Question:My son participates in track and field events at the college level. His best event is the shot put. Lately he's been complaining of pain across the back of his wrist. It seems to bother him the most when the shot put is in his hand and he's just ready to throw it. The coach doesn't know what could be causing the problem. What should we do?
Answer:Wrist pain is a common problem among many athletes. Over training and competing places great demands on various body parts. Shot put throwers are especially at risk for symptoms in the upper extremity.
Pain across the wrist during hyperextension described could be from any number of problems. There could be a problem in the bone such as a fracture or bone impaction. Or the pain could be caused by something in the soft tissues. This could be a torn tendon, ligament, or cartilage.
A recent study of athletes with similar symptoms found a new condition causing wrist pain. This is called extensor retinaculum impingement. The retinaculum is a band of fibrous tissue that goes across the wrist. It provides a protective covering over the tendons of the wrist and hand.
But the retinaculum can become thickened from overuse. Repetitive motion causes inflammation of the lining around the tendons. When the wrist is extended fully, the edge of the band puts pressure on the swollen and tender tendons. This pinching causes the pain athletes describe.
A medical exam is needed in order to know for sure what's causing your son's painful symptoms. It could be impingement or something else. The physician will take a history and perform an exam. X-rays or other imaging studies may be needed. Treatment depends on the underlying cause.Ann E. VanHeest, MD, et al. Extensor Retinaculum Impingement in the Athlete. A New Diagnosis. In The American Journal of Sports Medicine. December 2007. Vol. 35. No. 12. Pp. 2126-2130.
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