Wrist Exercises


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

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.

 

Description: https://hocinc.us/carpal2.gif Description: Neck Strain Exercises: Illustration Description: https://hocinc.us/carpal4.gif
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
Description: https://hocinc.us/carpal5.jpg Description: https://hocinc.us/carpal6.jpg Description: https://hocinc.us/carpal7.jpg
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
Description: https://hocinc.us/carpal8.jpg Description: https://hocinc.us/carpal9.jpg
Video at the bottom of the page
Description: https://hocinc.us/carpal10.jpg
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
Description: https://hocinc.us/carpal1.jpg
Sitting positions to avoid
Night splinting: To keep the wrist straight and prevent it from bending thus preventing the compression of the nerve
Description: https://hocinc.us/carpal2.jpg
Once pain reduces and flexibility improves start with shoulder strengthening to improve posture

 Description: PreOp® Patient Education Carpal Tunnel Syndrome Repair
PreOp® Patient Education Carpal Tunnel Syndrome Repair
Description: Carpal tunnel test
Carpal tunnel test (Tinels)

Description: Carpal Tunnel Release for carpal tunnel syndrome, by John Mahoney, M.D., more at www.DoctorMahoney.com
Open Carpal Tunnel Release

Description: Endoscopic Carpal Tunnel Release Surgery
Endoscopic Carpal Tunnel Release Surgery

Description: Mousing
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

Description: https://hocinc.us/wrist_10.jpg Description: https://hocinc.us/wrist_11.jpg Description: https://hocinc.us/wrist_12.jpg
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
Description: https://hocinc.us/wrist_13.jpg  Description: https://hocinc.us/100_1724.JPG Description: https://hocinc.us/100_1723.JPG
 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
 Description: https://hocinc.us/wrist_14.gif  Description: https://hocinc.us/100_1720.JPGDescription: https://hocinc.us/100_1710.JPG Description: https://hocinc.us/wpe1A.jpg
 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
Description: https://hocinc.us/wrist_strengthening2.jpg  Description: https://hocinc.us/carpal14.gif  Description: https://hocinc.us/100_1687.JPG
 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
Description: https://hocinc.us/wrist_15.gif Description: https://hocinc.us/wrist_16.gif  Description: https://hocinc.us/100_1688.JPG
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.
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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
Description: How a wrist fracture is treated
How a wrist fracture is treatedDescription: Distal Radius Fracture 1
Distal Radius Fracture 1Description: Cross Pin Fixation System
Cross Pin Fixation SystemDescription: Kapandji pinning of colles fracture
Kapandji pinning of colles fractureDescription: Volar Plating Distal Radius
Volar Plating Distal RadiusDescription: Scaphoid fixation
Scaphoid fixationDescription: Percutaneous scaphoid # mpg1
Percutaneous scaphoidDescription: Scapho-lunate ligament tear
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 Description: Test for thumb tendonitis
Test for thumb tendonitisDescription: http://i1.ytimg.com/vi/lfe4TfpbAfk/default.jpg
Dequervains conservative managementDequervains Surgery

TFCC

Description: TFCC Peripheral tear Welding Suture
TFCC Peripheral tear Welding Suture
Description: central tear
central tear
Description: https://hocinc.us/FCU1.JPGDescription: https://hocinc.us/FCU.JPG Stabilization strap
Description: Unstable TFCC
Unstable DRUJDescription: TFCC test
TFCC test

Ganglion

Avoid wrist extension with typing / mousing of  or other activities
For Ergonomic setup click here
For Ergonomic Equipment click here
Description: https://hocinc.us/100_1710.JPGDescription: taping techniques
taping techniques during day timeDescription: https://hocinc.us/new_pa12.jpg
Splinting at night time during sleepingWe can also use iontophoresis patch and use ice to calm the symptoms down.
Description: gosma
ganglion aspiration with needleDescription: Recurrent Dorsal Ganglion
Recurrent Dorsal GanglionDescription: Ganglion of tendon sheath
Ganglion of tendon sheathDescription: Carpal Boss
Carpal Boss