What is Wrist Strain?
A wrist consists of eight carpal bones along with a complicated web of ligaments and nerves. All the eight bones hold up an area known as the carpal tunnel. Carpal tunnel consists of median nerve and the tendons.
Wrist is the body part which gets injured very easily as it is used in many types of sports activities like boxing, badminton, tennis, baseball, etc. Apart from the sports, the wrist is also used aggressively in performing certain activities such as typing which involves repetitive movement of the wrist posing a risk factor of wrist strain.
A wrist strain is a condition in which the injury occurs to tendons (tissues connecting muscles with bones) and ligaments. Severe wrist strains usually tear the tendons or ligaments of the wrist either partially or completely which is often disabling and painful. A wrist strain can either be a simple overstretching of the tendon or the ligaments of the wrist bone, or it can be a tear in the tendon or the ligaments, which can again be partial or complete depending on the type of wrist injury.
Generally wrist strain occurs when a sudden force bends the wrist in an abnormal position. This force could actually be beyond the tolerance power of the wrist. This often happens due to a repetitive strain injury which is followed by repetitive movements of the wrist.
Types of Wrist Strain and Its Recovery Period or Healing Time
The Wrist Strains can broadly be classified into three types depending upon the type of wrist injury.
- Grade I Wrist Strain are mild.
- Grade II Wrist Strain are moderate.
- Grade III Wrist Strain are severe.
Each type of Wrist Strain has particular signs and symptoms which assist in evaluating the severity of the wrist injury.
- Grade I Wrist Strain and Its Recovery Period or Healing Time: This type of wrist strain is referred as mild strain of the wrist. This kind of wrist strain often damages only some fibers of the ligaments. Grade I Wrist Strain heals up easily within the duration of two or three weeks.
- Grade II Wrist Strain and Its Recovery Period or Healing Time: This kind of wrist strain is a step ahead to the Grade I wrist strain, which means comparatively it is severe than mild strain. Grade II Wrist Strain extensively damages the fibers of the ligaments, but the ligaments of the wrist joints do not rupture totally. Grade II Wrist Strain takes the duration of about three to six months for healing.
- Grade III Wrist Strain and Its Recovery Period or Healing Time: This type of strain is very severe in nature as it could lead to complete rupture of a ligaments of the wrist joint. Grade III Wrist Strain is often treated by surgery in order to repair the injured tendon and ligaments of the wrist bone. The recovery period or the healing time for Grade III Wrist Strain could be about three months or more.
Causes and Risk Factors of Wrist Strain
- Wrist strain is frequently experienced by individuals doing heavy manual work.
- The major cause of the wrist strain could be a sudden movement of outstretched hand to break a fall while falling down.
- Wrist strain may also occur due to twisting and pulling a tendon or muscle.
- An injury to any portion of the wrist may cause strain and have a strong impact on the capability of using the hand or the wrist.
- Wrist strain could also be caused by performing same continual movements like in case of carpal tunnel syndrome, repetitive stress and arthritis.
- Wrist strains are very frequent in several sports such as tennis, bowling, snowboarding, golf and gymnastics.
- Wrist strain could also be caused by performing repetitive activities such as cutting hair; knitting or typing that usually puts heavy pressure on the wrist and hand.
- Individuals suffering from leukemia, lupus, under active thyroid gland, diabetes and scleroderma could also be at a higher risk of wrist strain.
- Wrist strain may also be a result of over stressing of the muscles such as lifting heavy objects improperly.
Signs and Symptoms of Wrist Strain
- Development of gradual or sudden pain around the wrist joint can be a sign of strained wrist.
- Tenderness in the area of the wrist.
- Development of swelling around the wrist can also be a sign of wrist strain.
- Appearance of bruising.
- Feeling of pain during movements of the wrist.
- Weakness in the muscles.
- Muscle spasm is often experienced.
- Inflammation around the wrist joint can be a sign or symptom of strained wrist.
- Muscles may fail to function properly in case of a severe strain.
Treatment for Wrist Strain
First step towards treatment for athletes suspected of second or third degree wrist strains is to immobilize the hand and wrist and transport them to a local urgent care for proper medical evaluation.
In case of mild-to-moderate wrist strains, they generally heal on their own with rest and time. However, few measures can be taken to speed up the recovery process of wrist strain:
- Rest the strained wrist for at least 48 hours.
- Ice the strained 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 associated with wrist strain.
- Wrist compression with a bandage is quite helpful treatment for wrist strain.
- Another effective treatment modality for wrist strain is elevation of wrist above the heart.
- Non steroidal anti inflammatory drugs such as Motrin, Advil or Aleve to help with pain and swelling associated with wrist strain. These drugs can be taken only under the supervision of a medical practitioner.
- Applying a cast or splint to the wrist for immobilization also helps treat strained wrist.
Surgical repair is required in more severe grade III wrist strains where there is major or complete rupture of the tendon or the muscle. Surgery for wrist strain involves repairing the tear of the affected tendon or ligaments.
Physical Therapy Treatment For Wrist Strain: Physical therapy is required for all the patients to speed up the healing process of Strained Wrist and restore normal functioning of the wrist and hand. Physical therapy for Wrist Strain may include:
- Joint mobilization.
- Soft tissue massage.
- Application of heat and ice is also a helpful remedy for wrist strain.
- Dry needling.
- Wrist bracing is quite helpful if you have a wrist strain.
- Wrist taping.
- Exercises to improve flexibility, strength and endurance of the wrist joint following wrist strain.
- Activity modification.
- Gradual return to activity program.
Exercises for Wrist Strain
- Wrist Flexion to Extension Exercise For Wrist Strain: This exercise is performed by placing the forearm on a table and the fingers over the edge. Bend the wrist in the backwards and forward directions until a mild to moderate pain-free stretch is felt. Repeat 10 times ensuring there is no exacerbation of symptoms.
- Forearm Rotation Exercise For Wrist Strain: This exercise is performed with the elbow at the side and bent to 90 degrees. 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 of wrist strain.
- Wrist Side Bend Exercise for Strained Wrist: This exercise for wrist strain 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.
- Wrist Extensor Stretch For Wrist Strain: This exercise for strained wrist is performed by keeping the elbow in a straight position and bending the wrist downwards with the help of other hand until a mild to moderate pain-free stretch is felt. Hold this position for about 15 seconds. Repeat 4 times ensuring there is no exacerbation of pain.
- Wrist Flexor Stretch for Wrist Strain: This exercise for strained wrist is performed by keeping the elbow straight move the wrist in the backward direction with the help of the other hand until a mild to moderate pain-free stretch is felt. Hold this position for about 15 seconds. Repeat 4 times ensuring there is no exacerbation of pain.
Exercises for Wrist Strain
Tests to Diagnose Wrist Strain
A complete subjective and physical examination is necessary to diagnose a wrist strain. A thorough neurovascular examination of the hand and the digits is performed to assess for injuries to the nerves and vessels. Typically an x-ray is done to assess and rule out any underlying fractures.
Other diagnostic tests may include:
- Magnetic Resonance Imaging (MRI).
- Electromyography (EMG).
- Nerve Conduction Velocity Test (NCV).
- CT scan.
- Bone scan.