
- Step 2: supported weight-bearing with less wrist bend, using parallettes, wedges or push-up handles.
- Step 3: short wall handstand holds, low numbers.
- Step 4: basic skills on soft surfaces, low repetitions.
- Step 5: volume built up over weeks. High-impact vaulting and tumbling come back last.
(Coaches: a written return plan shared between parent, athlete and coach does more than any brace. Everyone knows which step they’re on.)
Is this normal?
Usually expected:
- Some stiffness in the wrist after weeks off weight-bearing.
- A little ache as weight-bearing comes back, settled by the next morning.
- Frustration. Gymnasts hate time off. That’s normal too.
Check with your doctor if the pain is there at rest or at night, or comes back every time training builds up.
If it isn’t going to plan
They took 3 weeks off. The pain went. Back in the gym…and within a fortnight they’re rubbing the wrist again.
Pain-free at rest isn’t the same as healed. A growth plate that’s still irritated, loaded at full training hours, can be pushed toward closing early, and that’s a change you can’t undo later.
Go back to the doctor and ask for a return plan built on criteria and steps, not dates. A hand therapist or sports physio can help the coach set one. The Closing Window Chart shows which hand and wrist problems run on a clock like this one. It’s free.
When can they…?
Typical ranges. The doctor’s plan comes first.
| Activity | Typical timing |
|---|---|
| Legs, core, conditioning | Straight away |
| Light hand loading, like weight shifts on fists or parallettes | Once pain-free, after at least 4 to 6 weeks off hand weight-bearing, with the doctor’s go-ahead |
| Handstands and tumbling | Later in the staged return, built up step by step |
| Full training hours | Often 3 months or more if the X-ray showed growth plate changes |
What else causes wrist pain in young gymnasts?
Worth ruling out rather than assuming:
- A scaphoid fracture after a fall, which hides on first X-rays at any age.
- Pain on the little-finger side, which suggests the ulnar side of the wrist rather than the growth plate, and can mean the process above has already progressed.
- A ganglion cyst, which is common in this age group and usually harmless.
- Pain at rest and at night, which doesn’t fit a loading injury and needs looking into properly.
See also: growth plate fractures and buckle fractures in children.
Get it checked today if
- After a fall: the wrist looks deformed, swells quickly, or can’t be used.
- Tenderness in the hollow at the base of the thumb after a fall. That’s the scaphoid until proven otherwise.
- Numbness, tingling, or fingers turning pale or blue.
- A hot, red, swollen wrist, especially with a fever.
Get it checked if
- Back-of-wrist pain with weight-bearing has lasted more than 2 weeks.
- The pain settles with rest but comes back every time training restarts.
- Pain has moved to the little-finger side of the wrist.
- The wrist bends back less than the other one.
- Pain at rest, or pain that wakes them at night.
Be firm about the rest. The reason isn’t this season. It’s the wrist they’ll have at thirty.
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. Persistent wrist pain in a growing athlete needs assessing rather than managing around.