A sprain is a stretch or partial tear of the ligament. Wrist sprains are often seen in sports that involve a lot of sliding, falling, and/or landing on your hands like baseball, football, or gymnastics, but they’re a fairly common injury in day-to day life as well. Anytime you land or fall on your wrist or your wrist takes on excessive force, there’s the potential for a sprain.
First Things First
If you injure your wrist, the best thing to do initially is to rest it and apply ice for about 20 minutes at a time, two or three times a day. Don’t apply the ice directly to your skin-use an ice pack or a frozen package of vegetables wrapped up in a towel. If you continue to have pain and swelling for more than 48 hours and/or if you’re having trouble moving your wrist, then you should seek care from a physician, ideally an orthopedist. Your physician will assess your injury, and may order an x-ray.
After Your Diagnosis
If your physician diagnoses your injury as a wrist sprain,you’ll need to keep your wrist immobilized with either a soft splint or a custom splint to allow your ligaments to heal or scar. Your doctor may give you a referral to see a physical therapist who specializes in the upper extremities and can provide you with a home exercise program to avoid stiffness. At Hospital for Special Surgery, it’s not uncommon for a physician to send their patient to see an Occupational Therapist in the Hand Therapy Center directly from their appointment.
The amount of time that you’ll need to wear the splint varies-it could be for as short as a week or two, but severe sprains may require more time. After a week or possibly less depending on your doctor’s instructions, you may be directed to remove the splint two or three times a day so that you can do some simple range of motion exercises.
Range of Motion and Strengthening
After your ligaments have had some time to heal, your physical therapist will provide you with a set of active range of motion exercises to restore the pain-free range of motion in your wrist, help lubricate the joint, and provide the joint with some stimulation. Anytime a part of your body has been immobilized you can get scar tissue, inflammation, or irritation of the joint when you start to move it again, so you want to increase your range of motion gradually. Once you’re able to move your wrist without pain, you can add in some strengthening exercises to try and strengthen the joint to compensate for the ligaments which have been stretched or partially torn. With the wrist having been immobilized it’s very common for the muscles higher up on your arm to lose some strength from not being used, so eventually you can expand your program to strengthen at the elbow and shoulder with your physical therapist’s supervision.
Lee Rosenzweig is a doctor of physical therapy and certified hand therapist at the Joint Mobility Center at Hospital for Special Surgery.