Wrist Exercises

Wrist Exercises

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• Carpal Tunnel
• Wrist Stiffness s/p fracture wrist
• Wrist Tendonitis
• TFCC
• Ganglion
• Carpal Instability
• CMC arthritis

Carpal Tunnel Syndrome
Since Median Nerve involvement can occur at the Wrist and at the neck (Double Crush) treating both areas is extremely important. If you are on the computer you can download a break program that monitors the amount of keyboarding and mousing and on every break perform 4 repetitions. Hold each repetition to a minimum count of 5.

Neck ROM All 6 ranges Chin Tucks Aligns the neck to the shoulder to the hips Door or corner Stretch to stretch the pectoralis muscles Shoulder Rolls Backwards to counteract the tendency to perform activities in front Shoulder Squeeze Squeeze it back and down to keep the shoulder blades attached to the rib cage and shoulder in alignment Stretch the flexor and pronators as one of the tendon sits directly above the Carpal tunnel Video at the bottom of the page Stretch the thumb out and down Perform Snow angels; it helps align the spine and stretch the pec muscles and allow for nerve and tendon gliding and open up the TOS area Do ice the wrist 3x day for 10 mins each to remove inflammation from around the nerve. So ice at Lunch, Evening and Before going to bed. Always have a cloth between the skin and ice pack Sitting positions to avoid Night splinting: To keep the wrist straight and prevent it from bending thus preventing the compression of the nerve Once pain reduces and flexibility improves start with shoulder strengthening to improve posture

PreOp® Patient Education Carpal Tunnel Syndrome Repair Carpal tunnel test (Tinels) Open Carpal Tunnel Release Endoscopic Carpal Tunnel Release Surgery Mousemate:enables mousing while keeping the wrist straight For Ergonomic setup click here For Ergonomic Equipment Click here

Wrist Stiffness
Wrist stiffness after a wrist fracture or carpal tunnel release can be treated with the following exercises.
Always start with heating up the wrist either with a hot pack or under warm water, and then exercise
For Early Motion protocol Prescription for Wrist Fracture, Blatts Procedure, Proximal Row Carpectomy, etc. Click Here
This is just a guide, your therapist needs to customize t the program based on your injury

ROM Wrist Flexion: Put the affected arm on the edge of the table and push it with the other hand Wrist Extension: Put the affected arm on the edge of the table and push it with the other hand Supination: affected arm by your side, rotate it with the other hand    Pronation: Elbow by your side 90 deg, turn palm down and then use the other hand to push it further  Radial Deviation: with the forearm placed on the table, move the wrist up with the other hand Ulnar Deviation: with the forearm placed on the table, move the wrist down with the other hand      Start with larger dowel and then with smaller dowels, move the wrist up while curling the fingers around the dowel  Flexibility: keeping elbow straight palm up bend the wrist and fingers back, Palm down bend the wrist and fingers down  keeping palm down, stabilize with the other hand and bring forearm up as tolerated      Strengthen wrist: forearm on the table, palm up bring wrist up starting with light weight, then palm down bring wrist up, forearm neutral bring wrist up and lastly elbow straight, shoulder extended bring wrist up.  gripping putty  Pinching with 2 fingers and thumb   Use a light weight hammer, keep elbow by your side 90 deg, the turn palm up or down you can make this exercise with the help of a chopping board and a rolling pin. Put hook velcro on the board and loop on the rolling pin, grip the handle and move the pin on the board. Intrinsic Stretch: At times after wrist fracture patients are not able to make a fist. Keeping the MCP of  the fingers hyperextended, bend the 2nd and the 3rd joint by yourself Peg Rolls: rolls the pegs from the tips of the finger all the way to the base of the palm, then into a hook position and end with a fist. Graded gripper with pegs for strengthening

How a wrist fracture is treated Distal Radius Fracture 1 Cross Pin Fixation System Kapandji pinning of colles fracture Volar Plating Distal Radius Scaphoid fixation Percutaneous scaphoid Scapho-lunate ligament tear

Dequervains Tendonitis

Tendonitis at the base of the thumb can occur from incorrect typing / mousing technique, incorrect baby handling positions. To correct workstation setup  click here For proper baby handling position  click here

Test for thumb tendonitis Dequervains conservative managementDequervains Surgery

TFCC

TFCC Peripheral tear Welding Suture central tear  Stabilization strap

Unstable DRUJ TFCC test

Ganglion

Avoid wrist extension with typing / mousing of  or other activities For Ergonomic setup click here For Ergonomic Equipment click here taping techniques during day time Splinting at night time during sleepingWe can also use iontophoresis patch and use ice to calm the symptoms down.

ganglion aspiration with needle Recurrent Dorsal Ganglion Ganglion of tendon sheath Carpal Boss

Carpal Instability: SL Exercises Click here