Wrist Pain and Injury Therapy

Wrist injuries are common among all walks of life, from computer users, to factory workers to athletes. Many people can’t tell wrist sprain treatment with bracethe difference between a sprained wrist and a broken wrist, the wrist pain is similar, but these are very different injuries. Wrist tendinitis is the most common form of wrist injury for folks who use their hands and arms frequently throughout the day and comprises of 25%-50% of all sports injuries. The elderly are most at risk for wrist injuries because of decreased forearm and grip strength, along with weakened elasticity of wrist tendons from overuse. Physical therapy is very helpful for treating wrist injuries and can help guide patients to full recoveries by increasing wrist strength, stability, and range of motion.  

What is Wrist Tendinitis?

Wrist tendinitis is when the tendons of your wrist can become inflamed or irritated from repetitive strain. The tendons of the wrist are actually elongated from muscles of the forearm, and connect to the fingers of the hand so that the muscles can cause different grip and hand movements. The tendons are much like cable, and are easily visible on the backs of your hands. Following are the most common conditions of wrist tendinitis:

  • Wrist tendinitis is a term to describe the early stages of tendon inflammation and irritation.
  • Tendinopathy is a term when wrist tendinitis has becoming chronic and has persisted for a long time, typically more than 2 months.
  • Tenosynovitis describes the irritation that develops in the synovial sheath, where the tendons glide in. The sheath thickens from inflammation and restricts tendon gliding.
  • De Quervain’s Tendinitis is a special tendinitis in that it describes the inflammation to the thumb tendons at the radial aspect of the wrist. This is most commonly seen in mothers who pick up young children a lot.

Signs and Symptoms

Following are what a patient may feel if they have wrist tendinitis:

  • Pain and aching at the wrist, pain may radiate up the forearm and to the elbow.
  • Pain on the radial aspect of the wrist (where the thumb joins the wrist), or on the ulnar side of the wrist (the pinky finger side).
  • When the wrist is twisted or put under strain, pain ensues. This wrist pain may get worse if left untreated and activity is not modified.
  • Pain with weight-bearing pressure onto the hand, like when performing a push-up or when pushing off a chair to stand up.
  • Stiffness in the wrist enabling the patient from fully bending and straightening the wrist joint.
  • Swelling in the wrist area.
  • Tenderness to pressure and massage in the wrist and forearm muscles.  

How Is It Diagnosed?

Your physical therapist will conduct a thorough evaluation of your wrist to properly discern the anatomical structures affected. He/she may have to rule out other conditions such a carpel tunnel syndrome, or more serious orthopedic cases like a large cartilage tear, wrist strain, or even a fractured wrist. Your physical therapist will also ask you relevant questions such as the activity that caused the injury, the manner, and movements in which your symptoms can be aggravated, and most importantly which activities of daily living are affected by your injury. You will undergo an objective exam, whereby your range of motion, amount of swelling, forearm strength and grip strength are recorded to establish a baseline for your progress.

Physical Therapy Treatment for Wrist Injuries

Physical therapy is highly effective for treating tendinitis and wrist injuries. Everyone’s plan of care and length of treatment will differ according to presentation and functional goals, but here is an example of the key focus areas your physical therapist may treat you with:

Pain Management. Your physical therapist will hone on in painful movements of the wrist and help you avoid noxious movements and activities, so you prevent further strain and stress on the wrist structures. Rest may be recommended in the short-term if the wrist pain is acute, as well as ice to treat the inflammation and alleviate pain. Your physical therapist may also recommend a wrist brace to help stop you from performing painful ranges of movement, and to stabilize your joint for better comfort and allowance for tendons to heal.

Manual Therapy. Gentle joint movements when the wrist injury is acute, or more aggressive joint mobilizations when the injury is chronic may be done to help your ease of motion. Soft tissue massage will also help tight and sore muscles relax. Your physical therapist could also prescribe your you stretches to do in the clinic and at home to get your wrist to move better.

Strengthening and Range of Motion Exercises. Your physical therapist will determine the progression of exercises for you to strengthen the stabilize the wrist, along with promoting healthy joint motion. Most times, the entire arm and shoulder can be weakened and be the cause of the wrist injury. This movement dysfunction is apparent in all sorts of movement where weakness from the shoulder can cause the patient to compensate with the wrist and hand. Your physical therapist will design home exercise programs and in-clinic exercises to help you meet your functional goal.

Patient Education. Your physical therapist will likely recommend you keep your wrist in a neutral position while lifting and doing activities to best protect wrist tendons and cartilage. They will show you how to keep this neutral position while simulating different sports maneuvers and activities. This simulation of activities is integrated into the exercise program as because your physical therapist wants to make sure you can return to full activity healthfully and prevent future re-injury.  

Can wrist injuries be prevented?

Wrist injuries can indeed be prevented. Here are several tips:

  • Avoid repetitive wrist and hand movements, especially those that require a lot of grip power, high arcs of movement, and force. If you have to perform these movements, make sure to take frequent resting breaks for your hands.
  • Warm up the wrist and forearm muscles before starting repetitive hand activity (be it a sport or work). Your do this by making wrist circles, or using a hand gripper.
  • In addition to resting breaks, perform regular wrist stretches to maintain flexibility.
  • Make sure you maintain upper-body conditioning if your are performing an upper-body sport (like tennis, weightlifting, or boxing). Strong shoulders always means less stress to wrist and hand muscles.
  • If an activity causes you wrist pain, don’t work through it. The pain signifies something wrong, like tendon irritation and/or damage. Discontinue your activity and rest – at least until the pain subsides.

Seeing  a skilled physical therapist is crucial with wrist injuries in order to determine the source of dysfunction, whether that be a weakness, joint hypomobility, or a carpal tunnel issue. Often the most beneficial wrist sprain treatment for tendon injuries will include a training modification and specific strengthening exercises. These are very individualized wrist injury treatments, so it’s important to team up with a Doctor of Physical Therapy such as those at the Portland Area Stride Strong clinics who are willing to put the time into treating your wrist pain ailment.

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Alice Holland, DPT

Doctor of Physical Therapy, Director at Stride Strong Physical Therapy
Alice earned her Doctorate of Physical Therapy from USC in 2007, and have practiced Physical Therapy for 12+ years in the Outpatient Orthopedic Setting. Certified in ASTYM, she also has been a featured expert on Physical Therapy on numerous publications including health.com, healthline.com and yahoo.com.
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Latest posts by Alice Holland, DPT

Ana Lucia Pinheiro
Ana Lucia Pinheiro
02:18 20 Oct 17
This place is amazing. I am so happy I found Stride Strong PT. Alice pays attention to all of the details, she watches every single move I make, my posture, and the way I move through every exercise. She is very knowledgeable, she was able to pin-point the problems in my back and she has a plan to help me become stronger where I need. The place is brand new, huge, and has nice exercise machines. I tried a few physical therapists in the area, and Alice is TOP, second to none, and I feel super lucky to have found her. Highly recommended!!
Prashant Gupta
Prashant Gupta
01:00 02 Oct 17
Dr. Alice at Stride Strong is one of the best PTs I have come across. Her attention to detail and assessment of the root cause of injury is very good. She is excellent in evaluating pain patterns and giving a training schedule for a rehab & injury prevention, she is extremely knowledgeable. I would strongly recommend Stride Strong to anyone looking for PT. It is easily the best PT clinics in Hillsboro area.
steven zollin
steven zollin
20:57 14 Sep 17
Highly recommend Stride Strong Physical Therapy , Alice showed me proper form to assist in recovery with my shoulder and is very knowledgeable.
Lindsay Nied
Lindsay Nied
23:33 18 Dec 17
I recently had a massage from Joel at the Hillsboro location. He was able to work on an ongoing issue I have been experiencing with my back after a sports injury, and I left feeling so much better. The whole facility looked incredible, and everyone I met was friendly and welcoming. I would highly recommend Stride Strong for massage and physical therapy.
JoAnn Hatch
JoAnn Hatch
08:20 08 Nov 17
Dr. Sydney is by far the absolute best physical therapist I've worked with ever! Her expertise in designing highly effective and efficient exercise plans is beyond compare. I feel so much better as my strength and function increases. She comes up with the most brilliant and fun ideas to motivate. To my delight she even offered to come to my home in Vancouver and work with me on my own equipment including a Stott Pilates Reformer. Talk about going above and beyond! Couldn't be more grateful I found her!!!
Clare Perry
Clare Perry
21:58 23 Oct 17
A full hour of a dedicated PT professional's time without aides or techs? That's just one of the things that sets this clinic apart from others. Competent, professional, and amiable, Dr. Alice Holland and her team are the best in the area. While I generally see them at the Cedar Mill Clinic on Cornell, situational constraints took me to their new Hillsboro clinic today near Intel Jones Farm. Beautifully furnished, spacious with easy parking and access. May you continue to grow and thrive, Stride Strong!
Joyce Heideman
Joyce Heideman
08:28 11 May 18
After foot surgery I went to Stride Strong for therapy with Alice Holland. She helped me reach my full mobility again by continuously introducing new and challenging exercises. The entire staff is friendly and professional. They are always on time and do not rush. I look forward to doing 1/2 marathons again and riding my recumbent trike. Thank you Stride Strong for your care and high level of expertise.
Suad Daher
Suad Daher
20:48 28 Feb 18
The best physical therapy ever. Both JP and Sydney were a great PT, they helped me understand how I can help treat my injury and how it may have caused. And also they informed about so many techniques that I can use to help my injuries or any other injuries I get in the near future. They are both friendly and nice to talk too, and verbunformative. And there is also Krystal, she is the best front desk receptionist ever, she is nice and friendly and can easily manage your schedule based on the patients comfort if they want to schedule or not. She can help and she replies fast to any patients email. And she is easy to talk to. Thank you Stride Strong Physical Therapy.
Amanda O'Rourke
Amanda O'Rourke
21:38 15 Jun 18
In just a month I've seen great progress! I've been incorporating the exercises taught to me into my daily workout routine. Im very happy with my continued results.
Albert Szal
Albert Szal
23:43 10 Jun 18
Mary Szal here: I've had three sessions with Brittany at the Hillsboro location. I can say that she has been the most effective and instructive physical therapist I've ever experienced. Her personality, energy, knowledge and results are top notch.
Osa Phiangdae
Osa Phiangdae
00:05 22 Mar 18
Awesome place for PT. Hillsboro location has plenty of parking and very spacious. I had the pleasure to work mostly with Dr. Alice Holland and JP. I came in with a shoulder injury and thank goodness they understood what I was going through. They are the best of what they do, I would recommend Stride Strong to anyone who needs PT.
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