The wrists, hands and fingers are areas commonly injured during sport. Acute injuries may involve tendons, ligaments, joints or muscles and should be treated promptly. The wrists, hands and fingers are also commonly affected by osteoarthritis, particularly in older adults.
Carpal Tunnel Syndrome
Carpal tunnel syndrome refers to compression of the median nerve (one of the nerves in your arm) as it passes through the carpal tunnel in the wrist. The carpal tunnel is a small space on the palmar side of the wrist made up of small carpal bones and ligaments. For various reasons the median nerve can get compressed through this tunnel and cause symptoms like wrist pain, pins and needles, numbness and weakness of the hand.
Physiotherapy can help to manage symptoms of carpal tunnel syndrome with advice on activity modification, bracing or taping, mobilising stiff carpal bones or helping to release tight tissue in the hand. Your physiotherapist will be able to provide education on personal factors that may be affecting your carpal tunnel, for example inflammatory arthritis or pregnancy. Your physiotherapist can also help to establish an ongoing plan to help prevent a recurrence of carpal tunnel syndrome.
De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is a common condition causing pain usually around the thumb side of the wrist or even up the forearm. It is the result of inflammation or irritation to two tendons, abductor pollicis longus and extensor pollicis brevis as they pass through the wrist up to the thumb. This is often caused by repetitive hand or thumb movements over time or due to a variety of other factors such as disease, scar tissue build up or weakness. Often people will experience swelling around the painful area or may even feel the tendon creaking as it slides around during hand and wrist movements.
Physiotherapy treatment will include adjusting biomechanics of activities involving the hand, advice on managing inflammation and exercises to strengthen the involved tendons to help prevent future recurrences.
Fractures & Dislocations
Fractures and dislocations of the hand and fingers are commonly caused by traumatic injuries such as falls onto an outstretched hand. They are very common in older adults as well as people who play ball sports. If you are ever unsure whether you have sustained a fracture or dislocation you should always go to ER for medical attention. There are many different joints in the wrist and hand that can be fractured or dislocated and due to their location become very frustrating to manage, especially if they occur on the dominant hand.
Often these injuries will need a period of immobilisation and can leave the hand and wrist feeling very stiff, sore or weak afterwards. Your physiotherapist can help to restore your hand function back to normal after immobilisation using a combination of exercises and manual therapy to loosen joints and scar tissue.
Ligament Sprains
Ligament sprains of the fingers or wrists are also common in people who play high impact sports or have had falls. Often a ligament sprain will be accompanied with bruising, swelling, pain and stiffness of the area. Your physiotherapist is able to help you through the rehabilitation process right from the initial management where braces/tape and inflammation reduction is necessary, all the way through to giving you exercises and making sure your hand or wrist is back to full function before you return to sports and daily activities.
Triangular Fibrocartilage Complex Tear
The triangular fibrocartilage complex (TFCC) is a triangular shaped piece of cartilage at the base of your wrist on the little finger side of your hand. It’s role is to assist in keeping your wrist joint nice and stable. TFCC tears can be painful when compressed or when lifting and twisting. Your physiotherapist can help determine if bracing will be helpful as well as strengthening exercises to improve the stability of the wrist joint.
Mallet Finger
Mallet finger is an acute injury to the finger which occurs as the finger is forced to bend at the same time the finger is trying to straighten. This can result in the muscle which helps to straighten the finger being torn and the consequence is that the end of the finger can’t actively be straightened.
Mallet finger injuries are common in ball catching sports. If untreated this injury can be permanent. Your physio can help pick up this injury early and splinting of the finger is commonly required.
Jersey Finger
Jersey finger is an acute injury the the finger which occurs as the finger is forced to straighten at the same time the finger is trying to bend. Imagine grabbing an opponent’s jersey as they run away from you, the fabric rips out of your grasp and the fingers are forced to straighten. This can tear the muscle which bends the finger off the bone and results in the inability to bend that finger actively.
Partial tears can be treated with conservative management. Complete tears may require surgical intervention.
Osteoarthritis
Osteoarthritis can occur in any joints in the hand and wrist but is most commonly seen around the thumb area and in the fingers. Symptoms can include pain, stiffness, aching and sometimes swelling around the affected area. While arthritis itself cannot be reversed, physiotherapists are able to educate you on how to best manage the symptoms. Treatment often includes education about activity modification, pain management strategies and exercises to help with the range of motion, pain and strength in the wrist and hand.
