44 Comparing our sample of Portuguese gymnasts with elite male gymnasts,45 and 46 it is demonstrated that our gymnasts

training, on average, is much lower than the elite level on the training variable h/week (17.8 vs. 27 h/week). Our results indicated that there were no MLN8237 significant associations between training stimulus (h/week or starting age) and UV values. Several studies suggest that gymnastics training, with sufficient volume and intensity may precipitate abnormal changes of the distal radial growth plate and eventually lead to a premature physeal closure and consequent positive UV.8 and 18 Based on these supposed consequences, it is possible to expect a tendency toward a positive UV over the years as a result of gymnastics

training. However, it is not clear if training load HA-1077 datasheet provokes UV changes. In most studies the authors did not find significant association between UV and training variables.12, 17, 36 and 44 Because most studies have cross-sectional designs, the association between time of exposure to training and UV changes is unclear. Some longitudinal studies obtained also contradictory results about the possible influence of gymnastics training on UV. Chang et al.18 and Mandelbaum et al.47 observed a tendency toward a positive UV with the increase in years of training. DiFiori et al.12 found a significantly higher positive UV in a group of elite compared to non-elite collegiate gymnasts. In contrast, Claessens et al.41 have shown that the observed negative UV in female gymnasts at baseline became more pronounced next over the years when training level increased,

contradicting to the results of positive UV found in the literature. For this reason, some authors consider that AG training does not have a direct negative impact in the relative position of the distal extremities of the ulna compared to the radius, resulting in an ulna’s overgrowth.41 In our study, the etiology of pain was micro traumatic or gradual onset (43.5%). The pommel horse was the apparatus most frequently related to wrist pain (53.3%), which is in accordance with the results of other research.12, 16 and 47 Pommel horse demands repetitive, high intensity wrist impacts on a rigid structure, with sustained periods of body weight support on the wrist.7 Despite presenting symptomatic wrists, a considerable amount of our gymnasts (60%) were able to train without limitations, which is a similar finding as demonstrated in other studies.16 and 34 In fact only a few percentage has been forced to interrupt at least one training session per month, suggesting an underestimation related to the wrist pain, which may create a potential factor of morphologic alterations from distal radius or/and ulnar growth plates, changing the UV.