Forearm Stress Fracture in a Young Polo Player: A Rare Case

Polo is an exciting sport, but it can be dangerous as well. Horses can collide. Players can be thrown from their mounts. Injuries include cuts, bruises, and fractures. Injuries to the face and arms are less common but can occur after being hit with a mallet or ball.

A case of stress fracture of the forearm was reported in a 20-year-old male polo player. A stress or "fatigue" fracture is the reaction of bone to repetitive stress. Stress fractures are common in sports and activities that involve the same motion over and over.

What caused this injury in the polo player? The player increased his practice time to prepare for an upcoming series of games. He went from two hours per week to 10 hours during the two weeks before the tournament. Finally, pain and swelling in the right forearm kept him from playing. The pain was so severe, he couldn't hit the ball with the mallet forcefully enough to compete.

X-rays showed an area of bone in the forearm that was lifted up and slightly disrupted. A bone scan showed increased bone activity in this same area. The player had a history of taking the steroid prednisone for Crohn's disease (inflammation of the intestines). This medication is known to cause bone problems when taken over a long period of time.

The player also admitted to a tendency to "top the ball," which may have contributed to his injury. Polo players strike the center of the ball when it is lined up with the player's toe. A tendency to strike the ball above its center point causes topspin of the ball. Topspin creates increased force through the mallet into the player's forearm. It's possible that this improper form, combined with the increased practice time, led to the bone fracture.

Forearm stress fractures are not often seen in polo players. This young player was taking a medication that can affect muscles and bones. He also increased his practice time before competition and used an improper method for striking the ball. Each of these factors may have contributed to his injury.

References: Russell J. Clark, MS-III, MPT, et al. Stress Fracture of the Ulna in a Male Competitive Polo Player. In The American Journal of Sports Medicine. January/February 2002. Vol. 30. No. 1. Pp. 130-132.