Wrist soreness and/or pain can be very debilitating altering our work, daily lives, sports, athletics and our recreational activities.  Even the easiest of tasks such as buttoning a shirt or trying to lift a cup of tea or coffee.

Most wrist injuries and pain is caused by repetitive motions. These motions can be a combination of directions from rotating the wrist from palm up to palm down or from bending wrist downward, (flexion) and upward (extension).

The most common overuse injuries are given the following diagnosis names of carpel tunnel syndrome, (compression of the nerves running through the wrist), tendonitis, (inflammation of the tendons) and arthritis of the wrist (changes to the bony structures of the wrist).

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More often than not these conditions are treated with wrist exercises and cortisone injections and bracing of the wrist. However, what is actually going on at the wrist that is causing these conditions is ignored.  Something is causing the nerves to be compressed, tendons inflamed and boney structures altered. That something is dysfunctional position of the wrist.

The dysfunctional position of the wrist places the bones in mal-aligned positions to start with. With the bones in awkward and poor positions any movement caused irritations within the joints and soft tissue of the wrist.

To fix the dysfunctional position of the wrist we much look up the kinetic chain to the shoulder. A dysfunctional shoulder will lead to a dysfunctional wrist. Imagine the arm as a whip.  The handle of the whip is where the power and stability begin. From there the power and stability is transferred through the whip to the very small end which is used for precision but yet provides quickness and power at the point of impact.

The wrist and arm is much the same. The shoulder provides power and stability but through proper movement transfers that strength and power down through the elbow to the wrist where the wrist performs finer motor skills but with greater power behind it.

Take the tennis swing. Bounce a ball on front of you and it hit just with the wrist moving the racquet. The ball won’t move very far. Now hit the ball using the shoulder with a back swing. The shoulder gives the power. The wrist directs where that power will go.

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In a dysfunctional shoulder we see the shoulders rounded forward, arms rotated inward and sitting more forward in the shoulder joint. This alters the wrist position before any movement has begun.

In standing, hands at your side take a look at your hands. If the back of your hands are facing forward your wrist, elbow and shoulder are dysfunctionally rotated inward. (The correct position is to have your thumbs and index finger facing forward.)

The wrist is now stressed in an over rotated position inwards and in deviation. Now when the wrist is used to lift something or tries to type the structures of the wrist are compressed on one side and stretched on the other creating an internal tug-of-war. Because of the position of the shoulder the wrist and shoulder cannot return to a position of neutral to recover from the dysfunctional position.

The repetitive movement in this position will cause the compression, inflammation and bony changes mentioned above. As for bracing. Bracing limits proper movement and locks the wrist into poor dysfunctional positions. This limit if movements creates compensations along the kinetic chain.

Exercises that help to decrease existing pain and prevent wrist strain and stress:

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Wall Clock

Standing facing a wall with feet slightly pigeon toed, Place arms at the 12 o’clock position rotating arms outward towards the thumb side of your hand. Hold for 30 – 60 seconds. Repeat with arms at 10 and 2 positions of the clock and at 9 and 3 positions of the clock.

Supine Groin Stretch

Lying on the ground place one leg on chair so hip and knee are at 90 degrees. Place the other leg straight on the floor with toe facing upward. Maintain position for 10-15 minutes each side. This will help to reset the shoulder, back and hips to support the wrist.

Air Bench

Stand again a wall, press your hips and the small of your back into the wall as you walk your feet forward until you are sitting against the wall with knees at 90 degrees or higher if comfortable. Press low back and hips into the wall. Progress to 3 minutes as tolerated. This will help to take the stress off of the upper body decreasing stress throughout the wrist and arm.

Scapular Contractions

Perform in standing or sitting, squeeze shoulder blades down and back together pulling shoulders into neutral position and out of the rounded position. Repeat for 3 x 15. This will strength shoulders into optimal position to support and maintain proper shoulder, elbow and wrist position.

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