A doctor or therapist holding someone's writs and pressing it with both hands.

This week, we wanted to cover all things wrists & hands with tips and advice from our Physiotherapy team on how best to recover from an upper limb injury.

Hand Therapists work with a wide variety of people, including athletes, manual labourers, new mothers, elderly people, and children, basically, they’re our hidden heroes getting people back to the things they love after significant trauma & loss.

Have you had an injury to your wrist and you now find it difficult to weight bear through your hand and wrist during activities such as Pilates, Boxing or Gym training? Or, do you experience pain when simply pushing up from a chair?

You may be experiencing pain localised to the side of your wrist (below your little finger – see image below) with twisting motions of your wrist such as: wringing out wet clothes; turning a doorknob; lifting or carrying an object with your palms turned upwards? These are all symptoms of an injury to the ulnar side of your wrist.

Specifically, you might have a TFCC ligament injury. The Triangular Fibro-Cartilage Complex (commonly called the TFCC) is one of the most commonly injured structures from a fall on an outstretched hand or with a heavy twisting motion of the wrist. An injury to the TFCC may also occur at the same time you break your wrist and is quite often missed by the emergency department if they’ve only done an x-ray to check the bone injury. The TFCC is the main ligament and support structure on the ulnar side of the wrist that stabilises the forearm against load and rotational forces (such as twisting and grasping objects) TFCC injuries are painful, especially when lifting, carrying objects and loading on your wrist to push/pull.

Consultation with a Hand Therapist is recommended to determine whether you have a TFCC injury, or pain on that side of your wrist to help diagnose the specific problem. Hand Therapists have the specialised skills required to examine a painful wrist and use their knowledge of anatomy and biomechanics to prescribe appropriate treatment for each different wrist injury. They can also determine whether you need to see your GP for X-rays, ultrasound or MRI.

Hand Therapy for a TFCC injury may involve:

  • Assessment of your wrist to determine the appropriate treatment approaches specific to your injury
  • Educate you on the specific biomechanics and activities that will aggravate your symptoms – so you can adjust and reduce your pain & allow the injured structure to heal
  • Prescribe the correct splint/orthoses for your needs:
    Option 1: To provide a larger wrist splint to immobilise the wrist (for example a thermoplastic custom-made orthoses)
    Option 2: prescribe a Wrist Widget® splint which takes over for the TFCC and prevents the radius and ulna from spreading which provides pain relied & may allow you to continue training and using your wrist for daily activities while it heals
  • Prescription of graded postural and stabilising exercises at the right stage of your rehabilitation and in a graded manner, which has been shown to improve pain, strength, stability, and coordination to help you regain normal use of your wrist after injury.

Are you needing assistance with your upper limb rehab? Contact your nearest Sports & Spinal Clinic today

If you would like any more information on Hand Therapy please click here.