Wrist Injuries: General Info
The wrist joint is actually an intricate arrangement of smaller joints. The ends of the two forearm bones, the ulna and radius, connect with a row of carpal bones. A second row of carpal bones connects with the long bones of the hand. A tube, the carpal tunnel, runs through the wrist and contains tendons and the median nerve.
All the bones and the carpal tunnel are held in position by ligaments, which are strong bands of connective tissue. The ligaments stabilize and support the joints, allowing for movement within certain limits.
Tendons connect muscles to bones, and allow movement of the hand.
Wrist injuries can include strains, sprains, and fractures.
A strain occurs when a muscle or tendon is overstretched or pulled too far, resulting in tears to the microscopic muscle or tendon fibers. Damage from repeated injuries to the wrist tendons can lead to painful conditions such as DeQuervain’s Syndrome and ECU Tendonitis.
Treatment for a strain includes resting the wrist, icing the joint, taking anti-inflammatory medication, and elevating the wrist above the level of your heart. Wearing a wrist brace or splint will help eliminate unwanted movement.
A sprain is an injury to one or more ligaments, and is often the result of falling onto an outstretched hand. The ligament fibers can fray or break, or even completely rupture if the injury is particularly severe. Sprains are graded according to severity. A Grade 1 sprain is relatively mild; some partial tearing has taken place, but the wrist joint is stable. A Grade 2 sprain describes some instability of the joint, and more extensive ligament damage. A Grade 3 sprain is a completely ruptured ligament with a resulting unstable joint.
Treatment depends upon the category of the sprain. All cases require resting the joint completely. Wearing an elastic bandage, wrist brace, or splint will help achieve this. Icing the joint, taking anti-inflammatory medication, and elevating the wrist will help reduce swelling and pain.
Most wrist injuries should be medically assessed. Depending on your particular injury, you may need to wear a brace, splint or cast for at least a week to immobilize the joint and allow the ligaments to heal. Surgery to repair the ligaments might be necessary, following which you would need to wear a cast or brace for a period of time, followed by physical therapy.
A fracture is when one or more bones are broken. Often it is the scaphoid bone (one of the carpal bones) that breaks, again frequently as a result of a fall onto an outstretched hand.
Depending on the type of fracture, treatment may consist of immobilizing the wrist in a cast, and following the same home care described for strains and sprains, but sometimes surgery may be necessary. Following surgery your wrist would need to be supported in a cast or wrist brace for some time, followed by physical therapy to restore range of motion and flexibility.
To prevent injury to your wrist,
• warm up before exercising,
• wear a wrist guard for some sports, and
• wear properly-fitting footwear with non-slip soles.