Cindy Midkiff, M.S., Ed., ATC, VATL

A lineman on a high school football team recently came into the athletic training room and said, “I feel like I have shin splints in my forearm.” He was basically right, except we call it “forearm splints.”

This is typically caused by overuse of the forearm muscles and loading of the wrist in a weight-bearing position. It is mostly seen in gymnasts, body builders, boxers, and baseball players. It is occasionally seen in football players whose position requires them to push or jab to block or hold the line.

Athletes with this injury often experience pain at approximately the middle one-third of the forearm. Initially, they will feel a deep dull ache. This can increase over time and when playing or delivering an axial load to the extended wrist (such as a pushup position). If left untreated, the pain will intensify and extensor muscles will weaken. Early recognition is important, as is resting from the action or activity causing the pain. An X-ray should be performed to determine if there is a stress fracture. If the X-ray is negative, then conservative treatment can be started.

Initial treatment calls for ice, nonsteroidal anti-inflammatory drugs, a compression wrap, and avoiding wrist extension and axial loading. The next step includes stretching exercises and a gradual strengthening program for the forearm muscles as they become pain-free.

In the last phase of rehabilitation, controlled axial-load exercises should be added. Start with just having both hands on the wall and rocking back and forth. This can be progressed into two-hand wall pushups, then to one-hand wall pushups. To increase the load, move to a table or bench and finally the floor. All exercises should be pain-free.

When the athlete no longer has tenderness in the forearm and can do all exercises without pain, they should be put through functional testing. If they pass the functional tests of their sport (for football: blocking, jabbing, and pushing against a moving player), then they can return to a full practice. It is helpful to do a compression taping before practice and to use ice after practice. The athlete should also continue a maintenance strengthening and stretching program.

If your child has persistent forearm pain, schedule a visit with one of CHKD’s sports medicine physicians. They may also need follow-up treatment from a sports medicine physical therapist or certified athletic trainer.

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About CHKD Sports Medicine

CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.