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common sports injuries
Wrist and Hand
Fractured Scaphoid
Carpal Tunnel Syndrome
RSI- Repetitive strain injury
Broken wrist
Wrist sprain
Handlebar Palsy
location
Small bone at end of hand/ wrist
The Wrist one or both!
Most commonly Hands/wrist and fingers
Hand/Wrist  Broken wrist is a fracture or break in the distal (wrist end) of either forearm bones (Radius and Ulna) or any of the small carpal bones in the wrist.
Hand/Wrist  sprain is a ligament injury to any one of the many wrist ligaments.
Compression of the ulnar nerve in the wrist in the handlebar in cyclists.
what why how
This is the most common carpal bone fracture and is caused when outstretched hand used to break fall.  Pain in the wrist which may settle down soon after the fall, there is usually rapid swelling to the back of the wrist and there is discomfort when gripping.
Tenderness when pressing in on the wrist, especially when compared other hand. The exact area of tenderness is called the anatomical snuff box - located between two tendons on the thumb side of the wrist.
Compression of the thumb inwards towards the wrist causes pain.















Carpal Tunnel syndrome (CTS) symptoms usually increase gradually and may initially only be present at night. Carpal tunnel syndrome may be in one or both wrists.
A dull ache in the wrist, forearm (worse at night) in so radiates pain to the, elbow, shoulder, hands, thumb and fingers (excluding the little finger).  There will be tingling or burning in the hand or four fingers.  Weakness in the fingers and hands may be present.
Carpal tunnel syndrome can be caused by a number of factors; A traumatic wrist injury such as broken or sprained wrist, repetitive use of the wrist (Carpal tunnel syndrome is a form of RSI).
Pregnancy - causing fluid retention in the wrist.  The use of vibrating machinery.
Congenital - some people naturally have a smaller, narrower carpal tunnel.
Arthritis.
All of these conditions can cause a narrowing of the space through which the median nerve passes. The cause may be structural such as with a fracture or congenital cases, or due to swelling, inflammation or fluid retention.
Carpal tunnel syndrome is 3 times more common in women, probably because they have a smaller carpal tunnel. It also has a higher prevalence in people with diabetes and other conditions which directly affect the nervous system. It usually occurs firstly and sometimes solely in the dominant hand, where it is also more painful. Some professions are more at risk of developing carpal tunnel syndrome, especially people working on an assembly line, who are continually repeating the same movement.
RSI stands for Repetitive Strain Injury and is usually associated with injuries to the forearm, wrist and hand. However, repetitive strain injuries can occur throughout the body.
RSI is caused by repetitive movements of the wrist or fingers and is an umbrella term for a whole range of conditions; Carpal tunnel syndrome, Tendonitis, Bursitis and Muscle inflammation.
RSI is an overuse injury and so symptoms gradually develop and become more severe over a period of time. Initially the symptoms tend to only occur whilst performing the aggravating activity, however with no rest or treatment they will progress, to be present with other activities and then even present at rest where pain, dull ache, tingling, numbness and throbbing is experienced.
Causes can be occupational, using a computer mouse or sport related as in racket sports. The problem is usually exacerbated by factors such as poor posture, inadequate wrist support or desk set-up, poor sporting technique or inadequate equipment.
The symptoms will vary slightly depending on the grade of injury from sudden pain following an acute trauma to the wrist to pain increases when trying to move the wrist or hand, swelling, deformity, open fracture when bone pierces the skin and tingling or numbness anywhere into the hand or fingers indicates nerve damage.

If you suspect a broken wrist it is important to go to Hospital A&E IMMEDIATELY.  Where the wrist can be x-rayed to confirm extent of the fracture.
A wrist sprain is quite a common injury, which usually occurs after a fall onto an outstretched hand. Other accidents or impacts can cause a sprained wrist, although it usually involves the wrist being bent either forwards or back.  Wrist sprains vary in severity. A (grade 1) wrist sprain may involve the ligament being stretched. Moderate (grade 2) injuries are partial tears of a ligament and severe (grade 3) injuries are full ruptures of one or more ligaments. Grade 3 injuries may also involve an avulsion fracture (fragment of bone is pulled off with the ligament).
Wrist sprain symptoms vary depending on the extent of the injury and the location of the sprain. Sudden pain when forceful wrist movement is made, there may have been a be tearing or popping feeling experienced and, an area of tenderness especially on touch and light bruising may develop.
Handlebar palsy is sometimes also known as ulnar neuritis ulnar nerve compression. It is caused by compression of the ulnar nerve where it passes through the wrist. From there the nerve runs into the little and ring fingers.
It is common in cyclists due to position of the wrist and compression on the handlebars.  The client will show symptoms in the outer hand, little finger and outer half of the ring finger of neural signs;  tingling, numbness and weakness and potential feeling of clumsiness of a lack of co-ordination in the hand and pain present during activities which use the wrist
treatment
A&E or Doctor.  Wrist X-ray to confirm the diagnosis. The injury may not always show up on an X-ray. If the therapist suspects a fracture but the X-ray is normal then a fracture cannot be ruled out. In this case an MRI or bone scan reveal the fracture.
Immobilize the fracture for 8 weeks in a cast extending from just below the elbow, over the wrist and base of the thumb.
After 8 weeks the injury is re-assessed and rehabilitation exercises can begin along with a return to sport.  Scaphoid fractures can have a risk of not healing properly due to the poor blood supply. If this happens then the fracture should be immobilized for a further 4 to 6 weeks.
If you suspect carpal tunnel syndrome you should visit your Doctor as soon as possible. They will ask you about your symptoms and examine your hand and wrist for tenderness, sensation, warmth and colour. They will often try to get you to reproduce your symptoms by performing an aggravating movement.  Treatment of carpal tunnel syndrome should initially be conservative and led by your Doctor. The first period of treatment should include complete rest for the wrist, which is normally immobilised in a splint. If there is inflammation and swelling present, using a form of RICE will help to relieve this.
RSI is often divided into two types:
1 RSI includes conditions such as carpal tunnel syndrome, and frozen shoulder. These conditions are often a result of overuse, but not always. They also often present with symptoms which are atypical of RSI's, for example swelling and inflammation, which are not present in true RSI conditions.
2 RSI conditions are less well defined. There is no swelling or inflammation and sometimes the cause of the pain is not known. Repetitive motion is always a factor. These conditions are true RSI's although are often given other names such as 'diffuse RSI', 'occupational overuse syndrome' and 'non-specific pain syndrome'.
There is no test or imaging which can diagnoses RSI. Diagnosis is therefore made based client’s  history of the condition, symptoms, occupation and sporting participation.
A straight forward fracture requires a cast for immobilisation of splint for 4-8 weeks to allow the bone to heal.
If the X-ray reveals any complications, such as multiple fractures or displacement, then surgery may be required to realign the bones and hold them together whilst they heal.
It is important to get all but the wrist sprains assessed. Even a minor injury can result in prolonged and recurring wrist pain and disability.
A doctor will assess the wrist, looking for swelling, bruising, deformity, tenderness, pain on movements etc. They will also ask about how the injury happened and any previous injuries to the area.
A referral may be made for an x-ray or MRI to rule out a fracture and to assess extent of the injury.
Most wrist sprains can be treated at home using the PRICE protocol:
Protection - Use a wrist support or splint to protect the joint and reduce movement to allow healing.
Rest - Don't keep using the wrist - this will only cause additional damage.
Ice - Apply ice to reduce pain, swelling and inflammation. Repeat every 2 hours.
Compression - Using a compression bandage or support will help reduce swelling.
Elevation - Raising the wrist above the level of the heart will also help reduce swelling.
The most important feature of treating this condition is to correct the cause of the problem. In cyclists, this may mean checking the bike set up such as the height of the saddle and handlebars and the wrist position when riding. Correcting these problems will usually stop the symptoms!
In cases where this does not work, seek advice from a professional sports injury therapist. They will be able to assess the injury. These symptoms could be due to compression of the nerve at any point along its course, not just at the wrist.
The neck may be a problem and so posture should be checked, as well as other activities which may put a strain or pressure on the nerve higher up.
exercises
With up to 8 weeks in cast there may be stiffness in wrist joints and muscle waste.  Mobilisation and strengthening will be required and daily exercise regime followed.  Swimming would be ideal re-introduction to activity.
Following a period of immobilisation, stretching and strengthening exercises can be used to help prevent a reoccurrence of symptoms. All exercises should be performed pain-free. If pain occurs, go back a step. Firstly you should aim for a full, pain-free range of motion, before moving on to strengthening. Resistance bands are excellent for performing wrist strengthening exercises.
Other, more alternative treatments, which may be worth trying include acupuncture and yoga, which have been linked to an improvement in carpal tunnel syndrome symptoms.
Rest from any activities that aggravate, easier said than done if it is a work-related activity. However, making modifications to your workspace or work responsibilities may be possible.  Apply RICE protocol when stiff or painful.
Take more regular breaks, move about and stretch the arms and wrists.
The use of a wrist brace or support can help in the early stages to provide additional support and comfort.
Seek out an injury specialist who can;
Provide strengthening or stretching exercises to help improve your posture and strengthen the associated muscles.  Massage therapy, ultrasound and or acupuncture may help.
Soft tissue therapy, stretching, strengthening exercises and program required.  Swimming is a good start point.
After initial period the rest the wrist may feel stiff so mobility and stretching program is important to get more ROM range of motion. Strengthening exercises should be introduced used to strengthen muscles around wrist area which helps to support the injured ligament.
Copyright 2012 - Releaf