How to Take Care of a Sprained Wrist

Anatomy

A sprained wrist is an injury to the ligaments of the wrist region. Ligaments are fibrous pieces of connective tissue that attach bone to bone. Ligaments serve to hold structures together and keep them stable. A sprained wrist means that the ligaments are partially or completely torn.

There are three grades of wrist sprain:

Grade 1: A mild overstretching of the ligaments, without any joint instability.

Grade 2: A partial rupture of the ligaments, with no or mild joint instability.

Grade 3: A complete rupture of a ligament with severe joint instability.

Breaking it down further, there are two types of wrist sprains:

Radial wrist sprains, which are most common and ulnar wrist sprains being less common.

Causes

Wrist sprains can be caused by bending, twisting or forceful impact involving the wrist. The most common cause of a wrist sprain is from a fall on an outstretched hand however they can also occur from overuse of the wrist which occurs in sports like tennis, boxing and basketball.

What Does a Sprained Wrist Feel Like?

A wrist injury can be quite painful, especially when you move it. It may also:

  • Feel sore
  • Feel warm
  • Make a popping or crunching sound
  • Be difficult to move
  • Feel weak

What’s the Treatment for a Sprained Wrist?

Treatment will vary depending on the severity of the wrist sprain. First things first, in phase one of treatment, it is important to rest. Stop activity and use of the wrist for 48 hours or until the pain and swelling around the wrist has subsided.

Apply ice to the affected area (cold pack) for 15 minutes at a time, several times a day.

Wrap an elastic compression bandage around the wrist to limit swelling. If you can, start wrapping at the base of the fingers and stop just below the elbow, this works to push fluid away from the injured tissue. The wrap should feel supportive and snug, but should not cut off any circulation to the affected area.

Try to keep the wrist above heart level as often as possible for 48 hours. This helps to drain fluid and reduce swelling around the wrist.

Nonsteroidal anti-inflammatory drugs (NSAIDS) are also recommended, but it is important to speak with your GP before taking any new medication.

In the second phase of treatment, it is important that the client begins gradual retraining exercises for the wrist. These include exercises to increase the flexibility of the wrist joint and exercises to strengthen the injured site. It is important to begin strengthening exercises to prevent stiffness and weakness from developing. As a general rule of thumb, you can begin strengthening exercises as soon as pain allows you to do so. However, it is recommended that exercises and strength training is guided by a Physiotherapist or Osteopath.

Active wrist mobilisations can be performed at home in phase 2. Some of these include:

  1. Place your forearms on a table with the palm of your hand on the table. By only moving at the wrist, bring the hand off the table towards the ceiling. Relax the hand back down on the table and repeat 10 times, controlling the motion throughout.
  1. Place your forearms on a table with the palm of your hand facing the ceiling. By only moving at the wrist, bring the back of the hand off the table so that the palm rises towards the ceiling. Relax the hand back down on the table and repeat 10 times, controlling the motion throughout.
  1. After completing the above two exercises for one week. Start adding weight by means of a theraband or small hand weight. The goal of this is to put a resistance on the movement and progress the strength in the wrist. You should always start with a low resistance/weight and many repetitions to train the muscle endurance first, then gradually increase resistance/weight but decrease repetitions to train muscle strength.

When Will I Feel Better After a Sprained Wrist?

A mild wrist sprain will begin to feel better 24 – 48 hours after you begin treatment. It will fully heal in 1-2 weeks. With a moderate or severe sprain, recovery can take 6-8 weeks. If surgery is required a full wrist rehab can take 6-8 months.

While the wrist heals, it is recommended that other forms of exercise are commenced that do not put additional strain on the wrisst joint, for example bike riding or walking/jogging.

If you are managing a sprained wrist, it is important that you do not return to your previous level of physical activity until you feel no pain in your wrist when it is at rest. It is also important to be able to grip and move objects without pain.

How Can I Prevent a Sprained Wrist?

Whether you are swinging a tennis racket, carrying grocery bags or typing on a computer, your wrists are often hard at work and in need of your protection. Proper wrist flexibility and stability is important to help prevent injury.

Two simple exercises for strengthening the wrist are:

  1. Resistance Band Wrist – Flex: Wrap a resistance band around your hand with your palm facing up and your elbow by your side, similar to curling a dumbbell. Keeping your elbow bent to 90 degrees, slowly curl your wrist up, squeezing your hand and forearm muscles. Repeat on the other wrist. Do three sets of 15 repetitions.
  1. Resistance Band Wrist – Extend: Keeping your elbow by your side, wrap a resistance band around your hand. Keep your palm facing down and your elbow bent to 90-degrees, like a reverse curl. Slowly curl your wrist up, squeezing your forearm muscles. Repeat with the other wrist. Do three sets of 15 repetitions each.

Some people will benefit from using a wrist guard or tape for stability. These work to prevent the wrist from moving into positions that place the wrist in unfavoured positions.

Outlined is a simple way to wrap a sprained wrist for support:

  1. Start by wrapping the wrist and hand in a protective pre-wrap.
  2. With all the fingers and thumb spread apart, which tightens the muscles, place three pieces of tape around the wrist with each one ascending up the arm as you go.
  3. Place a piece of tape starting at the inside of the wrist on the anchor wrap up between the thumb and index finger back down to the back of the wrist. Do not wrap this piece tightly.
  4. Flex the hand slightly and apply three to five pieces of tape from the wrist anchor to the top of the palm. Each piece needs to be placed so that you are making an X or fan shape.
  5. Anchor the last pieces of tape you place around your wrist and again on the top of your palm with a piece wrapping around your hand. Be sure to keep your wrist in a flexed position as you secure the anchor tape.

When to See a Physiotherapist

In most cases, a sprained wrist can be managed with rest, ice and the appropriate strengthening exercises. Mild sprains heal in approximately 2 weeks, while moderate sprains can take 6-8 weeks to heal. If you are experiencing discomfort in your wrist or have sustained a recent injury, be sure to make an appointment with a Physiotherapist at Pillar Health today for assessment, treatment and management advice. You can do so by phoning 03 8899 6277 or by booking online at pillarhealth.com.au.