Tiger paw usage.

[rbw]

The opinions of some sports medicine specialists who have long studied wrist injuries in gymnasts are summarized below with respect to injury prevention and clinical management. Perhaps the best recent articles on the subject are these:

• DiFiori JP, Caine DJ, Malina RM. Wrist pain, distal radial physeal injury, and ulnar variance in the young gymnast. Am J Sports Med. 2006 May;34(5):840-9.
• DiFiori JP. Overuse injury and the young athlete: the case of chronic wrist pain in gymnasts. Curr Sports Med Rep. 2006 Jun;5(4):165

The authors suggest several preventive measures, including these:

• decrease training loads and skill progressions during periods of rapid growth (for many girls that's about age 12; these authors suggest measuring the athlete every three months, and moderating training during the growth spurt)
• increase in training should not occur in a stepwise progressive manner (training should cycle)
• early detection and treatment
• knowledgeable personnel (e.g. athletic trainers) should be available to assist gymnasts

These authors state that there are no direct data on the effect of bracing regarding protection from repetitive loading, but they note that it is plausible that by reducing loading across the joint, bracing could be beneficial.

It may be that many gymnasts consider use of wrist supports only when the situation has already progressed pretty far. (Although DiFiori's studies show that half of young, beginning to midlevel gymnasts experience wrist pain of at least six months duration, very few of those injured kids ever see a physician for their wrist injuries. In studies of young, nonelite gymnasts 5 to 16 years of age, 42% to 63% of gymnasts with wrist pain reported that the symptoms caused them to limit workouts or reduce training time.) By then, simply adding wrist supports may relieve symptoms but not really address the problem.

If these specialists in adolescent sports injuries are correct that wrist pain in gymnasts is caused by overuse, there seems to be little evidence to support the idea that wrist pain is caused by weak wrists, or that strengthening the wrists will solve the problem; similarly, there seems to be little support for the idea that wearing wrist braces will weaken the wrists and lead to further problems.



Instead, these specialists draw on two decades of study of gymnastic wrist injuries to offer some recommendations for clinical management of gymnastics-related wrist pain:

• gymnasts with persistent or recurrent wrist pain should be evaluated by a sports medicine specialist who is familiar with gymnastics
• avoid doing what hurts
• consider taking some time off (six weeks if there is radiographic evidence of injury)
• reduce training volume; slowly return to the former level, adding last those elements that had formerly caused pain

These recommendations do not include continuing training at the injured gymnast's current training volume while either adding wrist braces or performing wrist exercises.

[lakshmi369]

Wow, thanks for the additional info. My DD has been in gymnastics for over sevn years and has trained some heavy workout schedules in the past years but is currently on the shortest practice times we have had the pleasure of in probably 4 years! I appreciate all the insites but my DD will never have to worry about "weak wrists" anyway as she will never wear "Tiger Paws" if she cant get the contraptions broken in! LOL

[rbw]

Although wrist pain in adults may commonly be associated with injury to soft tissues, it's important to understand that many cases of gymnast's wrist are injuries to bone; that's why these authors recommend monitoring training during the adolescent growth spurt, which is associated with increased risk of wrist pain: it's at that time that the growth plates near the ends of the bones are especially vulnerable to stress-related injury. Gymnasts 10 to 14 years of age are more likely to have wrist injuries than older or younger athletes.

Gymnast's wrist is analogous to other well-documented, stress-related overuse injuries in children like shoulder (and elbow) problems in Little-League pitchers, swimmers, and volleyball players; these are also injuries to growth plates. The best way to avoid injury to these sensitive parts of growing bone is to avoid overuse rather than to rely on specific strengthening exercises; in particular, overuse should be avoided during periods of rapid growth. Once the bone has been injured, the general remedy involves rest with a gradual return to activity.

DiFiori suggests in another article on growth plate injuries in youth sports (Br J Sports Med. 2006;40:749-760) that "although data on injury prevention are lacking, physical conditioning, including strengthening" may help to reduce the occurrence of these injuries. However, the emphasis that some coaches place on strengthing the wrists of already-injured gymnasts may be based on a misunderstanding of the nature of the injury.

[lannamavity]

Quote:
Originally Posted by Imat3 Well, it sounds like I am in the minority here on my opinion. A little background though...my daughter did T&T for a couple of years. Practice consisted of about an hour of constant tumbling. Her pass was round off 7 bhs. So, her wrists really hurt. She actually broke one of them while doing a bhs. No, her wrist were not turned out...her form was good. She wore a cast for 6 weeks, followed up with 3 mos of PT. The PT helped some, but she really needs the tiger paws and the therapist and doctor agreed that she needed the support. I had also heard that the tiger paws will make the wrist weaker, but it is what she needs to be able to do gymnastics. She loves them, and they work for her. I guess gymnasts don't really need grips either, but most use them to help them out with their grip on bars. Maybe if they never used the grips, they would have no trouble hanging onto the bar as they would have more grip strength? Not sure...just a thought. Imat3

Tiger paws and grips are two very different things. Grips do not keep hands from hurting...they are equipment used to enhance performance.

Tiger paws do not enhance performance, they add support to an injured body part.

[ihraxhunnie]

yea, i understand the fashion trend thing.
i coach the beginning kids at our gym up
to pre-team. i have had rollers (first level)
gymnasts wearing tiger paws. now these
are girls doing bridge from stand as their
most impacting move. we had so many
rollers through kippers (lvl 1-3) girls wearing
tiger paws that we actually have banned
them in the lower level classes unless
the child has a doctors note. they only
wanted to wear them because the big
girls up front we wearing them and i
had to when i was coming back from my
broken wrist in order to spot without
pain...

[gymdog]

I can see both sides of this. I do NOT think that Tiger Paws should be the first answer, and I think that they are over used to some extent. I first started having wrist pain when I switched from my more recreational gym (I was already competitive and had all level 6 skills) to a competitive one, but it wasn't bad. When I started training level 7 and hours increased again, it started to get worse. It was usually strike pain that would go away soon after it came on really bad. It actually always continued to be like that. Basically what I mean is even today I can sometimes do a BWO or BHS on floor or beam (or vault, even yurchenkos) with nothing on my wrists and it won't really hurt. It's not like a soreness. But maybe like 3/5 times my wrists will hit, even on something like a BWO, and I'll just get intense pain. It varies from "gosh that really hurts" to having to sit down because it's dizzying. I always said it felt like the bones were hitting each other and I have no cartilage (this is important later in the story lol)

So for L7 and part of L8 I used tiger paws but then my coaches thought maybe my wrists were weak. So we decided to stop using them and do more wrist conditioning. I did that for a year. My wrists got progressively worse and it was closer to 5/5 times that I was having intense strike pain. About a year after I stopped using them I did a yurchenko and I felt my wrist hit so hard, extremely painful, and then kind of give out (just one - left). I couldn't move it. It hurt to flex and would "click" for about two or three months after that. After the whole MRI thing, it turns out I have some genetic lack of cartilage (it wasn't wearing away I don't think, it just is that way). For some people with this even normal activity poses trouble but not for me. It was just the impact at certain angles that was...not fun. So, I started taping (beam) and wearing Tiger Paws again and I'm back to the point where I will (carefully) do a BWO or BHS on floor without them and it's generally okay. For me they keep the angle more stable, although they don't completely prevent all my strike pain, occasionally it happens, just much less. I also had tendonitis after not using them for a year because of the impact and I don't think I do anymore...it doesn't hurt me to squeeze my wrists anymore.

But yeah, generally as a coach, for soreness, I would recommend limiting activity and maybe conditioning. Even when they have Tiger Paws they should try to limit use in my opinion, simply so they don't become dependent on them and so they can more accurately gauge what affects the injury. I would agree it's hard to stop using them once you're used to the feel. It is different. I was able to do it but there is a different feel. When I used them on beam (now I tape) my hands slipped several times in BHS series, and that's never happened without them, but it caused mental blocks on series. I think they are an option and effective tool to be used appropriately but I have to say I have heard of (not necessarily observed - very few gymnasts used them at either of my gyms) less than appropriate use.