RECOVERING FROM WRIST INJURIES

I'd like to start this post off by saying that every injury is different and requires different treatments.  I am writing this post for one of my favorite gamers and Twitch streamers and my tips in here are with his specific injury in mind. These tips may help with recovery from a wrist injury, but you should consult a doctor if you have one. If you are seeing a therapist, do what your therapist says since he or she knows your injury.  

When addressing wrist fractures there are several symptoms that can plague you after the bones have healed.  Actually, the bones' healing process is usually the easiest part to deal with.  In this post I want to address how to deal with:

• Nerve symptoms
• Decreased range of motion
• Decreased strength
• Managing pain

Nerve symptoms are very common in wrist and hand injuries.  The anatomy in the wrist is very small and contains a lot of nerves. Injuries to the area often compress nerves, or in extreme cases, may sever the nerves (which sucks).  Nerve irritation or pain presents itself as: a burning sensation, shooting pain along the affected nerve, numbness, and tingling (like your hands are falling asleep).  I would love to say that nerves always make a full recovery, but that's not true.  Sometimes nerves make a full recovery and sometimes they don't, and unfortunately there isn't a good way to predict the outcome (they just do whatever they want).  But the good news is there are things you can do to help improve the healing of nerves and manage the symptoms.  Keep in mind that depending on the extent of damage, it can take years for nerves to recover.  Of course, the earlier you address the damage the better chance you have. Don't be discouraged if a lot of time has already passed since your injury, there may still be time to recover.  SO!  How do we help your nerves regain their function.

• Vitamin B: Vitamin B helps with nerve conduction and sometimes it can help damaged nerves function better.  It doesn't always work, but it is simple to add into your daily life and it won't hurt. Your pee will also be the color of lemon-line Gatorade! Exciting! And a small price to pay for better functioning nerves.
• Mobility Exercises: These will help your fingers build neural pathways and improve your motor function.  The symptoms you feel are the side effect of your nerves not functioning properly, so helping your nerves relearn how they work and improving your motor function may help to decrease your overall symptoms.
• ABC's: Use your finger to trace all the letters of the alphabet.  This will get your fingers to move in just about every direction possible.  You'll want to do this for each finger individually.
• Finger opposition: Touch the tip of your fingers to the tip of your thumb, one at a time.  
  
• Stretching the Nerve: A lot of people don't realize this, but you can stretch nerves just like you can stretch muscles.  If you have tingling or numbness in your thumb and pointer finger, you'll want to stretch the radial nerve. If the feeling is in your middle finger, that would be your median nerve, and in your ring finger and pinky you should stretch your ulnar nerve.  If you're unsure which one, just do them all.  I recommend doing the stretches one step at a time and holding the position for at least 10 seconds before adding the next part.  If you feel tingling during the stretches don't advance the stretch to the next part until the tingling goes away.  If you feel shooting or sharp pain or a burning sensation stop immediately.  If you feel tingling in the beginning and then it turns to numbness, that usually means your nerves need a break.  Just like muscles, it's possible to fatigue nerves.
• Radial Nerve: first make a fist, then flex your wrist towards your forearm.  Next straighten your elbow and extend your arm out behind you.  It can also help to tilt your head away from the side you are stretching.
  
   
• Median Nerve: Start by extending your fingers away from your palm, then extend your wrist towards the back of your arm, so your palm is flat and you can see the back of your hand.  Next, straighten your elbow, then raise your arm to shoulder height.  Extend your arm behind you, and again tilt your head away from the side you are stretching.
  
• Ulnar Nerve: Extend your fingers away from your palm, and then extend your wrist towards the back of your arm, like in the stretch above.  Raise your arm out at your side and place your palm on the side of your face (or as close as you can).
  

When you fracture your wrist, you also may experience a decrease in your range of motion.  Damaged tissue rarely recovers to 100% of what it was like before the injury, because scar tissue is much less elastic than the original connective tissue.  Now, if the bone wasn't properly set, or recovered in an abnormal way, and you have a bony block decreasing your range of motion, there's not much you can do (I mean, unless you can shave down the bone and that's not something you should do at home - it makes a mess).  If the decreases in range of motion are caused by scar tissue though, or from being immobilized while the bones healed (in a cast or splint), then you should be able to get your range of motion back.

• Stretching: Over time, stretching will increase the elasticity of your muscles and tendons.  Again, you want to start very gently.  I recommend doing these stretches with your elbow bent before you try them with your elbow straight.  You want to stretch your wrists, but don't forget your fingers too.
  
  
  
  
  

  

  granny hands

• Joint Mobilization:  These are techniques for stretching the joint capsule (think bubbles around your joints).  For these techniques the two bones of the joint are moved in opposite directions (which sounds painful but its not, you sort of do one every time you crack your knuckles).  This movement should only be performed by a trained professional so ask your doctor or therapist if they think it would improve your condition (don't be dumb and try this at home like the kids after watching Jackass).

Decreased strength usually comes from a lack of exercise of your hand and wrist muscles.  When you have an injury, and movement causes pain, it makes sense that you wouldn't want to exercise that area (duh).  Likewise, if you were in a splint or cast, you would not have been able to exercise the affected muscles.  Significant levels of pain can even cause an automatic response which decreases your strength (basically, pain shuts down your muscles' function).  To remedy this, do some strengthening exercises.  Start with 1-3 lbs. and work your way up.  Remember, these shouldn't hurt, so don't force it. If you can't move the whole way the first time that's OK.  Work with what you can, and you'll get better as you get stronger.

• Wrist Curls:  Hold a weight in your hand and then bend your wrist towards your forearm.  It can be helpful to stabilize your arm on a hard surface with your wrist hanging off.
  
• Wrist Extension: This is the opposite of a wrist curl. Hold the weight and extend your wrist to the back of your arm.
  
• Finger Curls:  This one is sometimes tricky, you have to hold your arm palm up and the weight in your hand.  You open your fingers and let the weight roll out to your fingertips, then curl the weight back up towards your palm by making a fist.  You can also do this by squeezing a stress ball though as your strength improves the stress ball may not be enough resistance.
  
• Finger Extension: For this one you need play-dough or something similar.  Put the blob of play dough on a table and then use your finger tips to spread the play dough out flat.  You can also put a rubber band around your finger tips and then stretch it out.
  
• Wrist Supination and Pronation:  For this exercise, hold one end of the weight so the other end goes straight up in the air.  Stabilize your arm on a table and then rotate your wrist slowly in both directions so that the weight moves to one side then the other.  
  

Thankfully, managing your pain is the easiest part.  The general rule when managing pain is to do whatever works for you.  This may take some time to figure out, but if it decreases your pain in a healthy way, then go for it.  Remember, sometimes the above exercises will make your pain temporarily increase, but if it lasts for too long, you may need to use less weight or be easier on yourself.

• Heat: Heat can help relax your muscles, and also improve the elasticity of your connective tissue.  Plus, it sends happy hormones to your brain which help to combat the pain signals your brain receives.  Unfortunately, most heating pads don't penetrate very deep (they rarely go further than the skin and fat) so your best bet is making a hot bath, hot tub, or something like that.  Remember that you will have to keep adding hot water as it cools (and if the water feels like its too hot guess what it probably is).  Paraffin wax, like the kind used for manicures, is also amazing if you can use it (most of us can't).  If heat works for you, awesome, just be careful you don't burn yourself.  Heat can also help make your stretching more effective, so you can try it in combination.
• Cold: If you're gonna use cold, I recommend using ice in a bag (think ice cubes) instead of a cold pack, because you don't have to worry about frostbite with ice. Ice freezes at 32 degrees and ice packs actually freeze colder than that.  For most people heat works better for pain management, but if cold works for you the affects will last much longer than heat.  Just put the ice pack where ever your pain is a leave it for about 20 minuets.  BOOM done!
• Massage: This can be especially useful if you also have the decrease in range of motion.  Start gentle and always move towards your shoulder. This can also help improve circulation (it can be uncomfortable and sometimes painful to pull your blood towards your fingertips, so don't do that unless a doctor or trainer tells you to specifically).  If you don't know how to do a massage, that's OK just try small circular motions with your thumbs until you find something that helps your muscles relax.  Start in your fingers and hands and then move up to your forearm, upper arm and shoulders.  If you are completely at a loss, and can afford it, go get a manicure from a spa or salon that includes a massage (or just get a massage) and then copy what they do.
• Joint Mobilizations: As I mentioned before these can help increase range of motion, but they can also be useful for pain because as you glide the bones you increase the fluid surrounding the joints, which helps increases the nutrients you absorb.  Plus, they help stretch the joint capsule which can feel nice.  Remember this requires a professional.

Keep in mind none of these tips work miracles. It's going to take you being faithful and doing them on a daily basis to make a difference in your symptoms.  When you do these exercises, remember, they are meant to rehabilitate an injury, so start slow.  Also, before you do any of these, ask a professional, either a doctor or trainer, or whoever is working with you for your injury, to make sure they are okay for you to do with your specific injury. If they are okay, you still may not be able to do every single thing on the list - just be patient, progress will come.  If you feel your symptoms start to act up more than what you feel in your normal life (tingling, shooting pain, achy joints, burning, numbness, ect.) it means its time to take a break.  Wait for your symptoms to go away before your try again, and don't be surprised if it takes hours or even a day for the symptoms to start to go away.  These exercises may also make you feel sore and weak in the beginning.  As you get better and stronger at the exercises, your symptoms should start to decrease and you should be able to do the rehab for longer periods of time before your symptoms act up.  Work up to doing these 3-4 times a day, especially the stretches.  I hope that eventually your symptoms go away permanently and you make a full recovery.

I hope this guide was helpful!

If you have a specific injury that you have experienced and would like some tips on it or if you would like me to elaborate on anything in this post, leave me a comment.

**NOTE: These tips do not replace medical attention from a doctor.  If you are experiencing pain you should see your doctor first.  Always consult your doctor before you start a rehabilitation program**