Question:Our 16-year old daughter was just diagnosed with a wrist impingement problem. When she does the horse and floor activities, there's excruciating pain along the back of her wrist. So long as she doesn't bend her wrist back all the way, she's okay. But she can't compete at her best without full wrist motion. What's a good treatment for this problem?
Answer:It sounds like your daughter may have an impingement of the extensor retinaculum. The retinaculum is a broad band of fibrous connective tissue. There is a retinaculum across the tendons on both sides of the wrist.
Athletes who participate in activities that require hyperextension are at increased risk of extensor retinaculum impingement. Gymnasts, platform divers, and shot put throwers are the most likely to develop this problem.
A recent study of seven athletes with this condition showed that steroid injection or surgery to release the retinaculum work equally well. Patients in both groups were able to return to full participation in their sport.
The steroid injection is less invasive than surgery and recovery time is faster. Patients were followed for several years without a return of their symptoms while still continuing with their practice and competitions.
An orthopedic surgeon may be the best one to advise you. Reviewing her history and the results of the exam will guide the doctor in suggesting the best course of treatment for your daughter.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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