Your Personal PT, Rachel Tavel, is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS), so she knows how to get your body back on track when it’s out of line. In this weekly series, she gives you tips on how to feel better, get stronger, and train smarter.
Winter and the cold weather it brings can be fun, but you know what’s not fun? Ice. It just takes one slip and fall on the ice to sprain your wrist, so be careful out there.
This type of accident is called a “FOOSH” injury in the medical world. FOOSH stands for “Fall On Outstretched Hand.” Our bodies are hardwired to have one priority during a fall: Don’t hit your head and damage your brain. Our reflexes are designed to prevent exactly that.
Fortunately (or unfortunately, depending on how you look at it), this means that our arms wind up breaking our falls when our brains sense that we are going down. While this reaction can protect our heads (and precious brains), our wrists aren’t always so lucky.
These falls easily result in sprained wrists. Sprains are defined as an over-stretching or tear of the ligaments—the thickened tissue crossing a joint that helps provide stability by connecting two bones. In the case of the wrist, which is formed by two rows of tiny carpal bones and the bones of the lower arm (the radius and ulna), there are many ligaments that can get injured. The most common injury is a hyperextension injury in which the palm hits the ground and the wrist bends too far upwards. This can result in pain, stiffness, and swelling in the wrist.
A sprained wrist takes time to heal. Sprains come in multiple degrees of severity, and can range from a minor or low-grade sprain (stretch or partial tear of ligaments) to a complete tear, which may require surgery. For the lower grade tear injury, there are some things you can do about it. But if you are experiencing constant or frequent pain, swelling, bruising and difficulty moving or using the wrist and hand, get to a doctor or physical therapist as soon as possible. You may need imaging to rule out a more severe injury or a wrist splint to temporarily immobilize the wrist and allow the ligaments to heal.
If there is pain/swelling, try icing and elevating the wrist for 10 to 15 minutes a few times a day. Do the following exercises only if they are relatively pain-free.
Move It: Perform active range of motion (AROM) by slowly and gently moving the wrist in all directions to maintain mobility. Start with flexion and extension: with arm outstretched in front of you, palm in “stop” signal, slowly lower palm down then back up, isolating movement from the wrist. Then perform “bye bye”movement (radial and ulnar deviation) with palm facing the floor, wrist neutral, rotate palm towards the thumb then towards the pinky like you’re wiping a table.
Strengthen It: If pain is minimal, try gentle resisted wrist flexion, extension, radial and ulnar deviation (movements listed as AROM above) to improve wrist strength in every direction. Begin with 1 to 2 sets of 10 reps with no weight up to 3 pounds. Isolate movements at wrist so only hand moves while forearm is still. For radial deviation, make sure movement is against gravity (starting position is with thumb towards the ceiling, so it’s like you’re moving the weight upwards from the wrist).
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