Remember! Our guides are to be used following an assessment with a qualified medical professional. Do not attempt these exercises if you have not been given a formal diagnosis, or given consent to complete these exercises by a Physiotherapist.

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Wrist Sprain Physical Therapy Guide

What Is A Wrist Sprain?

A wrist sprain is caused through directed trauma such as slipping or falling onto an outstretched hand whilst competing in sports, specifically a fully pronated hand! If there is sufficient force through the ulnar side of the extended wrist then an injury or tear to the surrounding soft tissues will occur. A sprain is defined as an injury to a ligament. Ligaments are the connective tissues that connect bones to bones and provide support to the surrounding joint; they could be thought of as tape that holds the bones together. Wrist sprains are also sometimes known as a triangular fibrocartilage complex injury (TFCC). The TFCC lies between the ulnar and the first row of wrist bones (carpus). It is the major stabilizer of the radioulnar joint and injury to it can be a very serious condition that can leave the wrist joint with a considerable amount of instability, pain and weakness. All the soft tissues surrounding the wrist joint work together to ensure that the wrist is sturdy when performing movements with your arms, and a injury to any one of the wrist structures will unbalance this. Ligament sprains can be graded into 3 categories depending on the severity of the injury:

  • Grade I: is the least harmful injury, and results from stretching or slightly tearing the ligaments/soft tissue with mild tenderness, swelling, and stiffness.
  • Grade II: is a larger but incomplete tear of the soft tissue and presents with moderate pain, swelling, and bruising.
  • Grade III: is a complete tear of the affected ligament or soft tissues with severe swelling and bruising.

What Causes A Wrist Sprain?

Compressive loads to the wrist, especially if accompanied by wrist deviation may tear the central portion of the cartilage or overstretch the ligaments and soft tissues. These compressive loads are extremely common in sports, specifically in athletes that compete in high impact sports such as gymnastics, tennis and basketball. Sports participants are very prone to developing a sprain injury due to the high amount stress that goes through the wrist joint. The injury is also extremely common in adolescents and children.

Wrist Sprain Symptoms 

Spraining a wrist can be an extremely traumatic and painful injury and may often require a visit to the emergency room to get it scanned or strapped up. Pain usually arises from the underside of the wrist after it has been hyper extended.

The most common symptoms of a wrist sprain include:

  • Swelling or bruising in the wrist.
  • Pain on wrist joint movement and weight bearing.
  • Clicking sensations on wrist movement.
  • Reduced grip strength
  • Inability or difficulty moving the joint actively and passively.
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Wrist Sprain Strapping And Taping

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There are plenty of advantages to immobilising the injured wrist joint! Rest is an important part of the recovery process and slightly immobilising the painful structures with a strap is certainly an advantage to allow better healing times, this can be achieved by using a wrist strap or KT tape. When performing any activities that put the wrist at risk, a strap could be seen to help avoid re-injury by giving proprioceptive feedback to your muscles, tendons and ligaments. Check out our favourite tape here!

 Treatments For Wrist Sprains

There are many treatment options available to people who suffer from a sprained wrist! Your rehabilitation programme and recovery time depend entirely on how severe the sprain is. Make sure you get a full assessment from your health care professional before commencing any exercises.

Rest & Time

Initially, you need to stop doing the activities that caused the wrist injury in the first place and prevent agitating it further, this normally includes weight bearing exercises or active wrist movements. Immediately following the wrist sprain you can commence the RICE protocols:

  • Rest. Relax and protect your wrist. Stop, change, or take a break from any activity that may be increasing your pain.
  • Ice. Cold packs will reduce pain and swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day. Do no place ice directly on to skin, wrap it in a towel first to avoid ice burn!
  • Compression. Wrapping the wrist with a compression strap will help decrease swelling and improve recovery time.
  • Elevation. If you present with swelling and bruising in your wrist and hand, try to regularly elevate it.

Physical Therapy

Although rest is a vital component of the recovery process, it doesn’t mean the affected wrist has to be completely immobilised for long periods. In fact, the soft tissue needs to be placed under tensile loads to grow and stay healthy.  The easiest way to strengthening you wrist muscles? Exercise! 

Wrist Sprain Exercises

1) Wrist ROM

It is imperative that you continue to maintain and improve the range of movement in your wrist and fingers, as they often get very stiff due to pain and swelling. Its the simplest, yet most effective way to improve your wrist sprain.  To make the exercise harder you can add weights and slowly strengthen the muscles through movement. Remember “motion is lotion!”

How to do it:

  • Simple, your wrist moves in multiple directions, throughout the day try and move your wrist in these directionsl
  • Do not push through pain, if its painful, try something else.

Repeat multiple times throughout the day!

2) Wrist Isometric Strength

It is very important that you try to maintain the muscular strength in your wrist and hand, as the muscle can often begin to waste away if you don’t use it! Isometric strength training is easy and can be done anywhere! It’s similar to tensing your muscles without moving them.

How to do it:

  • Place your affected hand palm down on a table in front of you.
  • Place your non-affected hand on top of your injured hand.
  • Try to move injured wrist up towards the ceiling, whilst stopping it from moving with your non-injured hand (tensing your forearm muscles).
  • Hold for 10-15 seconds.

Repeat 10 reps, 3 sets. Try to do this 3 times per day.

3) Hand Squeezes

Relieve carpal tunnel stress and strengthen your hands, forearms and fingers with this simple exercise. It can be completed with a resistance ball that you can purchase here!

How to do it:

Repeat 10 reps, 3 sets. Try to do this 3 times per day.

4) Prayer Stretch

The Prayer stretch is actually used as a diagnosis tool used by Physical Therapists, as it often compresses the median nerve in the carpal tunnel. With that in mind, it is a good idea not to over do this stretch, only use it as a means to stretch the tight muscles in the wrist and forearms gently! 

How to do it:

  • Start with your palms together in front of you, just below your chin.
  • Slowly start to lower your hands towards your waistline, keeping your hands close to your stomach and your palms together.
  • You should feel a mild to moderate stretch under your forearms. Hold this stretch for 10-15 seconds.

Repeat 10 reps, 3 times per day.

5) Pinch Extensions

  • Using your injured arm, bring your fingertips together as if making a beak shape
  • Place a rubber band or modified Theraband over your fingers so that it holds the tips of your fingers together
  • Slowly move your fingers away from each other against the resistance of the band 
  • Repeat 10 times, 3 sets. Try to do this 3 times per day.

6) Tyler Twists

The Tyler Twist exercise is mainly used in the treatment of lateral elbow tendonopathies for forearm strengthening, but it can be beneficial in cases of Carpal Tunnel Syndrome. It requires the use of a Theraband Flexbar, which can be purchased here!

How to do it:

  • Grasp the Flexbar with your injured arm near to its base and extend your wrist.
  • Grasp the upper end of the bar with your non-affected arm so that it faces away from you.
  • Twist the bar with the top hand as you stabilise with the bottom hand.
  • Hold both wrists steady as you extend both elbows in front of you. The wrist on your injured side should be extended whilst the other wrist is flexed.
  • Slowly release the bar with your injured side, while maintaining tension with the uninjured side.
  • The more twisting motion you can apply with your uninjured side to begin with, the better the resistance will be for the injured side.

Repeat 10 reps, 3 sets, try to do this 3 times per day.