Wrist pain and dysfunction can occur through overuse, injury or structural changes resulting from degenerative conditions such as arthritis. Wrist physiotherapy exercises are dependent on the nature of the problem, pain symptoms and dysfunction experienced. They are utilised to regain range of motion, movement, strength and stability of the wrist, hand and forearm.
The wrist is a collection of eight different bones, called the carpal bones. Its function is to connect the hand and the forearm. It also provides stability and motion to the hand and forearm. Wrist movement includes flexion and extension, and radial and ulnar deviation, or lateral movements to the left and right. The wrist also assists with the movement of the forearm, called supination and pronation to position the palm up or palm down.
Due to the intricate structure of the wrist, problems with the wrist can occur through things like tendinitis, or the inflammation of the connective tissue which connects muscles to bone; arthritic conditions where the cartilage covering the ends of the bones begins to wear away; and fractures or dislocations, disruptions or breaks in bone. Symptoms can include a general ache or pain in the area, pain radiating into the hand or fingers, or general wrist movement limitations or pain with movement.
Wrist Physiotherapy Exercises for Acute Problems
A treatment protocol for injuries or dysfunction of the wrist is typically provided by a qualified physiotherapist, commonly referred to as a physical therapist. Initially, the goal of rehabilitation of a wrist problem in the acute phase includes the use of pain-relieving modalities such as ice or heat application and equipment such as electrical stimulation and ultrasound. A gentle stretching program may also be instituted at this time to maintain available range of motion.
Wrist Physiotherapy Exercises for Flexion and Extension
Once the initial or acute phase symptoms diminish, wrist physiotherapy exercises concentrate on continued relief of pain, and maximising wrist movement and wrist strength. This is done through the use of stretching techniques and exercises. Exercises to increase wrist strength and mobility can be performed against gravity or without the influence of gravity. For example, to flex and extend the wrist without gravity, the hand can be positioned on a table, with the thumb up. Flexion and extension is performed by sliding the hand on the table. To perform extension against gravity, rest arm, palm down, on table and lift. Conversely, for flexion, place palm up.
Wrist Physiotherapy Exercises for Other Movements
Wrist physiotherapy exercises for lateral deviations can be performed in similar positions as flexion and extension, except the antigravity position is palm down and against gravity is sideways with thumb up. To strengthen the wrist for assistance in forearm supination and pronation, the elbow is bent at side and the forearm is then moved palm up, then palm down. An overall wrist strengthen program to include elbow, hand and fingers is beneficial in attaining maximal range of motion of the lower portion of the arm, from the elbow to the wrist.