What is Wrist Sprain?
Wrist sprain is a condition generally caused when there is an injury or tearing to a cartilage, ligaments and joint capsule of the wrist.
The wrist consists of the amalgamation of eight little bones in the hand along with two bones passing to the forearm that is ulna and radius. Several small joints lie between the wrist bones individually comprising of strong connective tissue covering around the bone ends and cartilage that lie between the exterior joint reducing the impact of the bones on each other while performing the regular activities.
Compression or stretching forces are placed on the wrist joints while performing certain movements or activities of the wrist. Joint injury may occur due to excessive forces resulting from too much of repetition or force elevation which could lead to damaging of the cartilage or tearing of the connective tissue covering the joint. This condition is called as wrist sprain.
Wrist sprain is a very common injury suffered by athletes from all types of sports. Just a momentary loss of balance is enough to cause a wrist sprain. Whenever a person slips or loses balance, the immediate reaction is to stretch out the hand to break the fall. In this process, the hand hits the ground with great force taking all of the body's weight, which results in excessive stretching of ligaments connecting the wrist and the hand bones. The result is tearing or breaking down of the ligament leading to wrist sprain.
Classification and Types of Wrist Sprain
An injury caused to a ligament is referred to as a sprain. Ligaments stick bones together and help in providing steadiness to a joint. There are a large number of ligaments situated in the wrist putting an athlete at a risk of injuring multiple ligaments during sports activity.
The sprains can broadly be classified into three types depending upon the condition of the injury.
- First degree sprain as mild.
- Second degree sprain as moderate.
- Third degree sprain as severe.
Each type has its particular signs and symptoms which assist in evaluating the status of injury.
Mild Sprain: This sprain is referred as first degree sprain. This kind of sprain stretches the ligament without tearing it. Mild swelling, tenderness over the injured ligament and discomfort while moving the hand through extension and flexion or moving it side to side could also be experienced by the athlete.
If the athlete's pain tolerance power is more, the protective taping is applied to the wrist for assistance. This also helps in competing with the first degree ligament sprain.
Moderate Sprain: This sprain is referred to as second degree sprain. This kind of sprain is a step ahead to the first degree sprain, which means comparatively it is quite severe than mild sprain. The second degree sprain leads to a partial tear of the injured ligament. This also compromises the stability of the joints by increasing the laxity.
Severe Sprain: This sprain is referred to as third degree sprain. This type of sprain is very severe in nature as it could lead to complete rupture of a single or sometimes more ligaments. A significant force could be a reason for complete rupturing of ligaments in the wrist, as it may occur with falling from a height like for example a flyer who falls on an outstretched hand after being tossed in the air.
Causes and Risk Factors of Wrist Sprain
Most frequently, wrist sprain may occur due to a particular incident like falling down on an outstretched hand. This could happen with any fall but is more frequent in sports. Apart from this, there are many more causes for wrist sprain.
- Falls suffered by baseball players, divers, basketball players and gymnasts.
- Falls from skiing while holding on to a pole.
- Falls while skateboarding or snowboarding especially in icy environments.
- Falls suffered by skaters.
- Falls while cycling.
- Direct blow to the wrist.
- Repetitive strain linked with overuse. This generally happens in individuals performing heavy physical work with the wrist, which include repetitive use of a screwdriver or hammer.
- Twisting or applying excessive pressure on the wrist.
- Weightlifting or boxing may also cause a wrist sprain.
Signs and Symptoms of Wrist Sprain
A sprained wrist may cause a sudden wrist pain immediately after the injury. However, there are many other symptoms that may suggest wrist sprain.
- Warmth and tenderness around the wound.
- Stiffness and pain in the wrist.
- Pain on touching the affected area.
- Pain in the hand or forearm on the affected side, but this is a rare case.
- Tearing or popping in the wrist is felt.
- Feeling of weakness in the hand and wrist.
- Swelling or bruising.
- Back, sides or front of the wrist could get affected.
- Pain could also increase by performing certain heavy activities in which wrist and hand is used like general gripping activity, placing weight through the affected hand such as doing push-ups, opening jars or doors or picking up heavy objects.
Treatment for Wrist Sprain
First step towards the treatment for athletes suspected of second or third degree sprains is to immobilize the hand and wrist and transport them to a local urgent care for proper medical evaluation.
In case of minor-to-moderate wrist sprains, they generally heal on their own with rest and time. However, few measures can be taken to speed up the recovery process:
- Rest the wrist for at least 48 hours.
- Ice the wrist for 20-30 minutes every three to four hours. This needs to be done for about two to three days until the pain subsides. This helps in reducing the pain and swelling.
- Wrist compression with a bandage.
- Elevation of wrist above the heart.
- Nonsteroidal antiinflammatory drugs such as Motrin, Advil or Aleve to help with pain and swelling. These drugs can be taken only under the supervision of a medical practitioner.
- Applying a cast or splint to the wrist for immobilization.
Surgical repair is required in more severe grade III wrist sprains where the ligament is snapped.
Physical Therapy for Wrist Sprain
Physical therapy is required for all the patients to speed up the healing process and restore normal functioning of the wrist and hand. Physical therapy may include:
- Joint mobilization.
- Soft tissue massage.
- Application of heat and ice.
- Dry needling.
- Wrist bracing.
- Wrist taping.
- Exercises to improve flexibility, strength and endurance.
- Activity modification.
- Gradual return to activity program.
Exercises for Wrist Sprain:
This exercise is performed by placing the forearm on a table and the wrist and fingers over the edge. Bend the wrist forwards and backwards slowly until a mild to moderate pain-free stretch is felt. Repeat 10 times ensuring there is no exacerbation of symptoms.
This exercise is performed by bending 90 degrees with elbow towards the body. Rotate the palm up and down slowly as far as possible until a mild to moderate pain-free stretch is felt. Repeat 10 times ensuring there is no exacerbation of symptoms.
Wrist Side Bends:
This exercise is performed by placing the forearm on a table and the wrist and fingers over the edge. Bend the wrist from side to side slowly as far as possible until a mild to moderate pain-free stretch is felt. Repeat 10 times ensuring there is no exacerbation of symptoms.
Tests for Diagnosing Wrist Sprain.
Generally a complete subjective and physical examination is performed to diagnose a wrist sprain. Other tests may include:
- X-ray of the wrist.
- CT scan in rare cases.
- MRI in rare cases, generally if surgical treatment is required.